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Knowledge of confidentiality and perception of group trust

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Title:
Knowledge of confidentiality and perception of group trust the effects of counselors' explanations, students' role playing, and subjects' sex and race
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Messenger-Ward, Charlene Marie, 1956-
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xi, 192 leaves : ill. ; 28 cm.

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Subjects / Keywords:
Child psychology ( jstor )
Parents ( jstor )
Patient confidentiality ( jstor )
Privileged communications ( jstor )
Psychological counseling ( jstor )
Psychotherapy ( jstor )
Questionnaires ( jstor )
School counseling ( jstor )
School counselors ( jstor )
Students ( jstor )
Confidential communications ( lcsh )
Counselor Education thesis Ph. D
Dissertations, Academic -- Counselor Education -- UF
Elementary school counselors ( lcsh )
Professional ethics ( lcsh )
Orange County ( local )
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bibliography ( marcgt )
non-fiction ( marcgt )

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Thesis:
Thesis (Ph. D.)--University of Florida, 1984.
Bibliography:
Bibliography: leaves 176-190.
General Note:
Typescript.
General Note:
Vita.
Statement of Responsibility:
by Charlene Marie Messenger-Ward.

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Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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KNOWLEDGE OF CONFIDENTIALITY AND PERCEPTION OF GROUP TRUST:
THE EFFECTS OF COUNSELORS' EXPLANATIONS, STUDENTS'
ROLE PLAYING, AND SUBJECTS' SEX AND RACE
















BY

CHARLENE MARIE MESSENGER-WARD


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY


UNIVERSITY OF FLORIDA


1984
























Copyright 1984

by

Charlene Messenger-ward

















THIS PROJECT IS DEDICATED TO


. . all children and adolescents who ever
have had or will have the opportunity to
receive counseling services;

. . all counselors who provide such
services; and

. . all professionals who teach, assist
and inspire these counselors.













ACKNOWLEDGEMENTS


This project was truly an exercise in field-based

research, with major support for development,

implementation and data analysis received through

professionals in Orange County schools. Foremost,

appreciation is extended to Ms. Juanita Borysewich,

Director of Guidance, and Ms. Harriette Merhill,

Coordinator, for acting as outstanding female role models

in the field and for providing direction throughout the

project. Dr. Wesley Blamick of the Department of Program

Evaluation deserves special recognition for his generous

donations of time, energy and expertise in

computer-assisted data analysis. Thanks and a hat-tip go

to Ms. Annie Williams for assisting in the tedious task

of scoring responses, to Ms. Kathy Keating for reading

the first drafts, and to Ms. Cindy Green for typing the

final manuscript.

To the school counselors (Ron Duval, Debbie Griffin,

Joyce Henry, Cathy Pope, Susan Stephens, Sonia Warner,

Barry Weber and Mary Wyatt) and the sixth-grade classes

who participated, I am truly endebted. To my supervisor,

Dr. Kelland Livesay--who supported the efforts of a

full-time employee/student--and to my friends and

colleagues--who knew when to converse and when to give









space--I extend my gratitude. At the University of

Central Florida, appreciation is extended to Dr. Bob

Bollett and Dr. Lance Percy for demonstrating the essence

of counseling technique; and to Dr. Jack McGuire and Dr.

Hal Pringle for acting as consultants during different

phases of this project.

Professors at the University of Florida deserve much

credit for helping develop my competencies throughout the

program. Thanks are extended to the following: Dr. Paul

Fitzgerald for acting as my chairperson and fostering

independence and flexibility; Dr. Hannelore Wass for

generously giving empathy, honesty and expertise; Dr. Joe

Wittmer and Dr. Larry Loesch for responding to

individualized student needs; and Dr. Robert Myrick for

providing sufficient challenge along the way.

Finally, heartfelt gratitude is extended to my

family. I thank my parents for fostering the desire to

learn and excell and for encouraging me as I did so.

Most of all, my husband, Mike, deserves highest honors

for his love and support. During the past several years,

he has survived endless piles of papers and books and

numerous ups-and-downs; throughout, he has demonstrated

infinite patience--a quality that I am still developing.















TABLE OF CONTENTS


.Page


ACKNOWLEDGEMENTS ....... .................... iv

ABSTRACT ................................ ix

CHAPTER

INTRODUCTION .... ..............1

Need for the Study ...... ........... 4
Purpose of the Study . ........ 6
Rationale of the Study ... ... 7
Research Questions ...... ........... 8
Definition of Terms ... ........ .. 9
Organization of the Study ........ ..11

II REVIEW OF THE RELATED LITERATURE . . 13

Overview ..... ................ 13
Trust ...... .................. .. 14
Expressiveness and Self-Discovery . 17
Counselors' Professionalism .... 20
Other Variables ........... .. 21
Sex . ................. 21
Age . . ................ 24
Ethnicity ..... ............. 25
Technology . ......... 27
Confidentiality ................. 30
Ethical Standards .. .......... 32
Privileged Communication ........ .. 35
Case Records ................. 38
Group Settings .... ............. 42
Minor Clients .t................. .....49
Ethical Standards .. .......... 50
Legal Issues .... ............. .. 54
Practice and Trends ......... 59
School Counseling ... ............ 63
Ethical and Legal Aspects ...... 64
Confused Alligiance ......... 69
Counselor Perceptions and Practices 74
Expectations and Explanations ...... .. 79
Client Assumptions and Expectations 79
Counselor Explanations and Assurances. 83
Summary of the Related Literature . . 91










Page

III METHODOLOGY ............... 94

Research Design .... ............. 94
Population . . ............... 96
Sampling Procedure . .......... 97
Criterion Instruments ......... 102
Child Confidentiality Questionnaire 102
Group Environment Scale ....... 104
Procedures ...................... 107
Hypotheses . . .............. 1
Data Analysis . . . . . 111
Methodological Limitations . . .. 114

IV RESULTS . .................. 118

Group Environment Questionnaire . .. 118
Child Confidentiality Questionnaire . 120
Group Trust Questionnaire ........ ..123

V DISCUSSION ..... ............... 126

Summary ................. 126
Discussion of Results ........... 128
Group Environment Questionnaire . 128
Child Confidentiality Questionnaire 128
Group Trust Questionnaire ...... 132
Conclusion ..... ............... 137
Implications ............... 141
Recommendations for Further Research . 145
Summation . . . ............. 149

APPENDICES

A STUDENT LIST .............. 151

B CHILD CONFIDENTIALITY QUESTIONNAIRE . 152

C QUESTIONS BY AREA OF CONFIDENTIALITY . 157

D GROUP ENVIRONMENT QUESTIONNAIRE ..... 160

E GROUP TRUST QUESTIONNAIRE ......... 162

F TRAINING SESSION FOR COUNSELORS ..... 164

G PARENT PERMISSION FORM .. ......... 166

H GUIDANCE SESSION UNITS .......... 167

I CASE SITUATIONS FOR ROLE PLAYING . . 173

J STANDARD INSTRUCTIONS FOR SUBJECTS . 174


vii











Page


REFERENCES . . . . . . . . . . . 176

BIOGRAPHICAL SKETCH .... ............ . . . 191


viii











Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philisophy



KNOWLEDGE OF CONFIDENTIALITY AND PERCEPTION OF GROUP TRUST:
THE EFFECTS OF COUNSELORS' EXPLANATIONS, STUDENTS'
ROLE PLAYING, AND SUBJECTS' SEX AND RACE



By

Charlene Marie Messenger-ward

August 1984


Chairperson: Dr. Paul Fitzgerald
Major Department: Counselor Education


Despite the importance of trust and self-disclosure

in counseling process and outcome, there is a paucity of

research focusing on confidentiality with child-clients,

particularly students. This study investigated the

effects of school counselors' direct address of

confidentiality on sixth-grade students' knowledge of

confidentiality and perception of group trust. Small

groups were arranged by dividing into thirds each of

eight classrooms wherein a preexisting relationship had

been developed with the counselor through classroom

guidance. One group in each classroom had discussion of

confidentiality (explanation-only group); a second group-

had discussion and role playing (explanation/role-playing

group); and a third group served as a control, receiving









no exposure to confidentiality issues during their

session. Pretreatment assessment of students showed the

equivalence of their attitude toward other group members

and the counselor.

After particpating in group sessions, students

answered questionnaires assessing knowledge of

confidentiality (instrument based on professional ethical

standards) and perception of group trust (instrument

based on a scale of group environment). Results

indicated that mean scores for the

explanation/role-playing group were higher than the

explanation-only group and that mean scores for the

explanation-only group were higher than the control

group. However, statistical significance was only shown

between the explanation/role-playing group and the

control group. With trust perception, the

explanation-only group scored significantly lower than

either the explanation/role-playing group or the control

group. Overall, results suggest that an optimal method

to address confidentiality is combining explanation and

role play.

Students' sex and race were also investigated as

independent variables. As a main effect, neither was

identified as significantly related to overall initial

attitude, knowledge of confidentiality or perception of

trust. However, a number of two-way interactions for the

variables of sex and experimental condition were









identified for the trust measure and its subscales,

suggesting that the impact of subjects' sex may be highly

situation specific. Additionally, for knowledge of

confidentiality, in one specific subarea--counselors

revealing client disclosures to family and

friends--ethnic minorities scored significantly lower

than nonminorities.














CHAPTER I

INTRODUCTION


More than three decades ago, Wrenn (1952) proposed

ethical guidelines advocating confidentiality in the

counseling relationship with children. He maintained

that a child's trust in the counselor is as critical as

that of an adult and that the child's integrity must be

protected within the relationship. In his proposed

guidelines, Wrenn suggested that parents' consent be

obtained for treatment or referral but that before

disclosing information given during counseling, the

child's permission must first be obtained.

Since that time, various writers and professional

organizations have taken stands all along the continuum

regarding amount of confidentiality that should

be afforded the minor client. Some question whether it

is desirable, even possible, to maintain an attitude of

strict confidentiality with adult clients in counseling

but not with minor clients. Others contend that parents

represent the child-client and thus should have full

access to all disclosures. This diversity of opinion is

greatly attributable to the fact that each therapist's

perception is influenced by his/her personality structure

and professional development (Lowental, 1974), as well as









ambiguity in the ethical codes of professional

organizations (McGuire, 1974). Current principles of

ethical standards of various helping professions directly

address the issue of confidentiality, with some making a

distinction between minors and other clients (e.g.,

American Psychological Association [APA], 1981) and some

being considerably more vague, referring to all clients

in general terms (e.g., American Association for

Counseling and Development [AACD], 1981).

