Date of Award

12-2007

Degree Name

Doctor of Philosophy

Department

Counselor Education and Counseling Psychology

First Advisor

Dr. Alan Hovestadt

Second Advisor

Dr. Gary Bischof

Third Advisor

Dr. Peter Northouse

Abstract

This study examines couple therapists' policies, procedures, and perspectives regarding secrets between partners in couple therapy. Handling secrets appropriately is necessary to avoid legal, ethical and therapeutic problems, especially when the secret involves contentious or potentially dangerous material such as infidelity, divorce, paternity, and HIV/AIDS infection. One hundred sixty randomly selected Clinical Members of the AAMFT participated in a 38-question researcher-generated mail survey. Data provided descriptive statistics and allowed for between-groups comparisons to explore for differences between therapists with regard to experience and several specific practices related to handling secrets. The study also examined whether courses in HIV/AIDS confidentiality law and limits increased the likelihood of a therapist's adherence to state laws/statutes pertaining to such secrets. Most respondents reported verbalizing a "professional judgment" approach to secrets. Respondents varied greatly in the reported frequency with which they see partners individually during couple therapy. Clinical experience and supervision were reported as being the most influential in the formation of therapists' secrets-related policies and practices. One quarter of the respondents indicated having had clients raise a concern about their mishandling of a secret. Therapists' approach to handling secrets did not appear to have an effect on the frequency of raised concerns. An extra-relational affair, wanting a divorce, and Internet infidelity/chatting were the three most frequently reported types of secrets. Most therapists reported discomfort with keeping secrets between partners, especially when the secret pertained to one partner's positive HIV/AIDS-status. Couple therapists' experience did not appear to have a relationship with (1) the approach utilized in handling secrets, (2) the frequency with which therapists see partners individually, (3) the provided level of informed consent, or (4) the frequency with which written consent to share information between partners is obtained. Additionally, most respondents reported not informing their clients of HIV/AIDS confidentiality limits or obtaining written consent to share confidential information between partners. While most respondents reported considerable awareness of HIV/AIDS confidentiality laws, this awareness was not demonstrated in therapists' responses to vignette questions assessing clinical practice. Training in HIV/AIDS confidentiality laws appears to have an impact only on reported awareness, and not on actual practice. ported awareness, and not on actual practice.

Access Setting

Dissertation-Open Access

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