Are psychotherapists consistent in their ethical attitude to patient confidentiality?

Background: The issue of confidentiality often causes an ethical dilemma for the psychotherapist. Aims of the study: We investigated if therapists are consistent in their attitude to confidentiality or judge each case on its own merit. Methods: A questionnaire consisting of a series of clinical vignettes representing different ethical dilemmas in confidentiality in psychotherapy was completed by 93 therapists of different professional backgrounds and by a control group of 55 students from the fields of law and the humanities. Results: Subjects in both groups were inconsistent in their attitude to confidentiality in two-thirds of cases, and most of the participants based their decisions on the particular history and circumstances of each case. Conclusion: The rules guiding psychotherapists for the disclosure of confidential information are unclear. These findings failed to pinpoint a common denominator to explain the manner in which professionals handle information that may demand a break of confidentiality.