Within the public school setting, the issues

regarding confidentiality and disclosure of personal

information are even more complex. Allegiance to

students, parents or institution as primary client is

often a dilemma for school counselors. School counselors

have geared their efforts toward advocacy of students

(American School Counselors Association [ASCA], 1976),

yet parental rights are also recognized and, further,

some professionals maintain that as a public employee,

the school counselor is responsible to teachers and

administrators as well (Clar, 1967; Hart & Price, 1970;

Szasz, 1967). Studies indicate that although counselors

appear to have ambiguous or inconsistent perceptions

regarding issues of confidentiality with students

(Wagner, 1981), in actual practice, counselors and

psychologists do maintain the confidentiality of

communications of minors (Curran, 1969; Eisele, 1974;

McRae, cited in Clar, 1967; McGuire, 1974; Wagner, 1981).







3

Why is confidentiality in counseling with students

and other minor clients such a hotly debated issue? The

reason is found in literature which consistently

emphasizes trust and self-exploration as critical

elements in the counseling process. Self-disclosure is a

client behavior heavily dependent upon the client's

perception of confidence and trust with the counselor.

Effective counseling depends largely on the disclosure of

highly private information, so that both counselor and

client can have increased insight and understanding,

ultimately leading to more effective functioning for the

client. Most successful clients increasingly explore

their problems as therapy progresses (Blau, 1953;

Braaten, 1958; Egan, 1975; Seeman, 1949; Steele, 1948;

Truax and Carkhuff, 1967; Wolfson, 1949), and the role of

the therapist, in both traditional psychotherapy and

contemporary counseling, has been to facilitate the

self-exploration process. Nonetheless, the

responsibility to protect clients' privacy and maintain

the confidentiality of their communications is of

increasing concern to counselors, with both ethical and

legal implications. In addition to the ambiguity of

professions' ethical standards, there are the complex and

controversial issues of privileged communication as a

legal statute and the status of student records.

Despite the numerous exhortations regarding the

various issues, few actual studies have been done in the









area of child-client confidentiality. Those studies

available show that counselors tend to respect the

confidentiality of minors' communications. Suggestions

have also been made that distinctions could be drawn

between the rights and prerogatives of children according

to psychological age or condition of the client (Ladd,

1971; Slovenko, 1966). If the counselor is expected to

facilitate self-disclosure, and thus self-exploration,

within an atmosphere of confidence and trust, school

counselors must be cognizant of how they affect students

in counseling. With all the furor as to what counselors

should do or are indeed doing in relation to the issue of

confidentiality, there remains the question of whether

school counselors' direct address of the issue of

confidentiality in counseling has any impact on students'

knowledge and perceptions.



Need for the Study

The importance of trust and confidentiality has been

emphasized as critical to outcome of counseling and

psychotherapy by various writers (e.g., Egan, 1975; Ford

& Urban, 1963; Jagim, Wittman & Noll, 1978; Morwer,

1968a, 1968b; Reynolds, 1976; Shah, 1969a, 1969b; Siegal,

1976; Truax and Carkhuff, 1965, 1967). Typically,

clients implicitly expect confidentiality in the

counseling relationship (Edelman & Snead, 1972; Meyer &

Smith, 1977; Plaut, 1974; Woods, 1977), although







5

additional (fairly inconclusive) research suggests that

varibles such as sex (Graves, 1982; Kobocow et al., 1983;

O'Kelly & Schuldt, 1981; Rosen, 1977; Singer, 1978) and

race (Franco & Levine, 1981; Jourard & Lasakow, 1958;

Dimond & Hellkamp, 1969) may significantly impact the

amount of self-disclosure.

Most of the actual empirical attempts to assess the

importance of confidentiality have been limited to

samples of adults: therapists and counselors (e.g.,

Davis, 1980; Jagim et al., 1978; McGuire, 1974; Wagner,

1978, 1981); adults in counseling (e.g., Davis, 1980;

Schmid et al., 1983); or adult subjects in surveys or

analogue studies (e.g., Graves, 1982; Meyer & Smith,

1977; Woods, 1977). The importance attributed to

confidentiality by minor clients has been relatively

unexplored. Two studies which have focused on minors

(Kobocow, McGuire & Blau, 1983; Messenger & McGuire,

1981) have been outside the realm of the public school

setting and have been limited to individual

client/counselor relationships. The area of group

counseling with students remains a viable one for

research, particularly in relation to counselors

explicitly addressing confidentiality issues. Such is

especially relevant in that some research (Messenger &

McGuire, 1981) suggests that simple verbal explanations

or assurances have less of an imr ct on the counseling

relationship than a behavioral component.







6

Several needs were thus identified. Because of the

importance of confidentiality and trust in the counseling

relationship, the ethical and legal complexities involved

in counseling at school, and school counselors' confused

allegiance to students, parents, and institution, there

was a need to determine if counselors' explanation of the

issue of confidentiality actually impacted students'

knowledge of this complex concept in a therapeutic

relationship and/or their perception of group trust.

Moreover, there was a need to determine if student

involvement in the process further impacted such

knowledge and perception. Finally, it appeared that

variables of subjects' sex and subjects' race should be

further explored in relation to confidentiality and

trust.



Purpose of the Study

Confidentiality in counseling has been researched

largely regarding personal perceptions of adults (mental

health professionals, school personnel, adult subjects in

studies). There is a paucity of research exploring the

impact counselors have on minor clients' knowledge of

confidentiality and perception of trust, specifically

within the school setting. It was the purpose of this

study to determine whether a guidance session directly

addressing confidentiality would have an effect upon

students' knowledge and perception. Specifically, this








investigation attempted to determine whether the

independent variables of (1) counselors' instructions

about confidentiality (specifically, ethical

responsibility and limitations) and group members' role

playing situations to reinforce this explanation, (2)

subjects' sex and (3) subjects' race would have an effect

upon the dependent variables of (1) sixth-grade students'

knowledge of confidentiality in a counseling relationship

and (2) their perception of group trust.



Rationale for the Study

This study utilized the field experiment format

described by Kerlinger (1973) because its identified

advantages included ability to test broad hypotheses,

strength of the involved variables, and appropriateness

for studying complex social processes. Moreover,

Campbell and Stanley (1963) pointed out that the true

experimental method is recommended in the methodological

literature because sources of internal invalidity are

more tightly controlled.

Additional advantages involved the normal school

conditions under which this study was carried out. The

treatment conditions were "conducted by regular staff of

the schools concerned" (Campbell & Stanley, 1963, p. 21),

and the research was designed to appear to participating

students as an extension of structured classroom guidance

units in which they have already participated. The







8

latter fact carried a most positive aspect: Students and

counselors had established a working relationship prior

to this study, so that the disadvantages of an analogue

study (Woods, 1977) were greatly reduced. Finally, a

large number of students were accessible, a number of

representative schools could participate and external

validity was greatly enhanced by use of the school

setting.



Research Questions

The following research question were addressed in this

study:

1. Do school counselors' verbal instructions about

confidentiality (e.g., ethical responsibility and

limitations) have an impact on students' knowledge

of confidentiality?

2. Does the combination of school counselors'

instructions about confidentiality and members' role

playing situations related to this concept have an

impact on students' knowledge of confidentiality?

3. Do students differ by sex (male/female) regarding

their knowledge of confidentiality?

4. Do students differ by race (white/ethnic minority)

regarding their knowledge of confidentiality?

5. Do school counselors' verbal instructions about

confidentiality have an impact on students'

perception of group trust?









6. Does the combination of school counselors'

instructions about confidentiality and members' role

playing situations related to this concept have an
j
impact on students' perception of group trust?

7. Do students differ by sex regarding their perception

of group trust?

8. Do students differ by race regarding their

perception of group trust?



Definition of Terms

Some terms used in this study have been associated

with various meanings based on different authors'

viewpoints. Clarification of the generally recognized

elements under the rubic of "confidentiality," or

protection of private utterances, will be advantageous

for two reasons. First, there appears to be confusion

and a general lack of understanding for these concepts in

both principle and application, and second, these issues

affect virtually all practicing counselors and

psychotherapists in some way.

Confidentiality is "an explicit promise, protecting

the client from unwarrented disclosure, of any sort, by

the professional, except under conditions agreed to by

the source" (Graves, 1982, p. 7). Operationally,

confidentiality has been considered to be assessed

through the Child Confidentiality Questionnaire

(Messenger & McGuire, 1981) based on the APA Ethical
Standards of Psychologists (1977).









Confidential communication is "a statement made

under circumstances that clearly show the speaker

intended the statement only for the ears of the person

addressed; thus if the communication is made to the

counselor in the presence of a third party whose presence

is not reasonably necessary in order to achieve the

pupil's counseling goals" (p. 11), the communication is

not confidential (California State Department of

Education [C.S.D.E.], 1982).

Group Trust is the "therapeutic atmosphere necessary

for openness and risk taking on the part of the members"

(Corey, 1981, p. 33). Operationally, group trust has

been considered to be assessed through the subscales of

Expressiveness and Self-Discovery of the Group

Environment Scale (Moos, 1981).

Informed consent is "a person's agreement to allow

something to happen that is based on a full disclosure

and presumed understanding of facts needed to make a

decision intelligently; i.e., knowledge of risks

involved, alternatives available, and so forth"

(C.S.D.E., 1982, p. 12).

Judicial means related to or connected with the

administration of justice; having the character of formal

legal procedure; proceeding from a court of justice.

Minor refers to being under legal age, which varies.

from state to state; in Florida, legal age is

18-years-old.








Privacy means freedom of the individual to choose

for him/herself the time, circumstances, and especially

the extent to which personal beliefs, opinion, and

behaviors will be shared with, or withheld from, others

(Reubenhausen & Brim, 1966).

Privileged communication is a legal terms referring

to the client's right which exists by statute (if at all)

not to have confidences revealed publicly from the

witness stand during legal proceedings without the

client's permission; it is narrower in scope than

confidentiality (Shah, 1969a). The privilege itself is

basically an extension of the Fifth Amendment privilege,

and hence it is not the professionals' but the clients',

and they may waive it at any time (Boyd & Heisen, 1971).



Organization of the Study

The remainder of this study has been organized into

four chapters. In Chapter II, the professional

literature in regard to trust and confidentiality is

explored in relation to these major aspects:

expressiveness and self-discovery, other variables,

ethical standards, privileged communication, and case

records. Additionally, the areas of group settings,

minor clients, school counseling, and clients'

expectations/counselors' explanations are closely

examined. The research methodology, data collection, and

data analysis procedures are described in Chapter III.







12

The results of the study are presented in Chapter IV,

including analysis of the data. A summary of the study,

discussion of results, conclusions drawn from the

research, and recommendations for further research are

addressed in Chapter V.














CHAPTER II

REVIEW OF THE RELATED LITERATURE

Overview


Effective counseling depends largely on the

disclosure of highly private information and feelings,

and the client usually assumes that disclosures will not

be passed on to others without his/her knowledge and

consent. However, when the client is a minor, the

responsibility to protect the child-clients' privacy and

maintain confidentiality of communications becomes of

much greater concern to counselors functioning in both

public and private settings. While confidentiality has

generally been understood to refer to intimacy or privacy

of communication, in reality, confidentiality also has

legal and ethical implications.

