1. The Role of Confidentiality in the Therapist – Sex Offender Client Relationship Courtney Holt Mentor: Dr. David Finkelman Department of Psychology, St. Mary’s College of Maryland References Conclusions ResultsIntroduction Methods * Sex offenders are considered by some to be the “last pariahs” of our modern day society and are usually treated without much sympathy during prison sentencing and by the general public 2. American policy makers have taken a ‘get tough’ approach over the past four decades when dealing with sex offenders 3. In general, sentencing has become longer and “the average sentence of convicted rapists released from state prison has remained stable at about 10 years, but the average time served has increased from about 3.5 years to 5 years” 1. Most sex offenders enter treatment because it is a mandatory part of their sentencing. Therefore, issues such as confidentiality and privilege within the therapist-client relationship when the therapy is mandatory can and do arise. Confidentiality is a complex issue in therapy with clients who are not mandated to attend, but the issue becomes even more complicated when the client is mandated to attend and is also under the rules and regulations of probation in the criminal justice system Some professionals urge for the exceptions regarding confidentiality to be more explicitly stated for clients as well as professionals Therapists choose the option of developing a treatment plan when faced with the duty to warn more than they choose the options of civil commitment or reporting the client to the authorities More research needs to be done that focuses on the prevention of sex offenses. Some possible prevention measures that could be made include informing individuals with sexually deviant desires that treatment is available prior to committing offenses, and also making counseling more readily available for such individuals Participants To recruit informants, I sent out emails to each of their respective work addresses. Three legal professionals and two mental health professionals responded and these were the participants used in this study. The participants are identified by their initials and occupations. Mental Health Participants = R.W. and F.B. Legal Professionals = M.I., R.Z., and T.S. Materials I developed the interview questions for the purpose of this project. The interview questions were open-ended and were tailored to each participant’s profession. Questions related to participants’ professional backgrounds, knowledge of the laws regarding therapist-client confidentiality, and opinions on confidentiality. Procedure I conducted one interview through email correspondence, three over the phone, and one in person. I took handwritten and typed notes during each interview. The total amount of time for each phone and in-person interview varied from approximately 15 minutes to 50 minutes. The results of each interview are labeled under “Rules Regarding Confidentiality” and “Opinions on Confidentiality”. 1 American Psychiatric Association. (1999). Dangerous sex offenders: A task force report of the American Psychiatric Association. Washington, D.C.: American Psychiatric Association 2 Lancaster, R. (2011, August 20). Sex Offenders: The Last Pariahs. The New York Times. Retrieved fromhttp://www.nytimes.com/2011/08/21/opinion/sunday/sex-offenders-the-last- pariahs.html?pagewanted=allhttp://www.nytimes.com/2011/08/21/opinion/sunday/sex-offenders-the-last- pariahs.html?pagewanted=all 3 Mears, D. P., Mancini, C., Gertz, M., & Bratton, J. (2008). Sex crimes, children, and pornography: Public views and public policy. Crime & Delinquency, 54, 532-559 Rules Regarding Confidentiality R.W. Therapist must be considerate of who the client is--this matters in terms of competing interests and where the privilege lies. The client always retains the right to confidentiality except in mandatory reporting scenarios. Rules regarding confidentiality also differ when sex offenders are clients because of the fact that so many laws and polices surround them. F.B. The rules of working with sex offenders are the same for other clients At his clinic, the staff does not have clients waive their confidentiality--believes that if they required a client to waive confidentiality, the client would worry and not reveal certain information during therapy out of fear that the therapists would hurt rather than help them If a person shares an omission of parole or probation, the therapeutic staff would document this error because it is not violating the person’s confidence. Rarely break confidentiality; however, if mandatory reporting requirement applies the therapist would report this. Rules Regarding Confidentiality M.I Follow therapist ethical code of conduct Sex offenders as clients probably require therapist’s to break confidentiality more Attorney’s responsible for explaining the terms of confidentiality to client who may be required to attend therapy as part of their sentencing R.Z. If one is a risk to society, then therapist should report it One argument made is that one should leave it up to the psychiatrist to determine if there is a need to report T.S. Unsure of the exact statutes but when a mental health examiner is hired they are afforded the same protection and rules as an attorney is Often says he must remind them that they are not social workers, they are not actively treating the client and therefore do not have to report things that maybe they would report as a social worker Opinions on Confidentiality R.W. Reporting requirements can impact the relationship a therapist has with a client, especially when it is a convicted sex offender As long as it is made clear that therapist is working for the clients well being, the therapy is usually beneficial Believes aftercare should be paid for released offenders because most sex offenders can not pay for it themselves especially with all the restrictions society puts on them (zoning ordinances, GPS, etc). Treatment should be more available, engage in prevention and community involvement Polygraphs are a waste of money, will no longer be used in 10-15 years with sex offenders F.B. When someone is in danger to themselves or others then breaking confidentiality can rightfully be done but there are various ways of helping someone who is a danger that does not violate their confidentiality (hospitalization) Wants to encourage people to get treatment before they commit the act; wants to figure out a method of prevention Believes people do not seek prior treatment because they are too terrified of the stigma and labels (sexual predator) People are afraid to seek treatment also because they are aware of mandatory reporting laws but are concerned with what may be reported Opinions on Confidentiality M.I. People who are part of the criminal justice system are under court supervision and probation requirements and this may cause lessened confidentiality with a convicted sex offender client in therapy R.Z. If the probationer/patient reveals something that the state would have an interest in than that should be free Under the law, a probationer who signs terms of probation is considered fully informed Believes that it is better for attorneys and therapists to not leave anything up to question in terms of where confidentiality lies in therapy; person should sign a waiver that lists the circumstances under which confidentiality will be waived T.S. Sex offender registry is a problem because of all the restrictions it places on sex offenders “when do you stop feeling bad for an offender because they were abused as a child, and start getting mad that they are now sexual abusers?” As a lawyer, feels that he never wants anything detrimental revealed about his client but as a citizen, he is content with the way mandatory reporting laws are designed because it represents as a fair of a balance as possible Skeptical about how effective mandatory therapy is and knows that people do not seek treatment on their own because worry about reporting laws Mental Health Professionals Legal Professionals