Psychotherapist-Patient Privilege, Recordkeeping, and Maintaining Psychotherapy Case Notes in Professional Practice: The Need for Ethical and Policy Reform

Authors

  • Jon Mills Adler Graduate Professional School, Toronto

Keywords:

recordkeeping, confidentiality, psychotherapist-patient privilege, disclosure, consent, psychotherapy case notes' Code of Ethics, accountability, intellectual property, guidelines for psychotherapists, counsellors, & psychologists

Abstract

A growing trend in Canadian mental healthcare professes that the best standard of practice is to keep complete notes and correspondence of all patient transactions in the mental health practitioner’s file, including a record of intimate personal details revealed in therapy. This file, however, is subject to intrusive inspection by third parties who may ask to view its contents. This creates a conundrum and a potential risk for the field of mental health. Professionals of all kinds are asked to keep in confidence whatever is disclosed in sessions, but the law prohibits privileged communication. This article challenges the distinction between privilege and confidentiality, and discusses the recording and filing of psychotherapy case notes, as well as the greater ethical questions these issues generate. I advocate a corrective: an alternative method of recordkeeping that maintains files for process notes separate from the official clinical record. This procedure insulates the patient and therapist from potential risk of ethical and legal exploitation inherent in our current presumption that all clinical notes and records are subject to disclosure and inclusion in the client’s file. The future of professional policy is at stake for all mental health professionals in Canada unless this issue is addressed.

Author Biography

Jon Mills, Adler Graduate Professional School, Toronto

Jon Mills, Psy.D., Ph.D., C.Psych., ABPP is a psychologist, psychoanalyst, and philosopher. He is Professor of Psychology & Psychoanalysis at the Adler Graduate Professional School in Toronto, Director of Mills Psychology Professional Corporation, and is a diplomate and fellow in clinical psychology and psychoanalysis with the American Board of Professional Psychology.  He is the author of many works in psychoanalysis, philosophy, and psychology including thirteen books.  In 2006, 2011, and 2013 he was recognized with a Gradiva Award from the National Association for the Advancement of Psychoanalysis in New York City for his scholarship, received a Goethe Award in 2013, and in 2008 was given a Significant Contribution to Canadian Psychology Award by the Section on Psychoanalytic and Psychodynamic Psychology of the Canadian Psychological Association.

 

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Published

2014-11-14

How to Cite

Mills, J. (2014). Psychotherapist-Patient Privilege, Recordkeeping, and Maintaining Psychotherapy Case Notes in Professional Practice: The Need for Ethical and Policy Reform. Canadian Journal of Counselling and Psychotherapy, 49(1). Retrieved from https://dev.journalhosting.ucalgary.ca/index.php/rcc/article/view/61001

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