Within the counseling relationship, confidentiality

is a critical issue because of the inherently personal

nature of the client's communications. These personal

disclosures focus on clients' innermost feelings,

thoughts, and fantasies (Karusu, 1980). Indeed, some

approaches (e.g., Hollender's (1965) "patient-centered"

contractual psychotherapy) are dependent on the

establishment of a confidential professional

relationship.







14

While the client's disclosures within the counseling

relationship may be traumatic, the professional has a

right and a need to encourage them; the client has a

similar obligation to be frank in responding (Graves,

1982). It is the indispensable quality of trust that

allows both parties to know that confidentiality will be

preserved unless the well-being of themselves or of

society is at stake. McCormick (1978) noted that this

attitude of trust is supported not only by personal

commitment but by ethical codes or "private systems of

law" which are built into the professional structure by

its own members.



Trust

The aspect of trust may be considered a familiar

dimension within the counseling process, but it is

nonetheless, an essential element. From the viewpoint of

helping and interpersonal relating as part of social

influence process, Egan (1975) stated, "if he (the

client) is to stay with him (the helper) in any creative

way-- . this means self-exploration--he must come to

trust the helper" (p. 110). Throughout, it appears that

the perceptions of the client are paramount. Brodsky

(1972) referred to this as "the world, as the client

experiences it" (p. 362). The importance of clients'

perceptions was noted centuries ago by Chaucer, who

wrote:









Faith in the counselor is one of the
greatest aids to recovery. A doctor should
be careful never to betray the secrets of
his patients, for if a man knows that other
men's secrets are well kept, he will be
readier to trust him with his own. (cited
in Graves, 1982, p. 15)

In discussing counseling as a series of

interpersonal processes, Brammer (1973) described

trust/mistrust as a client perception which can help or

hinder the therapeutic relationship. Indeed, Fong and

Cox (1983) identified the client's perception of trust as

a dimension in the first stage of counseling which must

be developed in order for the "real work" of counseling

to begin.

Without the development of confidence and trust, two

undesirable outcomes are likely. The counselee may

become resistant and present nothing more than

superficial problems (Shertzer & Stone, 1976). Or the

counselee may prematurely terminate, sensing that it is

too threatening to risk significant self-disclosure with

the counselor (Fong & Cox, 1983).

Research supports predictions of negative

consequences of clients' distrust of their therapists.

Using tape-recorded, "semi-structured" interviews,

Schmid, Appelbaum, Roth and Lidz (1983) concluded that

psychiatric inpatients do highly value trust and

confidentiality in the therapeutic setting and are

concerned about the possibility of unauthorized

disclosures. Seventy-seven percent of the respondents









(23 of 30) stated it was important to them that the

hospital staff not tell anyone else that they revealed

about themselves. Eighty percent indicated that knowing

their communications would be kept confidential improved

their relationship with the staff. Most patients (77%)

responded that they trusted their confidential

communications were being kept; that is, members of the

staff did not talk to others without their permission.

Sixty-seven percent of respondents said they would by

angry or upset if they discovered that staff members had

told other people what patients had revealed without

their permission. Indeed, 17% said they would leave

treatment or stop talking with the staff member involved.

Meyer and Smith (1977) reported that clients would be

less likely to enter counseling or self-disclose once

there if they had been told that the information

discussed would not be considered confidential.

One client behavior heavily dependent upon the

client's perception of trust within the counseling

relationship is self-disclosure. Clients must be able to
"express their innermost 'secrets' and make themselves

vulnerable to the counselor" (Fong & Cox, 1983, p. 163).

The efficacy of the therapeutic encounter appears highly

related to the degree of disclosure of private

information, including feelings and attitudes, the client

shares with the counselor.









Expressiveness and Self-Discovery

For heuristic purposes, Truax and Carkhuff (1967)

have specified self-exploration as a necessary antecedent

for constructive personality change. Clinical

observations suggest that clients involved in successful

therapy do indeed become involved in a process of

self-disclosure and self-exploration (Corey, 1982). This

is a process of coming to know one's beliefs, motives,

values, fears, perceptions of others, relationships, and

life choices.

An early study by Steele (1948) reported data

showing that more successful patients increasingly

explored their problems as therapy proceeded, while less

successful patients explored their problems less as

therapy progressed. Braaten (1958) found, from a

comparison of early and later interviews with successful

and unsuccessful clients, that the more successful cases

revealed a higher amount of self-references, especially

revelations of the private self. Similar supporting data

were reported by Blau (1953), Seeman (1949), and Wolfson

(1949). In both traditional psychotherapy and

contemporary counseling, the role of the therapist has

been geared toward efforts to faciliate this

self-exploration process.

Without personal revelations by the client, the

therapist (and client) will lack the necessary insight to

formulate intervention strategies. Jourard (1959)









defined self-disclosure as the central process in

personality change. He further observed that the amount

of personal information that one person is willing to

disclose to another can be considered an index of the

closeness of the relationship and of the affection, love

and/or trust that exists between the two individuals.

Generally speaking, self-disclosure and cathexis for the

person may be said to be correlated.

Both systematic research and clinical observation

support this proposition (e.g., Blau, 1953; Braaten,

1958; Jourard, 1959; Jourard, 1971a; Kotter, 1980;

Seeman, 1949; Steele, 1948; Sparks, 1977; Swager, 1981;

Wolfson, 1949). When indifference and antipathy exists

between two people, low disclosure to each other and

little knowledge about one another as persons are the

resulting consequences. In contrast, therapists have

noted that clients who feel warmth, trust and confidence

will self-explore and self-disclose more readily and

freely than when they perceive the therapist as hostile

or punitive. Jourard (1968) wrote, "My willingness to

disclose myself to you, to drop my mask is a factor in

your trusting me and daring then to disclose yourself to

me" (p. 125).

Truax and Carkhuff (1965) suggested that adequate

self-disclosing behavior is predictive of therapeutic

outcome. During psychotherapy, both client and therapist

are engaged in attempts at self-understanding. The







19

opportunity must exist to know the client through his/her

disclosures in order for the therapist to empathize with

him/her. Moreover, through clients' self-understanding,

they can gain power, and therefore freedom.

Egan (1975) clarified that "no claims are made here

that self-disclosure 'cures,' for it is a stage in a

developmental process" (p. 115). He asserted that

self-disclosure should be functional and pragmatic, and

thus the client would be helped to uncover concrete and

relevant feelings, experiences, and behavior. Egan

further emphasized the importance of self-revelation as a

means to effective psychotherapeutic outcome. It is "not

a goal in itself . it usually is subsidiary to other

goals--that is, dynamic self-understanding and action"

(p. 154).

Overall, then, expressiveness and self-disclosure

are considered essential parts of the process of

self-actualization (Jourard, 1971a; 1971b). Mowrer

(1968a, 1968b) asserted that self-disclosure can release

a great deal of "healing" force or resources in any

client. Sullivan (1953) described the critically

important function of self-discovery through "consensual

validation" as a self-stablizing phenomenon within the

psychotherapeutic process.









Counselors' Professionalism

Trust is basic not only to the therapeutic process

but to the very image of counselors in society as well.

Unless people feel they can rely on the professional to

keep what they say in confidence, many who need

counseling will not seek it. Dubey (1974) stated that

if the therapist cannot maintain privilege,
the inherent (social) power of his medical
position and judgement can render him so
muscle bound as to be therapeutically
crippled while conducting patient-centered
therapy. The treatment situation is bound
to be destroyed if confidentiality cannot
be maintained. (p. 1094)

Several notable judicial opinions have supported the

relationship of confidence and trust as essential to the

image of the psychotherapist. Judge Alverson of the

Supreme Court of Atlanta has stated that "Psychotherapy,

by its very nature, is worthless unless the patient feels

from the outset that whatever he may say will be forever

kept confidential" (Reynolds, 1976, p. 109). Judge

Edgerton, of the Court of Appeals of the District of

Columbia, has pointed out that a patient may respond to a

physician's treatment for many physical illnesses even

though she/he may not trust the doctor or have confidence

in him/her; in contrast, for the treatment of mental

problems, a relationship of trust and confidence is

essential (Reynolds, 1976).

Additionally, violations of clients' confidences

outside the courtroom may give rise to several possible

consequences. Shah (1969b) wrote that a psychologist who









gives unauthorized disclosures could face disciplinary

action and professional sanctions by the American

Psychological Association or by the state certifying or

licensing authority (in relation to the practicioner's

certificate or license). Furthermore, the therapist

might be faced with legal action and could be sued in a

civil action if some damage to the client resulted or if

the breach of confidence could be construed as a

defamatory statement.



Other Variables

Although trust appears to be an index of the level

of therapeutic process between client and therapist,

other variables have been suggested as affecting the

amount of client expressiveness with the counselor.

Sex. A number of studies have explored differences

in client expressiveness as a function of client and/or

counselor sex. In Graves' (1982) study, it was found

that

not only did males disclose significantly
more across all conditions of assured
confidentiality than did females, the
differences were such that even the highest
mean amount of disclosure by females under
any given condition was less than the
lowest amount disclosed by males under any
condition. . This would seem to
clearly indicate that males are either more
open or more easily made trusting, or both.
(p. 72)

Likewise, in the study by Kobocow, McGuire, and Blau

(1983), adolescent females were significantly lower than







22

males in self-disclosure across conditions, even though

the females demonstrated a greater willingness than males

to participate in the study. The authors concluded that

"females are more cautious and have a higher level of

self-protective needs than males" (p. 441). O'Kelly and

Schuldt (1981) also found males to disclose more than

females, and Rosen (1977) found that females were more

likely than males to refuse to sign release of

information forms. Singer (1978) found that although

women enjoyed talking more, men were more willing to face

the risks associated with being interviewed for surveys

requesting personal and sensitive information.

In contrast to these findings, other investigations

have suggested that females disclose more than males. In

a study by Jourard and Lasakow (1958), results were

reported in which females had higher self-disclosure

scores than males. This finding has been replicated by

Dimond and Munz (1967), Himelstein and Lubin (1965), Hood

and Back (1971), Jourard and Landsman (1960), Jourard and

Richman (1963), Pederson and Breglio (1968), and Pederson

and Higbee (1969). Using written self-descriptions,

Pederson and Breglio (1968) found that females did not

use more words to describe themselves than males, but

they disclosed more intimate information about themselves

than did males. Jourard (1961) attributed considerable

importance to the obtained sex differences. The low

disclosure of males was perceived to be directly







23

associated with less empathy, insight, and, consequently,

a shorter lifespan, than females.

Other authors have asserted that there are no

differences between males and females in levels of

self-disclosure. Cozby (1973), from his review of the

literature, claimed no study (to that date) verified

greater disclosure by one sex. A number of studies have

shown no sex differences on the variable (Dimond &

Hellkamp, 1969; Doster & Strickland, 1969; Plog, 1965;

Rickers-Ovsiankina & Kusmin, 1958; Vondracek & Marshall,

1971; Weigle, Weigle, & Chadwick, 1969).

