When can a therapist break confidentiality?

A therapist may break confidentiality when a client poses an immediate threat to themselves or others because this situation is a critical exception to the general rule of confidentiality in therapeutic relationships. When there is a clear and present danger—whether it involves suicidal thoughts or intentions, self-harm, or the potential for violence toward others—therapists have a duty to act in order to protect their clients and others affected by the situation.

This principle is rooted in the ethical obligation to ensure safety and well-being. Therapists are trained to assess the severity of threats and would typically engage in a process that may include contacting authorities or emergency services to prevent harm.

The other scenarios do not warrant a breach of confidentiality. For instance, when clients ask for advice, it doesn't imply an immediate risk. Feeling overwhelmed is a common experience in therapy but does not justify breaking confidentiality. Sharing information with a colleague may be permissible for clinical supervision or consultation purposes but must still respect the client's confidentiality rights unless there is a clear risk of harm present.