Kevlar for the Mind: Ask questions to clarify confidentiality rights - Off Duty, Military Health and Fitness - Air Force Times

Kevlar for the Mind: Ask questions to clarify confidentiality rights

Confidentiality between service members and military mental health professionals has always been a hot-button issue — and a confusing one.

Basically, confidentiality within the psychotherapist-patient relationship is an agreement by the therapist that he will not divulge the content discussed during treatment to outside sources. However, there are limits. In the civilian world, psychotherapists are required by law to report child abuse or neglect to the appropriate authorities. The therapist also is required to break confidentiality if he believes the patient is at risk of hurting himself or others.

Like their civilian counterparts, military psychotherapists are required to report the above issues. But the regulations regarding military psychotherapist-patient confidentiality are vague. Two statements in particular are open to wide interpretation:

• “Federal law, state law or service regulation imposes a duty to report information.”

• Confidentiality can be breached if the information is important to “the accomplishment of a military mission.”

The problem with having vague guidelines for breaking confidentiality is that it may breed distrust in service members. Consequently, those who are in need of psychological and psychiatric care may not seek treatment. But it should not keep you from seeking help if you need it. Follow these to protect your confidentiality:

• Prior to meeting with a military mental health professional, you will be given a copy of your rights and the instances when confidentiality can be breached. Read this information carefully.

• Ask questions. If you are unsure about what is and what isn’t confidential in a psychotherapy session, ask the mental health professional to explain it to you.

• Use hypothetical examples. If you are unsure if something you want to tell the therapist may have to be reported to the authorities, use a hypothetical example first.

• Seek help from a civilian mental health professional. If you’re still unsure about talking with a military therapist, seek help from a therapist off base or post. A place to start is Military OneSource, at http://www.militaryonesource.com.

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Bret A. Moore is a board-certified clinical psychologist who served two tours in Iraq. E-mail kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only and is not intended to convey specific psychological or medical guidance. Readers should see a mental health professional or physician for mental health problems.