Woods (1977) also found no sex differences in

disclosure by males and females under conditions of

confidentiality. Under conditions of nonconfidentiality,

however, females disclosed less. In Messenger and

McGuire's (1981) study, there were no sex differences in

total scores on the confidentiality questionnaire.

Nevertheless, it was found that male subjects scored

significantly lower on the subarea concerning the

therapist's responsibility to explain the limits of

confidentiality. The authors concluded that either

female children simply interpret this responsibility as

part of their counselor's job while boys are less

concerned with this aspect or female children more than

male children look for verbal assurances and explanations

during psychotherapy.









Findings regarding differences in sex of interviewer

have also been inconclusive. O'Kelly and Schuldt (1981)

found that no significant effect occurred as a result of

the interviewer's sex. On the other hand, Dion and Dion

(1978), in a study of sixth-grade students, found that

girls were more willing than boys to disclose to a female

teacher.

In attempting to interpret the contradictory

findings in regard to sex differences affecting

self-disclosure, Cozby (1973) noted that some authors

(Jourard, 1964; Plog, 1965) have suggested the

conflicting results may be the result of samples from

different geographical areas which have different sex

role expectations. However, analysis of the studies

which tested for sex differences as a significant

variable yielded no consistent pattern which would

explain the conflicting findings to be based in

geographic locale or type of instrument used.

Age. Level of cognitive development, as a function

of chronological age, is a significant variable in

clients' conception of confidentiality, and thus would

impact their level of self-disclosure. Messenger and

McGuire (1981) found that older children have a

significantly better understanding of confidentiality in

psychotherapy than younger children. Statistical

analysis revealed that the scores of the youngest group

(age 6 to 8 years) and the scores of the middle group









(age 9 to 11 years) did not significantly differ; nor

were the scores of the middle group significantly

different from those of the oldest group (age 12 to 15

years). Interestingly, however, the total mean score of

the youngest age group was significantly lower than the

total mean score of the oldest group. The authors

concluded that children evolve a conception of

confidentiality in psychotherapy gradually as they grow

older. Very young children may misinterpret some of the

basic stipulates of confidentiality in the counseling

relationship. This conclusion was underscored by the

fact that the youngest children scored significantly

lower than either of the older groups on the specific

subarea concerning confidential information being

released only with the client's express permission.

Moreover, the young adolescents (oldest group) held

particularly conservative, negative attitudes regarding

the necessity of breaking confidentiality under any

circumstances. Similarly, Kobocow et al. (1983)

concluded that adolescents are extremely cautious about

confidentiality and disclosure issues. Such findings

suggest that children in counseling may have to be dealt

with differently, depending on age in order to maximize

self-disclosure.

Ethnicity. A number of demographic characteristics

of the discloser, particularly education, ethnicity,

race, religion, socio-economic status and vocational









affiliation, have been reported to have a significant
relationship to self-disclosure (Cozby, 1973; Jourard,

1961). Greco and McDavis (1978) pointed out that culture

can affect clients' perceptions, behaviors and choices.

In a discussion of the black population, McDavis

(1980) reviewed the historical background and current

status of this minority group and identified specific

problems such as labeling, discrimination, and lack of

role models, which may adversely affect the counseling

relationship. Avila and Avila (1980) reviewed factors

impacting on the counseling relationship with

Mexican-Americans, concluding with recommendations to

facilitate communication. Sue (1978; 1980) explored the

personal and counseling needs of Asian Americans, noting

that their learned patterns of emotional restraint and

formality may interfere with self-disclosure in social

interactions, specifically in counseling. Anderson and

Ellis (1980) suggested self-disclosure may be inhibited

in American Indians because they may develop

misdirections and ambiguities to avoid having to disagree

or contradict another individual, such as the counselor.

Franco and Levine (1981) declared that Hispanics and

Blacks are less disclosing than Anglo-Americans.

However, in a series of three studies by these authors

(Levine & Franco, 1980), results were inconclusive.

Study 1 showed Anglo and Hispanic students to be equally

comfortable with Anglo or Hispanic counselors; Study 2









showed Anglo males and females and Hispanic females to

prefer directive communication about some topics,

depending on the counselor's sex and ethnicity; and Study

3 showed that specific self-report, self-disclosure

patterns vary with the counselors' sex and ethnicity.

Jourard and Lasakow (1958) reported less

self-disclosure by blacks than by whites. Dimond and

Hellkamp (1969) replicated this finding and additionally

reported less self-disclosure by Mexican-Americans than

by Blacks. Jourard (1961) found that Jewish males were

significantly higher in self-disclosure than Baptist,

Catholics and Methodists, while none of the latter

significantly differed from one another. The various

findings, then, suggest that ethnicity may be a

significant variable in the development of counseling

trust and self-disclosure.

Technology. Recent technological advances

increasingly bring the client's protection of

confidentiality in conflict with society's right to know.

Plaut (1974) suggested that this escalting conflict

exists because of increasing government involvement in

areas which were previously considered private affairs;

electronic revolution in data collection, storage and

retrieval; and prevailing atmospheres of suspicion

between individuals and powerful authority figures. The

resultant inhibition of confidence by clients can be most









counterproductive in regard to the effectiveness of

treatment the client might rightfully expect.

The dilemma for the professional has been examined

by Slovenko and Usdin (1961). In some situations, to

release confidential information when it is not necessary

could result in actions for damages for defamation or

invasion of privacy; on the other hand, to not release

information in other situations may lead to a charge of

contempt of court. Simultaneously, the client is faced

with the dilemma of erosion of the therapeutic effort by

not self-disclosing versus opening him/herself to either

advertent or inadvertent relevation of personal

disclosures to varied unauthorized agents of numerous

government and private organizations.

As an increasing amount of information is being

stored in computers, it becomes more accessible to

individuals other than those for whom it was originally

intended. Concern exists about inadequate control of

accessibility, particularly since data can be directly

cross-fed from interconnected electronic systems.

McCormick (1978) wrote that

There is validity in the argument that the
use of mechanical techniques is unavoidable
in a bureaucratic society. There is also
validity in the fact that such approaches
pose a threat to human beings. It is
necessary to reckon with human error . .
but the difficulty is that no agency can
predict the eventual impact of personal
disclosure on individual lives. Helpful at
the moment, they may be disasterous in the
future. (p. 211; 220)









Sampson and Pyle (1983) noted that at present the AACD

Ethical Standards (1981) and the Ethical Standards of

Psychologists (APA, 1981) do not specifically address the

ethical issues of computer applications in counseling,

testing, and guidance. They insisted that ethical

standards should be revised to include guidelines for the

appropriate use of computers, with one specific topic

being confidentiality of client data maintained on a

computer. The authors also identified unique problems

which exist in maintaining confidentiality of client data

stored in a computer and proposed ethical principles.

The suggested principles emphasize ensuring that

confidential data maintained in a computer

are limited to information that is
appropriate and necessary for the services
being provided, . are destroyed after
it is determined that the information is no
longer of any value in providing services
[and] are accurate and complete.
ip. 285)

Access to the confidential data were addressed in that

"best computer security methods available" should be

used, and it should not be possible "to identify, with

any particular individual, confidential data maintained

in a computerized data bank that is accessible through a

computer network" (p. 285).

Support for the impedance of self-disclosure by

technological devices is given in several studies. Woods

(1977) found that audio tape recordings of an interview

significantly affected anxiety level of the interviewee









as well as level of disclosure among females. The

behavioral responses observed included shifting of

position, hand movements, nervous laughter and clearing

of the throat. Woods suggested that the high anxiety

tended to go with less self-disclosure. Graves (1982)

found that clients disclosed to a greater degree when the

interview situation was recorded manually by the

interviewer as opposed to having the session

video-recorded with clients' knowledge. These findings

suggest that fear of disclosure to the public can be

harmful to the development of trust and its part in the

therapeutic process.

The literature, then, indicates that trust appears

to be essential within a counseling relationship;

indeed, without it, undesirable outcomes may be

anticipated. Some variables (e.g., sex, age, ethnicity,

technology) may significantly impact the establishment

and development of counseling trust, although research is

still inconclusive. Intricately tied to the aspect of

trust is the counselor's responsibility to protect client

self-disclosures and maintain confidentiality of

communications.



Confidentiality

Ford and Urban (1963), in citing general

characteristics of psychotherapy, focused on

confidentiality. In their description, "the [counseling]









interaction is highly confidential, and since counselees

discuss themselves in an intimate fashion, it is highly

private" (p. 16). Likewise, Shertzer and Stone (1976)

indicated that the counseling relationship "requires

privacy--both auditory and visual--and confidentiality,

because of the self-revealing and intimate experiences

related by the counselee to the counselor" (p. 177).

In a survey of mental health professionals in North

Dakota, Jagim, Wittman, and Noll (1978) found that the

responding professionals were unified in their agreement

of an ethical obligation to keep the therapist-client

information confidential. Indeed, confidentiality was

perceived as a significant element in the maintenance of

a positive therapeutic relationship. Additionally, there

was consensus that confidentiality was an important and

integral aspect in the therapeutic encounter. More

specifically, confidentiality was seen as essential in

maintaining a positive therapeutic relationship by 98% of

the professionals (56% very strongly agree, 25% strongly

agree, 17% agree). In addition to the necessity of

confidentiality for the therapeutic relationship, 98% of

the mental health professionals agreed that there was a

professional-ethical obligation to keep information

concerning a client confidential (72% very strongly

agree, 14% strongly agree, 6% agree).

Interestingly, an earlier study indicated that

institutions in which the professionals practice do not

necessarily value confidentiality as highly. Noll and









Hanlon (1976) found that of the mental health centers

they surveyed, the majority (51%) report the client's

name, address and/or social security number to various

government agencies, and 36% of these do so without

informing their clients that they did. Further, 61% of

the mental health centers reported clients were not

advised that identifying information might be reported.

In considering the ethical standards of the various

helping professions, reporting of such information

appears unethical, particularly when the information is

given without the clients' informed consent.

In light of such a practice, considering the

interplay of confidentiality and trust, a review of

ethical standards of helping professions appears

warranted. Moreover, two other factors which have been

identified as pertinent to a discussion of

confidentiality are privileged communication and case

records (Trachtman, 1972).



Ethical Standards

Confidentiality at the professional level refers to

the ethical standards of counselors or other

professionals not to reveal private communications from a

client to others except under certain circumstances.

Shertzer and Stone (1976) stated that matters of

confidentiality and counselor ethics in general are

extremely complex. While the purpose of professional









confidentiality is the protection of the client from

unauthorized disclosure by the professional, maintaining

confidentiality, particularly with the client's

expectations of protection, appears as one of the most

complicated yet pervasive issues facing the profession.

Each professional organization specifies its own ethical

codes designed to prevent unauthorized disclosure of

clients' communications.

