Confidentiality and Informed Consent versus Collaboration

Conventional prescriptions for ethical psychotherapy practice are largely based on outpatient, office-based procedures. Maintaining confidentiality and insuring informed consent in nursing homes, however, becomes considerably more complex. These are situations in which following ethical norms inflexibly will detract from quality of care. This article discusses the conflict of values and ethics that can sometimes exist. Case examples are used to illustrate the tension between confidentiality and optimal therapeutic strategy; between informed consent and urgent needs of the patient.