CONFIDENTIALITY DILEMMAS IN GROUP-PSYCHOTHERAPY WITH SUBSTANCE-DEPENDENT PHYSICIANS

Objective: The purposes of this article are 1) to review federal and s tare laws relevant to confidentiality in group therapy with impaired p hysicians and 2) to provide empirical data concerning the actual confi dentiality practices and experiences of group therapists treating chem ically impaired physicians. Method: In the clinical research phase, 25 state medical societies identified 45 rehabilitation centers as those to which the societies preferentially referred chemically impaired ph ysicians. Fifty-one group leaders from 33 of these rehabilitation cent ers completed the survey questionnaire employed in this project. Resul ts: Because of the risk of potentially irreversible social and profess ional injury, physician patients were exceedingly concerned about brea ches of confidentiality. Go-members' infractions most often involved t he violator sharing with close friends and family members the name and abuse history of a fellow physician. In contrast, transgressors rarel y leaked information about a co-member's drug-related illegal behavior . Conclusions: Chemically impaired physicians would feel safer in shar ing secrets in group therapy if more jurisdictions adopted legislation making co-members liable for violating confidentiality. Currently the pertinent body of law is confusing and inconsistent and provides litt le protection to impaired physicians who enter group therapy. The auth ors propose ideas for model legislation.