The American Association for Counseling and

Development (AACD) clearly supports the practice of

maintaining confidentiality. In its Ethical Standards,

Section B, Counseling Relationship, subsections 2, 4, 5

and 7 stipulate that

The counseling relationship and information
resulting therefrom be kept confidential,
consistent with the obligations of the
member as a professional person . when
the client's condition indicates that there
is clear and imminent danger to the client
or others, the member must take reasonable
personal action or inform responsible
authorities. . Revelation to others of
counseling material must occur only upon
the expressed consent of the client. ...
The member must inform the client of .
limitations that may affect the
relationship at or before the time that the
counseling is entered. (AACD, 1981,
unpaged)

The American Psychological Association's (APA)

Ethical Standards state a very similar position.

Principle 5, Confidentiality, reads that

Psychologists have a primary obligation to
respect the confidentiality of information
obtained from the persons in the course of









their work. . They reveal such
information to others only with the consent
of the person or the person's legal
representative, except in those unusual
circumstances in which not to do so would
result in clear danger to the person or to
others. (APA, 1981, unpaged)

Like counselors, psychologists are expected to inform

their clients of the legal limits of confidentiality

where appropriate. Similarly, a statement by the

American Psychiatric Association (1970) described

confidentiality as a bond between therapist and patient

which is both "sacred" and "mandatory" (p. 1549).

The National Education Association's NEA Handbook

(1975-76) also emphasizes professional responsibility to

honor and protect confidences. Principle 1, Commitment

to the Student, reads, in part, that the educator, "shall

not disclose information about students obtained in the

course of professional service, unless disclosure serves

a compelling professional purpose or is required by law

(NEA, 1975-76, p. 235). Likewise, the National

Association of School Psychologists (NASP) has

established guidelines for professional relationships in

regard to confidentiality. Principles IIIb of its

ethical code emphasizes the school psychologist's

responsibility to explain to students the uses to be made

of information obtained and any obligation the

psychologist has for reporting specific information;

principle Vd points out the psychologist's responsibility

to "safeguard the personal and confidential interests of

those concerned" (NASP, 1976, p. 103).









Another professional organization which has

attempted to specify, although in only the broadest of

terms, a provision for guarding the confidential

communication of clients in its Code of Ethics is the

National Association of Social Workers (NASW, 1967). The

code stipulates: "I respect the privacy of the people I

serve" and "I use in a responsible manner information

gained in professional relationships." Additionally,

other helping professions, such as the American Hospital

Association and the Group for the Advancement of

Psychiatry, have been actively studying issues of

confidentiality and its maintenance (Reynolds, 1976).

The ethical standards of these various organizations show

that a relationship of confidence and trust is essential

to psychotherapeutic treatment.



Privileged Communication

Where legal testimonial privilege exists, the

client is protected from the possibility that private

information will be used as testimony in judicial

proceedings without his permission (Shah, 1969a). Most

frequently, the purpose of privileged communication is to

encourage confidential communication essential to

effective treatment and to prevent unwarranted

humiliation from courtroom exposure of intimate

information (Davis, 1971).









Dubey (1974) made the point that if testimony were

confined only to the medical issues of diagnosis and

treatment, there would be no problem. However, if the

testimony can be forced concerning content of

communications during psychotherapy, a therapist cannot

assure patients of confidentiality and hence the proper

setting for psychiatric work cannot prevail. Slovenko

(cited in Haines, 1962) asserted that there should be
"complete immunity" from cross examination for the

therapist. Without it, effective therapeutic examination

of the client (defendant) cannot exist unless the

therapist, in some way deludes the examinee. It would

seem an absurd position for the therapist to warn the

accused not to give him/her information in confidence and

then expect to receive information. Similarly, a

judically forced rupture of confidentiality would be

counterproductive for the court itself. As stated by the

Florida Appellate Court in the case of Morgan vs. State,

June 13, 1962,

To strip a pre-sentence report of its
confidentiality would be to divest it also
of its importance and value to the
sentencing judge because there might be
lacking the frankness and completeness of
disclosure made in confidence. (cited in
Graves, 1982, p. 20)

Some authors, however, have brought up the possible

conflict between the client's right to privacy and

society's right to proper administration of justice

(Arnold, 1970; Dubey, 1974; Schmidt, 1962; Shah, 1969a;







37

McDermott, 1972). Hollender (cited in Dubey, 1974) went

so far as to divide psychotherapy into two categories:

patient-oriented and society-oriented. In the latter

case, the therapist is "more or less the agent of people

or agencies other than the patient" (p. 1094). The

therapist does not necessarily promise confidence in such

a setting but may instead deliberately use the client's

information to exert power in influencing the patient's

social milieu.

J.H. Wigmore (1961) recommended four criteria for

the validity of a privileged communication.

1. The communications must originate in a
confidence that they will not be
disclosed [Schmidt (1962) clarified
that because a communication is made
in an expressed or implied confidence
does not necessarily allow it
privilege, however];

2. the element of confidentiality must be
essential to the full and satisfactory
maintenance of the relationship;

3. the relation must be one which in the
opinion of the community ought to be
sedulously fostered; and

4. the injury that would inure to the
relation by the disclosure of the
communication must be greater than the
benefit thereby gained for the correct
disposal of litigation.

The key words and phrases apparently qualify

psychotherapeutic consultations for the protection

offered by this privilege. Moreover, therapists have

some legal leeway in that they are under no obligation to

reveal information considered confidential unless under









oath or before a grand jury or court of law (Wrenn,

1952). Goldstein and Katz (1962) have stated that

treatment of the mentally ill is too
important and the assurance of
confidentiality too central to it, to risk
jeopardizing the whole because of the
relevance of some patients' statements to
some legal proceedings. (p. 735)

Legal testimonial privilege is not assured to

clients of therapists, however, and some states have no

privileged communication statute for clients of

psychologists and counselors. The California Supreme

Court, while endorsing the principle of

psychotherapist/client privilege has concluded that

absolute confidentiality was not needed to
protect the psychotherapeutic relationship
and that the judge could determine what
confidential information has to be
disclosed to ensure the carrying out of
justice. (Plaut, 1974, p. 1023)

Similarly, Hollender (cited in Dubey, 1974), concluded

that many of the diverse operations of psychotherapy do

not require confidentiality at all.



Case Records

The aspect of confidentiality of case records

presents a number of controversies: the right of outside

agencies to have access to the records, the availability

of records to various personnel within the institution

and the right of parents to inspect the records of their

children. This last area of confidentiality represents a

unique situation, since parents are ostensibly acting on

behalf of an individual who is a minor.







39

There have been two notable attempts to protect the

rights and privacy of students in recent years. In 1971,

the National Education Association, which has

traditionally argued for comprehensive record keeping,

approved a code of students' rights and responsibilities

(Burcky & Childers, 1976). According to this act,

students' interests supersede all other interests for

record-keeping purposes.

In 1974, federal legislative action--the Buckley

Amendment, Public Law 93.380--became effective. This act

requires that eligible students (generally defined as

eighteen years of age or older) or the parents of

students have the right of access to all official files,

records and data concerning their children (Education

Amendments, 1974).

McGuire and Borowy (1978) have focused on the

question of whether records in guidance offices,

counseling centers and diagnostic or evaluative service

centers are applicable. Typically, the statute is

interpreted to mean that the counselor's records are

confidential and do not become part of the student's

cumulative record (Cutler, 1975), yet some university

officials interpret the Buckley Amendment to mean that

counseling records of students ought to be made available

at least on a conditional basis (Kazalunas, 1977).

Perhaps more basic than the status of files is the

question of whether the Buckley Amendment violates the







40

ethics of confidentiality in the counseling relationship,

particularly since the ethical standards of numerous

helping professions directly address that information

resulting from a counseling relationship is to be kept

confidential. The AACD Ethical Standards, Section B,

subsection 5, clearly specifies

Records of the counseling relationship,
including interview notes, test data,
correspondence, tape recordings, and other
documents, are to be considered
professional information for use in
counseling and they should not be
considered a part of the institution or
agency in which the counselor is employed
unless specified by state statute or
regulation. Revelation to others of
counseling material must occur only upon
the expressed consent of the client.
(AACD, 1981)

Wilson (1978) asserted that there is certain

information that does not belong in a case record,

regardless of type of recording method used. Reasons to

eliminate data from a student's record would include

potential use of such material being against the best

interest of the client and/or agency if it were to be

supbpoenaed and possible negative effects upon clients

themselves should they see the entries. In her opinion,

material such as narrative recordings, information

regarding a client's political, religious or other

personal views, and extremely intimate personal details

have no place in any case record.

Kazalunas (1977) has asserted that revealing

confidences is now made possible by an act which was









intended to protect students' interests, particularly

their privacy. McGuire and Borowy (1978), however,

discussed the pertinent literature and concluded that

"the Buckley Amendment may be interpreted as being

consistent with established ethical and legal practices

of protecting the privacy of professional counseling

records" (p. 555). They did note, though, that the

decision of whether to release professional

communications to a counselee or student should be based

on the purposes for which the material was obtained

(e.g., for personal counseling versus degree-program

requirements).

The other side of confidentiality of case records

concerns releasing information to personnel within the

institution and outside sources. Miller (1971) stressed

the importance of safeguarding test data in particular

against improper dissemination. He pointed out that the

threat of information misuse may be exaggerated with test

data because of "the illusion of 'hardness' created by

numerical test scores or percentile ratings" (p. 94).

Friedenberg (1964) examined the effect on the

students' inner life and emotional dynamics when school

records are revealed to outside agencies.

By permitting agencies outside the
student-counselor relationship to use its
records, the school strikes at the very
roots of clarity and growth. It invades
the unconscious . throwing up barriers
of anxiety against self understanding . .
that it has made it dangerous for the









student to deal honestly with himself is
alarming. (p. 59)

Nonetheless, Boyd, Tennyson and Erickson (1973) have

found that, in practice, complete confidentiality of

records is rarely, if ever, extended to school-age

clients. A study by these authors reveals that while

counselors were more prone to deny requests for personal

interview data than general education-vocational

information, there was considerable individual

variability in the extent of release of student records.

Moreover, "school personnel receive more exact data about

individual students than do parents or the students

themselves" (p. 285).

The issue of confidentiality between client and

counselor has been explored by a number of authors with

respect to trust, professional ethics, privileged

communication, and school records. These considerations

provide a basis with which to examine clients' behaviors

and perceptions of confidentiality and trust within a

unique counseling relationship: the group. The efficacy

of the group therapeutic encounter appears highly related

to the degree of disclosure of private information,

including feelings and attitudes, the client shares with

the counselor and other members.



Group Settings

As in the case of the one-to-one counseling

relationship, various authors have indicated the









importance of confidentiality for the group processes.

Gazda (1978) wrote that many group leaders believe

confidentiality to be an essential component in the

entire group process, particularly in regard to the

development of trust among group members. Rogers (1970)

perceived an atmosphere of acceptance and trust (wherein

members could reveal aspects of themselves they typically

conceal) to be essential to group movement. Moreover, he

expressed an intense trust in the ability of group

members to develop their own potential. One such aspect

specifically focused on the group moving from lacking

trust and being closed and fearful with others to

becoming increasingly open and expressive in

interpersonal relationships.

