The Limits of Confidentiality: Informed Consent and Psychotherapy

Course overview

Course Description: This course examines the ethical complexities surrounding informed consent and the limits of confidentiality in psychotherapy practice. Drawing on real-world case illustrations, it explores how psychiatrists and mental health professionals navigate competing duties when patient safety or third-party welfare is at stake. Practitioners will gain a working knowledge of dialectical principlism, a structured ethical decision-making framework that helps clinicians prioritize and balance conflicting obligations in high-stakes clinical situations. Psychologists, social workers, mental health counselors, drug and alcohol counselors, marriage and family therapists, and other licensed or certified behavioral health professionals can benefit from this course. This course is appropriate for intermediate and advanced-level practitioners who require continuing education for license renewal. Authors: Darby & Weinstock Learning Objectives: This course will provide a professional with detailed information about the ethical dimensions of informed consent and confidentiality in psychotherapy. Specifically, the practitioner will: Identify the core components of informed consent in psychotherapy and articulate the legal and ethical basis for its application in clinical settings. Apply the framework of dialectical principlism to analyze competing ethical obligations, distinguishing between primary and secondary duties across different clinical roles. Evaluate clinical scenarios involving suicidal or homicidal patients to determine when withholding full disclosure of confidentiality limits may be the most ethical course of action. Citation: Darby, W. C., & Weinstock, R. (2019). The limits of confidentiality: Informed consent and psychotherapy. Focus: The Journal of Lifelong Learning in Psychiatry, 17(2), 98-104. https://doi.org/10.1176/appi.focus.20180033