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DOES THE PSYCHOTHERAPIST TALK too much? Does the modern practice of psychotherapy threaten confidentiality? Whatever disagreement may exist regarding methods used by a therapist in the course of treatment, there is a near unanimity of opinion that nothing about a patient should be divulged to third parties. Allegedly, the patient's full participation, essential to psychotherapy, cannot be obtained without an assurance of absolute confidentiality.1
Central to a discussion on confidentiality is an examination of whether therapists are concealing what should be told and revealing what ought to be kept confidential. When may the therapist divulge, when should he divulge, and when must he divulge? Adopting the stance that he is protecting the patient's privacy and creating a "safe atmosphere" for all potential patients, it is possible that the therapist is concerned as well with his own privacy and his method of practice. At times it may be that the therapist's self-gratification, his self-esteem, prompts divulgences. These concerns of the therapist are legitimate, to be sure, but may do little to further the best interest or protection of the patient.
The traditional confidentiality between physician and patient is said to be threatened by the growing complexity of health care and the utilization of computers. The number of recent page-one