The level of trust in a group seemingly depends on

two interrelated factors: "the willingness of the members

to share themselves and the quality of the response they

receive once they do share themselves" (Egan, 1975, p.

156). Trust is an issue that surfaces early as a new

group gets underway.

Members will often question their ability
to trust the group leaders, the other
members, and even themselves. . It is
clear that, if members are to drop their
defenses and reveal themselves--as indeed
they must if the group is to be
effective--they need assurance that the
group is a safe place to do this. (Corey,
1981, pp. 356-357)

The imporance of confidentiality is implied through the

members' need to believe the group is a "safe place" to









reveal themselves. Indeed, Ohlsen (1977) found that

group members must believe their expressions of feelings

and thoughts will not be told outside the group.

Without mutual trust among members and leader,

negative consequences are projected, just as for

individualized counseling. Corey (1981) identified the

following outcomes for groups without trust.

Group interactions will be superficial,
little self-exploration will take place,
constructive challenging of one another
will not occur, and the group will operate
under the handicap of hidden feelings.
(p. 32)

Meyer and Smith (1977) studied the issue that

threats of disclosure may prevent openness in group

therapy (i.e., that "confidentiality is crucial to the

effectiveness of group therapy," p. 638). After

administering a questionnaire to university students,

they concluded that without a belief in the

confidentiality of their communication, group

self-disclosure may be inhibited. Greene and Crowder

(1972) have stated that group psychotherapy with

adolescents can be effective only when confidentiality is

an essential part of the process. A specific group

therapy strategy for adolescents has been developed by

Vorrath and Bredtro (1974) in which the efficacy of

counseling is based in the very issue of confidentiality.

These authors asserted that the group must be convinced

of the confidentiality of the meetings, and, further,







45

that members must believe that they do not have the right

to reveal information outside the group.

Corey (1981) maintained that helping to build group

trust is a vital task for group leaders. The way in

which leaders approach the group was considered to be of

great importance, and he suggested that leaders attempt

to promote trust by describing the structure and goals of

the group and by explaining how the group process will

work. Corey recognized that practicioners of various

orientations utilize different approaches in establishing

a climate of trust during opening sessions, and he even

summarized some typical leader comments of the various

group models.

Davis (1980) emphasized the leader's responsibility

for group trust from a slightly different perspective.

She stressed that, because confidentiality and protection

of disclosures are necessary for a productive group, the

leader should directly address the topic of

confidentiality to group members. Her survey of members

of the Association of Specialists in Group Work (ASGW)

and their clients, however, indicated that, in fact,

members perceived that confidentiality of group

communications was not maintained.

Approximately 70% of the [group] members
thought they, other group members and the
leader, could talk or were talking freely
about the topics and activities from the
group. It was discouraging to discover
that more than one-third of the members
thought the leaders were talking about the









respondent and other group members outside
the meeting. . The people most
frequently attributed with receiving
information from the leaders were someone
at the university or agency, the member's
teacher, and/or the leader's friends.
(p. 200)

In his interpretation of self-disclosure in a

counseling group, Christiansen (1972) questioned whether

confidentiality could truly be guaranteed because the

information is told to all group members. He contended,

however, that in effective group interaction,

confidentiality of communications is a by-product.

As group members begin to trust one another
and feel more secure, the group loses all
concern about the possibility that another
member of the group may tell an outsider
about something that has been said in the
group meetings. Until they gain this
security, nothing much really happens in
the group. (p. 127)

Another facet of group work relates to

"self-selected" groups, wherein members may forsee the

confidentiality problem and thus exclude potential

informers (or "ratters") from their group (Christiansen,

1972). An advantage of a self-selected group has been

identified as a more quickly and freely moving counseling

process. Taping of sessions is another aspect of group

sessions in which success is dependent upon trust among

group members; if accepted, its advantages include

allowing members to listen to previous sessions or to

missed sessions and allowing the leader to improve

counseling skills by reviewing the tapes (Christiansen,

1972).









Similar to individualized sessions, trust affects

expressiveness and self-disclosure in group process.

While Gazda (1978) emphasized that self-disclosure is one

of the most basic components of group process, he

believed that the level of group self-disclosure is

greatly dependent upon the trust members have in each

other. If sufficient trust exists, members express

spontaneously and openly their thoughts and feelings.

Gazda further asserted that expressions of here-and-now

feelings, beliefs, and attitudes are highly desirable and

actively sought in most groups.

Yalom (1975) believed self-disclosure to be a

prerequisite for the formation of meaningful

interpersonal relations in the group situation. If

acceptance of others is preliminary to acceptance of

self, then the individual must gradually permit others to

know him as he really is, if he is to ever gain

self-acceptance. As far as self-help groups, Mowrer

(1973), in his philosophy of helping, asserted that

self-disclosure is central. The client, if he wants to

be helped, must reveal himself completely to the other

members in the self-help group; in this setting, the

leader's self-disclosure is also considered essential.

Immediate and total self-disclosure is characteristic of

many peer self-help groups, such as Alcholics Anonymous

(Hurvitz, 1970).







48

In a study of group psychotherapy, Peres (1947) had

found that successful and unsuccessful group

psychotherapy differed in that successful patients in

group therapy made significantly more personal references

over the course of therapy when compared to unsuccessful

patients. Indeed, the benefited patients made almost

twice as many personal references as did the

non-benefited patients. Research by Truax and Carkhuff

(1967) also has shown that patients' success in group

therapy correlated with their transparency during the

course of the group. Lieberman, Yalom and Miles (1972)

found that in encounter groups, individuals who had

negative outcomes revealed less of themselves than did

the other participants. Azima (1974), in describing a

useful strategy for group work with adolescents, noted

that one of the salient problems encountered is the fear

of self-disclosure.

Research by Drag (1969) suggested that the

two-person discussion group may self-disclose more than

eight-person groups, but not more than four-person

groups. Other findings, however, indicate that people

may disclose more or less readily in groups larger than

dyads, dependent upon the composition of the audience

(Chelune, 1976). Furthermore, the mode of communication

appears to affect the clients' perceptions of the

dilution they may expect for protection of personal

utterances (Spinner, 1978).









Generally, then, trust and confidentiality are

equally important in group settings as in individual

counseling. Self-expression, however, may be initially

inhibited by members' fear of disclosure of confidential

communications to others outside the group. Only within

an atmosphere of trust will expressiveness and

self-discovery be enhanced.



Minor Clients

The foregoing considerations of trust,

confidentiality and self-disclosure have presented a

number of aspects and implications for practicing

counselors. The discussion, however, has remained

focused on the therapist/client relationship in general,

in both individual and group settings. When the client

is a minor, numerous other issues become salient, many of

which represent diverse opinions.

As far as trust, research suggests that clients' age

does affect their conceptualization of confidentiality in

the therapeutic relationship (Kobocow et al., 1983;

Messenger & McGuire, 1981). It appears that young

clients, as well as adults, respond positively to their

recognition of a right to self-determination. This would

appear to include a full explanation of the counselor's

responsibilities for as well as limitations of

confidentiality in counseling. Interestingly, Rosen

(1977) has stated









The very act of telling a client that he
may rightfully refuse to sign a consent
form can indicate to the client that he too
is, and has the right to be, a decision
maker. Such an act may be the type of
communication that many clients need to
hear in order for a substantial improvement
to occur in their self-image and feeling of
self-worth. (p. 23)

Ross (1966) concluded that trust, more than

confidentiality may be the "critical ingredient" in

dealing with young patients.



Ethical Standards

The codes of ethical standards of the various

helping professions are considerably vague in reference

to minor clients. The AACD Ethical Standards never

specifically addresses minor clients but rather refers to

all clients in general terms. Statements in Sections A

and B specify

In the counseling relationship, the
counselor is aware of the intimacy of the
relationship and maintains respect for the
client. . The member must recognize the
need for client freedom of choice. Under
those circumstances where this is not
possible, the member must appraise clients
of restrictions that may limit their
freedom of choice. (AACD, 1981, unpaged)

Nowhere, however, does the code clearly differentiate

between the counselor's ethical responsibility to the

child-client versus an adult client.

The APA has shown an interesting pattern in their

various publications in regard to ethical codes, as if

members were struggling with the issue of where minor







51

clients fit in relation to professional responsibility.

The earlier APA Ethical Standards of Psychologists (1968)

made some implied distinctions between the child and the

adult client by referring to the "the responsible

person." Principle 7, Client Welfare, Section D, stated

that

the psychologist who asks that an
individual reveal personal information to
be divulged to him does so only after
making certain that the responsible person
is fully aware of the purposes of the
interview, testing, or evaluation and of
the ways in which the information may be
used. (unpaged)

Somewhat more strongly, Principle 8, Client

Relationships, Section B, stated that "when the client is

not competent to evaluate the situation (as in the case

of a child), the person responsible for the client is

informed of the circumstances which may influence the

relationship." Thus, as vague as this early code was in

reference to the psychologist/minor-client relationship,

it did imply that the minor client is incapable of

comprehending his/her position and is thus incompetent to

consent to treatment or have the same rights as an adult

in the psychotherapeutic relationship. It is not

surprising, then, that McGuire's (1974) study revealed a

general lack of awareness, at least among psychologists,

as to the content and applicability of existing APA

ethical codes to the child in psychotherapy.







52

The next APA (1977) code of ethics did not even make

the implied distinction of its predecessor. While

Principle 5, Confidentiality, emphasized the obligation

of the psychologist to safeguard information, it did not

clearly differentiate between minors and adults. Section

B of this principle stipulated

Information obtained in clinical or
consulting relationships, or evaluative
data concerning children . are
discussed only for professional purposes
and only with persons clearly connected
with the case. (unpaged)

Ambiguity arises here over whether "persons clearly

connected with the case" would include parents of minor

clients and whether "professional purposes" would include

sharing communications with parents in the case of minor

clients. Section D of this principle stated

The confidentiality of professional
communications about individuals is
maintained. Only when the originator and
other persons involved give their express
permission is a confidential communication
shown to the individual concerned.
(unpaged)

The vagueness of the term "other persons involved" left

The question of whether parents or guardians were to be

included when "the originator" was a minor client.

Significantly, a proposed revision to the principle

concerning confidentiality in the APA ethical standards

recognized the importance of confidentiality in the

psychologist/minor-client relationship. Section J of the

proposed guidelines stated









Where a legal minor is the primary client,
the interests of the minor shall be
paramount. The child's best interests to
do so [sic]. In such cases, psychologists
make a serious attempt to obtain the
child's consent. ("Proposed to," 1977,
p. 84)

Nevertheless, when the revisions were actually

adopted, the minor client's rights had been diluted,

although at least they were specified. Sections A and D

of Principle 5 of the current code state:

Information obtained in clinical or
consulting relationships, or evaluate data
concerning children, students, employees,
and others, is discussed only for
professional purposes and only with persons
clearly concerned with the case. . When
working with minors or other persons who
are unable to give voluntary, informed
consent, psychologists take special care to
protect these persons' best interests.
(APA, 1981, unpaged)

Thus, the current APA code recognizes the "best

interests" of minor clients but designates them as
"unable to give informed consent."

