Vote of confidence in confidentiality Supreme Court: Ruling could prove a boost for effective and affordable therapy.

June 21, 1996

THERE IS LITTLE disagreement that confidentiality is crucial to effective psychotherapy. This week, the Supreme Court lent important support to that concept by ruling that federal courts should respect therapeutic confidentiality and that licensed clinical social workers, not just psychiatrists and clinical psychologists, should also enjoy the privilege.

That is an important decision, since social workers are generally more affordable and more accessible for many people. In today's medical landscape, restricting the protection of confidentiality to psychiatrists and clinical psychologists would have the practical effect of limiting a privilege to those who could pay for it.

As Justice Antonin Scalia pointed out in his dissent, the Supreme Court's encouragement of psychoanalytic counseling comes at the price of occasional injustice. By shielding the information shared in counseling sessions from exposure in court, it may indeed be more difficult to get to the truth of a matter. Even so, common law has long recognized the importance of respecting confidentiality of some relationships, such as priests and penitents. Federal law also recognizes the confidentiality of lawyer-client and husband-wife communications.

Writing for the seven-justice majority, Justice John Paul Stevens noted, "Effective psychotherapy depends upon an atmosphere of confidence and trust in which the patient is willing to make a frank and complete disclosure of facts, emotions, memories and fears."

The decision came in the case of a police officer in a Chicago suburb who was sued for fatally shooting a man during an altercation. The officer subsequently sought counseling from a social worker. When the shooting victim's family sued for damages, they sought information from the counseling sessions at the trial.

That may have shed light on the officer's state of mind. But, as Justice Stevens wrote, the price of that "truth" would be high: "The entire community may suffer if police officers are not able to receive effective counseling and treatment after traumatic incidents, either because trained officers leave the profession prematurely or because those in need of treatment remain on the job."

Pub date: 06/21/96

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