What would you do if a client disclosed that they view images of child sex abuse (CSA)?
Viewing or possessing CSA images is illegal, but your client tells you they neither create nor distribute the images, have never sexually abused a child, and have no desire to do so. A crime has been committed. Do you now have an ethical and legal duty to breach confidentiality and report the offence?
I imagine this scenario will evoke anxiety and uncertainty for many therapists in private practice. And while the likelihood of it happening to you is remote, it is nevertheless a possibility. Peter Watts, who specialises in sexual addiction, considers this question in his article, ‘To Report or not to Report?’. Taking into account our commitment in the Ethical Framework to ‘put our clients first’, and balancing this with the requirement to protect clients or others from serious harm ‘or when compliance with the law may require overriding a client’s explicit wishes or breaching their confidentiality’, Peter makes an informed case for how not reporting and taking a curious, non-judgmental approach can give space to help the client understand their behaviour, manage their urges safely, and explore and potentially resolve some of the underlying causes behind them.
Also in this issue, writing from her personal experience of having suffered multiple miscarriages, Julia Bueno argues how much further we still have to go in offering adequate emotional support to those who need it – even in a counselling or psychotherapy setting. And Amanda Fletcher explains how neglecting her self-care led to an acute depressive episode. She recalls her husband asking her at one point, ‘What would you be saying to your clients in this situation?’, and how this brought home to her the futility of anything that she would say to a client in the depths of depression. ‘I wanted to scream at him, “You really don’t understand – stop trying to fix me!”, and in the same moment wondered how many clients had felt like screaming those same words at me.’ I wonder how many of us that will resonate with?
John Daniel, Editor
privatepractice.editorial@bacp.co.uk
