CHILD-ABUSE AND THE LIMITS OF CONFIDENTIALITY - FOREWARNING PRACTICES

Confidentiality is widely considered to be of great importance in psyc hotherapy. With few exceptions, the breaching of confidentiality is an ethical violation and grounds for litigation. One such exception is t he mandated reporting of known or suspected child abuse, representing a legally sanctioned limitation of confidentiality. Because clients ge nerally expect unlimited confidentiality in therapeutic relationships, many therapists have begun to ''forewarn'' clients as a matter of inf ormed consent. This research report: (a) briefly reviews issues surrou nding mandatory reporting and confidentiality as they relate to forewa rning, (b) defines and discusses forewarning as contrasted with ''info rming,'' (c) examines state statutes, case law and ethical guidelines relevant to forewarning, and (d) presents a survey of 428 mental healt h providers (MHPs) on their forewarning practices in which 36.9% forew arned all clients, 36.4% informed clients only upon suspicion of abuse , and 20.6% informed only after receiving a disclosure of abuse. The i mplications of these findings are discussed.