Confidentiality… To some of my clients they think this is no big deal and are very comfortable and trusting that there are no issues to really be concerned with. They are familiar with the counseling process, have had many more counselors than me, feel comfortable with their anonymity and can trust their privacy is safe with me.  Other clients, although most of these people may not vocalize it, appear to be uncomfortable from the “get go” when coming into counseling and about being put in a position to divulge information that is personal, information that they are ashamed by, and be concerned and unsure if they will be judged.  In either case, however, confidentiality is incredibly important.  I value each client’s privacy beyond the responsibility I have to be compliant with the HIPAA laws. The other day, I was at a restaurant and upon returning from the bathroom, I saw a client out of the corner of my eye.  Instinctively one may want to turn toward a familiar face and smile, maybe say “hello.” Not as a mental health professional.  This is one field where confidentiality is always at play.

I return to my table, make sure not to make eye contact and focus on my family and our dinner together…. I do not share with my spouse that I know someone in the room or that one of my clients is sitting next to us.  I think about my client and how they may feel in this position, possibly knowing I am sitting next to them.  I imagine (knowing this particular client) that being put in the position to have to explain who I am to their friends may be awkward and uncomfortable.  I would never put them through that.

When seeing clients out in public, I will never engage eye contact and say “hello,” for this exact reason.  I could be putting someone in a very anxiety producing situation and would not jeopardize their sense of comfort and trust in my securing their privacy.. I speak to my clients about confidentiality when we meet for the first time. “Should I see you out in public, I will not acknowlege that I know you or say hello!” “Not because I want to be mean or believe that therapy is a shameful thing.  But because I would never want to put you in a position to be uncomfortable” in public 🙂 “However, if you wanted to come and say hello to me, I promise I would be nice and happy to say hello back.”