Confidentiality and its Discontents: Dilemmas of Privacy in Psychotherapy by Paul W. Mosher and Jeffrey Berman (New York:  Fordham University Press, 2015;  xiii + 343 pp.)

Paul Mosher, a psychoanalyst and professor of psychiatry, and Jeffrey Berman, a professor of English, have written a fascinating book on the ethical dilemmas of confidentiality in psychoanalysis and psychotherapy. The structure of the book is a series of case studies of psychotherapeutic relationships in which the obligation of confidentiality in the relationship is challenged by some competing obligation. Each chapter presents a detailed account of the development of each case, and each can be read and used on its own as teaching material. The usefulness of the book is enhanced by the inclusion at the beginning of each of the main chapters of a short description of ‘what to look for’, and at the end of each main chapter there is a ‘take-home lesson’. This will greatly aid the student in identifying and thinking about the point of each chapter. Each case is a ‘real life’ case, several being well known in discussions of ethics and psychotherapy, and some being well known in medical ethics more generally. The care and richness of the presentation of each case is exemplary, and it should be a welcome addition to the shelves of any psychotherapist or teacher of practical ethics.

Following a detailed introduction, the book introduces cases relating to disclosure of confidential information in criminal and civil justice, in publication of case histories for fellow professionals, in novel-writing and biography, to warn or prevent harm to third parties, in assessing the risk of harm posed by a prisoner under consideration for parole or release, and the role of the consent of the client/patient in control of confidential information. The book carefully presents the difficulties inherent in the sometimes conflicting requirements of professional ethics, professional licensing bodies, and the legal system. It also discusses in detail cases where freedom of expression or biographical integrity come into conflict with the privileged control of confidential information. At the hear