The issue thus becomes whether it is desirable, even

possible, to maintain an attitude of strict privacy and

confidentiality with adult clients in counseling but not

with minor clients. More than three decades ago, in an

article entitled "The Ethics of Counseling," Wrenn (1952)

proposed ethical guidelines advocating confidentiality in

the counseling relationship with children.

It has been suggested that the confidential
nature of the interview is less to be
stressed when the client is a child and
that permission to transmit is not
necessary for children. I doubt this








assumption. A child's trust in a counselor
may be betrayed as well as an adult's. A
child is very much a person and the
integrity of his personality must be
protected while at the same time admitting
that parents' consent must be obtained for
treatment or referral. (p. 172)

In his proposed guidelines, Wrenn suggested that the

counselor must obtain his client's permission before

communicating any information about that client that has

been given in the counseling relationship, even to

parents.



Legal Issues

The legal aspects associated with the

psychotherapeutic treatment of minors, including

privileged communication and parental rights present

particularly thorny issues. Rosenberg and Katz (1972)

examined legal issues of consent in the psychiatric

treatment of minors. They considered the implications of

laws which provide that minors, even mature ones, do not

have the right to contract for or undergo psychiatric (or

psychological) treatment without the specific permission

of parents or guardians. It should be noted that the age

of the minor and complexity of treatment may affect what

situations the courts would likely favor making an

exception to this general principle. These authors

pointed out the privileged communication statutes fail to

establish to whom the privilege belongs in the case of a

minor--to the minor or to his/her parents or guardians.






55

Other authors have considered whether it is the parents'

or the child's right to waive the privilege (Shah, 1969b;

Geiser and Rheingold, 1964.)

This dilemma raises the further question of exactly

who the client is in psychotherapeutic treatment of a

minor. Some authors believe that the parent represents

the child-client while others contend that

confidentiality is just as essential in therapy with

children as with adults. This diversity of opinion is

greatly attributable to the fact that each therpist's

"idea of guarding secrets is considerably predetermined

not only by his personality structure but also by his

professional development" (Lowental, 1974, p. 236). A

further complication is the difficulty in defining

exactly "Who is a child?" when maturity levels vary so

greatly.

In discussing the individual's rights during

psychological treatment, Ackley (1974) stated that "the

services of the psychologist are rendered to a client and

belong to the client" and that "the client is the person

who has come to the psychologist for professional

services, whether he has come on his own initiative or

has been referred by another" (p. 21). He continued,

however, that "the parent of a minor who is a client has

the right of the client" (p. 21). He further maintained

that working independently of parents invades the

personal rights of both child and parent, the implication









apparently being that the child's communications to the

counselor are open to the parent.

Slovenko (1966) wrote that "child therapy can never

be a strictly two person arrangement" (p. 57). He

encouraged parental involvement in child therapy,

specifically noting that "environmental manipulation" may

be essential in the treatment of children. Slovenko and

Usdin (1961) took a similar position. These authors

emphasized the sanctity of confidentiality in the

patient/psychiatrist relationship, stating that for the

good of the patient "the psychiatrist is indeed forced to

keep the patient's confidence" (p. 428). Nonetheless,

they made the clear distinction that children (along with

the physically handicapped and alcoholics) are exceptions

to this psychotherapeutic approach because others are

directly responsible for them.

Goldman (1972) derogated the assumption that

children or adolescents should be given a confidential

counseling relationship because of his belief that

parents know what is best for their child. Only in cases

where the parent is ignorant, disturbed, hostile, or

negligent should the counselor supersede the usual

parental prerogatives.

Legally and morally parents are responsible
for their children, and no professional
person . has any business placing
himself in loc parentis. After all, it is
the parent who will have to live with the
outcome and will be responsible for what
happens thereafter. (pp. 371-372)









The confidentiality of communications of minor

clients has, then, been considered by these various

authors as secondary to the priority of informing

parents. Goldman (1972), while recognizing that children

of varying ages have varying degrees of judgement and

competence, nonetheless argued that the mental health

worker is not in a position to decide whether a

particular child is or is not competent to refer himself.

He referred to the decision as "a kind of God-playing"

which "really has taken the ultimate responsibility away

from parents, courts, everyone, and placing it in one's

own hands" (p. 373)

Considering the importance of trust, other authors

raise the question that if confidentiality is so critical

in therapy, why are children exluded? A number of

authors have maintained that the minor client is indeed

entitled to confidentiality of communications in

counseling.

Rosenburg and Katz (1972) noted that, "though the

law generally demands that parents have a right to

informed consent," it is not always therapeutically

desirable to provide details of the causes and nature of

treatment. These authors wrote that limiting the

psychotherapeutic treatment of minors "will not further

our traditional concern of providing for the protection

and welfare of minors" (p. 56).









Similarly, Hyman and Schreiber (1975) listed a

number of recommendations in their discussion of child

advocacy. Though these authors maintained that the

parent should be interviewed and explained his legal

rights, they specifically stated that "Children and

adolescents should be provided confidentiality with the

exception of the 'future crime limitation' which would

include plans to commit any crime, including suicide" (p.

56). The position statement for psychiatrists warns

against "divulging details about the youth's problems to

the parents--a practice that can be detrimental to the

young person" (American Psychiatric Association, 1970, p.

1546).

In a recent discussion of treatment of adolescent

psychiatric inpatients, Corder, Haizlip and Spears (1976)

specified that standards of sharing information should be

outlined in the treatment contract. They asserted that

parents should be informed only of issues such as the

goals and progress in general, but specific details of

the therapy session are to be kept confidential unless

they pertain to some area of danger to the patient or

others.

Along this line, Wilkerson (1973) wrote that at

certain ages and under certain circumstances, the child

is unable to care for or protect himself or make prudent

choices in his own best interests. Here the child has a

right to "parental responsibility," implying social









obligation and accountability of the parent, not the

parent's right to dominate the child because of his

immaturity.



Practice and Trends

Despite the numerous, and often heated, exhortations

on both sides of the issue, few actual studies have been

conducted in the area of child-client confidentiality.

Those studies available show that counselors and

psychologists tend to respect the confidentiality of the

minor's communications. As Trachtman (1972) stated

There seems to be some sympathy for the
psychologist having discretionary power to
withhold confidential verbal communication
from parents, even by those who would grant
parents complete access to the written
record. (p. 41)

McGuire (1974) surveyed forty-five mental health

professionals concerning their attitudes and behaviors

with regard to practical situations involving

confidentiality with children in therapy. These

professionals varied in age, years of experience and

degree. It was found that the mental health workers in

this sample tended to favor a position wherein

child-clients are extended the same rights and privileges

regarding confidentiality as adult clients. McGuire

wrote that this position appears to be basically

inconsistent with a strict interpretation of the APA Code

of Ethics.







60

It should be noted that even though the therapists

tended to respect the confidentiality of the

minor-clients, their responses were quite variant. The

author hypothesized that much of the variance was

attributable to lack of agreement among professionals as

to how they should behave. Within this sample, some

individuals experienced considerable conflict regarding

the nature of their relationship with a minor in therapy

while others experienced virtually no conflict. This and

other studies (e.g., Curran, 1969; McRae, cited in Clark,

1967; Eisele, 1974) reveal a trend among psychologists

and counselors to maintain confidentiality of minors.

This trend to maintain confidentiality in

psychotherapeutic relationships with minor clients exists

despite ethical codes and legal standards which dictate

welfare of the child to the parents or guardians. It is

interesting that the prevailing practice of notification

of parents in the treatment of minors for mental illness

is just the opposite the procedure generally followed in

the treatment of minors for physical illnesses. In the

former case, notification is made only in emergencies,

while in the latter case, lack of notification or

informed consent in emergencies is legally excused

(Slovenko, 1966).

Until more definite standards are officially adopted

by mental health professionals, it would appear that the

therapist will have to use the psychological age or the







61
condition of the client rather than chronological age in

determining the approach to be taken in dealing with

parents (Slovenko, 1966).

Ladd (1971) has presented the intriguing suggestion

of drawing formal distinctions between the ways in which

different age groups of children should be treated. He

suggested that those who deal with minors should

categorize them as young children (6 to 9), older

children (10 to 13), and youths (14 to 17) and should

delineate rights and prerogatives for each category.

Under such a plan, a 15-year-old's problem may be treated

with a confidentiality not appropriate to a 10- or

12-year-old. Ladd asserted that such a graded system

. would have at least the merit of
forcing both parents and professionals to
take account of a young person's expanding
rights and to realize that . the time
is coming for him to be . entitled to
all the rights of adulthood. (p. 268)

Rosenberg and Katz (1972) pointed out that some

minors are capable of acting autonomously and are capable

of making decisions about psychotherapy. In considering

the rights of children in general, Arthur (1973) wrote

that the child should be given the freedom to choose

between alternatives once he is about to "recognize each

alternative, forecast its consequence, and compare the

advantages and disadvantages" (p. 137). Without such

maturity, however, the child's choice between available

alternatives may be needlessly harmful to self or to

others.









The issue thus becomes whether the minor-client is

in fact capable of comprehending his/her position and is

thereby competent to undergo psychotherapeutic treatment

with the assurance of confidentiality afforded an adult.

The traditional concern of society with the protection

and welfare of minors is based on the notion that the

minor must be protected against his own innocence and

lack of experience. If the therapist can establish the

child-client's intellectual ability to contribute to and

participate in the psychotherapeutic process, this

concern would be unfounded. Moreover, there may exist

the possibility that the minor in psychotherapy may need

to be protected more against the divulgence of his

private communications than his own innocence.

Thus, divergent opinions appear in the literature as

to the status of the child in psychotherapy, and ethical

standards and legal statutes are vague on the issue.

Studies which have examined the attitudes and behaviors

of psychologists and counselors have found that

practicioners tend to respect the confidential

communications of their child-clients. The capacity of

the minor to comprehend the nature and consequences of

treatment appears crucial in determining the confidential

nature of the psychotherapeutic relationship.









School Counseling

Within the school setting, the counselor's

responsibilities focus on growth process through which

individual students or groups of students are assisted in

(1) defining goals; (2) planning and implementing

decisions; and (3) solving problems related to

educational, career, and personal-social development

(California State Department of Education, 1982). Some

typical issues which may be worked through in counseling

with adolescents are related to curriculum planning,

vocational choices, family conflict, peer group pressure,

or sexual confusion (Lewis, 1970). At the elementary

level, there had been a lack of effort directed toward

work with young children by counselors up until 10 to 15

years ago; however, one of the purposes of counseling

remains to help the child make adjustments to life's

demands that are acceptable to both self and society

(Muro & Dinkmeyer, 1977).

