During my coursework on Ethical Standards for Mental Health Providers, I was introduced to scenarios designed to stretch our thinking. These aren’t tidy “right versus wrong” puzzles, but complex dilemmas to make us pause, reflect, and wrestle with the grey areas where ethics, law, and human experience collide.
Here’s one that’s been sitting with me:
You are a psychologist providing therapy to a client who has endured assault. Much of your work together has centred on how they’ve coped with the long legal process. Recently, the trial ended with a guilty verdict, and the accused was sentenced to prison. Shortly afterward, your client confides: “He wasn’t actually the one who assaulted me. But I know he’s done plenty of other things, so I hope he rots in jail.” The client refuses to tell anyone else and insists you keep this secret too.
(Truscott & Crook, 2021)
What would you do?
At the heart of this scenario is a clash between two ethical responsibilities:
- Protecting client confidentiality: the cornerstone of therapy that protects the therapist-client relationship.
- Preventing harm and injustice: which includes the rights of people outside the therapy room.
Confidentiality is a sacred promise in counselling, but it’s not absolute. In rare situations, therapists may need to break it—usually when someone is at risk of serious and immediate harm.
This case is different. The client isn’t threatening violence, but they are admitting that an innocent person is serving time for a crime they didn’t commit. Do you stay silent to protect the client’s trust, or take action to prevent a wrongful conviction from standing?
Why This Matters
We’re presented with such challenging scenarios to highlight why ethics in therapy is more than following a checklist of rules. It’s about sitting with the tension, seeking consultation from trusted supervisors or colleagues, and making decisions that balance care for the client with responsibility to the wider community.
As a therapist-in-training, I can honestly say that I may not have the “right” answer. My instinct would be to encourage the client to disclose the truth themselves, and to support them through that incredibly hard process. But if they refused, I’d feel compelled to seek guidance, because doing nothing would mean allowing injustice to continue.
Am I right? Perhaps. Am I wrong? Probably—at least to some degree because I must acknowledge what I simply don’t know at my current stage.
Reflection Over Perfection
What I take from this kind of case study is that being “right” isn’t always possible. What matters is acting with integrity: consulting, reflecting, documenting, and being willing to acknowledge our biases and limits.
At best, ethical decision-making in therapy isn’t about rushing to fix — it’s about slowing down, being transparent, and holding ourselves accountable to more than just our personal opinions. And knowing when to ask for help.
Ethics in therapy aren’t tidy. They’re human, and therefore, messy. It’s in these messy spaces that some of our deepest growth — both personal and professional — can take root.
Reflection + Journal Prompt
- If you were the therapist in this scenario, what would you do?
- Did anything in this story spark a strong reaction in you?
- Reflecting on other situations in your life, how do you know when you’re being objective or holding a bias?
Sources
Canadian Counselling and Psychotherapy Association (2020). Code of Ethics.
Scenario Adapted from: Truscott, D. & Crook K. H. (2021). Ethics for the practice of psychology in Canada (3rd ed.). University of Alberta.
Photo by Priscilla Du Preez 🇨🇦 on Unsplash
