The travails of Martin Orne: On privacy,public disclosure,and confidentiality in psychotherapy

The experiences of one psychotherapist have brought to the fore the entire issue of privacy and confidentiality and the responsibilities of mental health professionals. In a computer driven culture, where data about patients become subject to public scrutiny, how does the mental health professional practice, guided by the concept of confidentiality? Where does confidentiality begin and end? What about the patient's right to self-disclose? What about patient autonomy? In this paper, illustrated by one particular case where the rule of absolute confidentiality, an intrinsic part of the practice of psychotherapy, was questioned, our current confusion comes to the surface. The reader is urged to re-think the concept of confidentiality and patient self-disclosure.     

Reconstructing the professional at the end of modernity

Faced with incidents of sexual misconduct within the professional ministry, some would have us return to a construct of the professional from the past and some would reject the construct altogether. Both those approaches may perpetuate systemic factors that contribute to injustice. This article explores the history of the professional construct and its challenges, and offers a reconstruction that could support a more just relationship between ministers and members of congregations.