Because the school is a public institution, the

issues regarding confidentiality and self-disclosure

become increasingly complex. While the previous

discussion of minor clients remains pertinent, the public

school setting is unique in that counselors are public

employees working with other professionals in the area of

education. Guildroy (1979) noted that as the school

counselor deals with student, parents, teachers,

administrators and colleges, the legal and ethical









considerations, particularly in regard to

confidentiality, are difficult to untangle.



Ethical and Legal Aspects

The American School Counselors Association (ASCA)

has an ethical standard which specifies different

responsibilities to pupils, parents, school personnel,

community, self and profession (1984). The code was just

adopted by the ASCA Delegate Assembly in March 1984 and

represents some significant adoptions from the previous

ASCA Code of Ethics (1972).

The present code, in Section A, Responsibility to

Pupils, stipulates that the school counselor

Has a primary obligation and loyalty to the
pupil . ., protects the confidentiality of
information received in the counseling process
as specified by law and ethical standards,
[and] informs the appropriate authorities when
the counseled's condition indicates a clear and
imminent danger to the counselee or others.
This is to be done after careful deliberation
and, where possible, after consultation with
other professionals. (p. 7)

Moreover, the current code specifically addresses

the issue of confidentiality in responsibility to parents

and colleagues. Significantly, the school counselor:

Informs parents of the counselor's role with
emphasis on the confidential nature of the
counseling relationship between the counselor
and counselee, . treats information
received from parents in a confidential and
appropriate manner, shares information about a
counselee only with those persons properly
authorized to receive such information, . .
[and] promotes awareness and adherence to









appropriate guidelines regarding
confidentiality, the distinction between public
and private information, and staff
consultation. (p. 7)

Such a code clearly indicates that school counselors

are becoming increasingly aware of the essential nature

of confidentiality in the counseling relationship and of

the dilemmas which they sometimes face. This increased

responsiveness by the ASCA organization is highlighted by

contrasting the current stipulates with the previous code

published more than a decade ago which was considerably

more vague in stating that the school counselor

Should respect at all times the confidences of
the counselee; should the counselee's condition
* [endanger] . self or others, the
counselor is expected to report this fact to an
appropriate responsible person. (ASCA, 1972,
unpaged)

Throughout, however, ASCA has maintained a position

of student advocacy. In its 1976 position statement, the

organization stated that it was

committed to be actively involved in that
students be treated as citizens of the U.S.A.,
with all due rights, privileges, and
responsibilities. Counselors are serving as
advocates, activists, and catalysts for
assuring these rights. . ASCA's position
is that the counselor is the 'student
advocate'--supporter, intercessor, pleader,
defender--through speaking, writing, and
action (pp. 281-282)

ASCA's position, then, appears to be a strong one

for the student, and the practices it promotes include

improvement of record-keeping, release of student

records' information/data in a law-abiding,
discriminating manner, and the recording of positive,









nonvaluative evaluations on student records and

documents. The association also clearly specifies the

importance of enlightening students about rights and

limitations by promoting

Student orientation to all rights and due
processes open to him/her, i.e., how to get
one's rights as a student; what to do if
searched, seized, or interrogated; reviewing
one's school records (or parental review of
same); resources of assistance available to
students; freedom to express one's views.
(pp. 281-282)

While the promoted practices are geared towards

advocacy of the student, ASCA also recognized the rights

of parents. The ethical code states that the school

counselor

Respects the inherent rights and
responsibilities of parents for their children
and endeavors to establish a cooperative
relationship with parents to facilitate the
maximum development of the counselee. (p. 7)

As far as the legal aspects, Nolte (1976) emphasized

that students' rights and guidance counselors'

responsibilities differ under various state laws.

Although some topics may be addressed by some federal

laws, issues which may vary for school counselors from

state to state include privileged communication statutes,

rights of parents, rights of school authorities,

confidentiality of student records, freedom of

information, due process, and legal ramifications of

various kinds of counseling (e.g., drug, medical, sexual,

moral). Litwack (1969) briefly reviewed the literature

regarding state laws concerning school counselors' legal









status and client confidentiality. He concluded that

professional associations need to assume leadership roles

in a push for uniform legislation.

A decade ago, the AACD (then the American Personnel

and Guidance Association, APGA) addressed the issue of

privileged communication at a national conference. The

committee report stated that privileged communication

refers to information that belongs to the student. While

it is shared with the counselor, it may be released only

upon authorization by the student involved. The document

also identified those states which had a communications

privilege for school students and counselors (Shafer,

1974).

Haney (1970) asserted that privileged communication

may not be what school counselors need, as it would

protect the pupil-client, not the counselor. Further,

information could not then be used to benefit the

counselee. The recommendation was made that each state

construct guidelines to give assistance in understanding

issues of protection of confidential information to

schools, especially school counselors. It should be

noted that "at least half of the states in the nation"

(p. v) have passed legislation giving pupils twelve years

of age and older the right of limited confidentiality in

their communication with school counselors (C.S.D.E.,

1982).









A study by Frerqueron (1974) examined school

counselors' ability to justify a need for statutory

protection of privileged communication of their clients.

The main arguments supporting privileged communication

for students working with school counselors were that

students would be reluctant to seek the school

counselors' services if they feared their communications

would be disclosed; the counselor needs the ability to

guarantee confidentiality in order to function in his

professional role; Wigmore's (1961) criteria for

privileged communication are satisfied by the counseling

relationship; and the very nature of the counseling

relationship necessitates the assurance of

confidentiality. Further arguments were cited in

comparing the school counseling relationship to

established privileged professional relationships (i.e.,

attorney/client, physician/patient, and

psychologist/client). Arguments opposing privileged

communication were: the school counselor lacks

professional standards; privileged communication acts as

an obstruction to justice and also restricts the

counselor's ability to consult with other individuals;

and a strong code of ethics is better protection than

legislation.









Confused Allegiance

Kottler (1980) noted that the school counselor

functions as a therapeutic model in many diverse roles,

and thus counselors must present an image of confidence

and competence to their clients. The unclarified

question remains who is the primary client--the student,

the parent, or the school? Various authors have taken

positions all along the continuum, and research suggests

that practicing counselors themselves have an

inconsistent perception of primary allegiance.

Shertzer and Stone (1976) examined both sides of the

question of whether the counselor should champion the

individual student or give primary loyalty to the school.

One side of the argument is that counselors' primary

obligations are to respect the integrity and promote the

welfare of counselees, even if they are students.

Further, if the school counselors cannot provide the

essential component of confidentiality while counseling

students, then their effectiveness is severely and

perhaps irreparably curtailed. On the other hand, the

argument could be made that the counselor is a member of

the school faculty and consequently has basic loyalty to

the employing institution. Moreover, privileged

communication for school counselors has not been given

legal status in many states. The authors concluded

Within the school setting, where the counselor
deals with minors' sexual behavior, delinquent
acts, and the like, there are no easy









solutions. Each situation must be considered
on its own merits, and each decision must be
based upon the client's welfare and not upon
the counselor's welfare. . when they are
forced to break confidence, they destroy the
counseling relationship probably for all time.
(p. 184)

Christiansen (1972) also explored both sides of the

issue, noting there are instances wherein it may be

advisable to break students' confidences to other school

personnel. Kaplan (1974), however, wrote that the

ethical duty to protect the confidences of pupil-clients

would force counselors to deny some requests of teachers.

He suggested counselors explain their feelings concerning

ethical behavior, especially confidentiality, in a

nonthreatening manner, personally and directly to the

staff. Slovenko (1966) took a similar, though more

extreme, position by stating that it is not the

responsibility of teachers to delve into a pupil's

emotional problems and the pupils "are not patients in

relation to the teacher while they are being taught"

(p. 66).

Gunnings (1971) declared strongly that the school

counselor should in no way act as "an arm of the

administration." To do so would sacrifice his/her

effectiveness. Rather, the only definitive manner in

which to ensure confidentiality is to insist that no

information be passed on to any one without the written

permission of the student involved. Gunnings concluded

that the responsibility of any counselor should be only









to the client--school counselors and student clients

inclusive.

The degree of allegiance to the student versus the

school has been explored in research of professionals'

attitudes. A study by McRae (cited in Clark, 1967)

entailed a survey of the attitudes of both counselors and

school administrators toward confidentiality with

pupil-clients. The results of this study indicated that

almost all the counselors (95%) and a majority of the

administrators (68%) agreed that a counselor should treat

information obtained in a counseling interview (and the

records of such information) as confidential to be

discussed with no one except the student in counseling.

Furthermore, the counselors were united in their

disagreement (92% disagree)--though a majority of

administrators were in agreement--regarding the position

that a counselor ought to furnish any information

obtained in a counseling situation to parents or the

principal upon legitimate request. Clark made a point

that the official position of the counseling profession

is one of limited confidentiality to minors; that is,

when a pupil is a minor with the attendant legal, moral,

and other responsibilities on the parent and school, such

information must be shared with them in some form or

manner. Nonetheless, these counselors did not support

the official position, instead taking the position that









they should maintain complete confidentiality of

information received during counseling.

Hart and Price (1970) compared principals'

expectations of counselor dimensions with ideal counselor

roles as seen by counselor educators. Confidentiality

was one area in which principals and counselor educators

differed; indeed all principals "differed markedly" from

the ideal role as viewed by counselor educators.

Within the college or university setting, the

psychotherapist often has conflicting roles. Blaine

(1964) pointed out that, although maintaining the

private, confidential nature in therapy is a primary

responsibility of the therapist, various situations may

arise wherein communicating student information to

administrators is necessary. Szasz (1967) examined the

role of the college psychotherapist, describing him as a

double agent with divided loyalties between students

(including minor students) and the institution. He

contended that college-employed therapists are so willing

to break confidences of their patients whenever they

personally consider it in the best interest of the

patient, the institution or the community, that "any

reference to 'confidentiality' is absurd" (p. 18).

Besides the allegiance to the institution of the

school lies the question of parental rights. While

diverse opinions are present in the literature regarding

minor clients in general, within the school setting,







73

parental rights tend to be acknowledged, although with

varying degrees of intensity. When the psychotherapeutic

relationship exists between student and counselor or

school psychologist, Blue (1973) and Goslin (1971) both

emphasized the importance of obtaining parental consent

and only secondarily mention that the consent of the

students is sometimes desirable. Along this same line,

Trachtman (1974) has clearly stated that he perceives the

parent as the client when the child is undergoing

counseling at school. The school, then, was viewed as an

instrument for the satisfaction of the parent.

McDermott (1972), however, acknowledged that

decisions as to whether or not to inform parents of facts

or professed facts revealed by pupil-clients are

difficult to make. While recognizing the importance of

confidentiality, he asserted that the pupil-client should

be informed that withholding confidence is not

guaranteed. He stated that the school employee

(counselor or psychologist) has neither the ethical or

legal prerogative to make an absolute confidential

agreement, nor does the child have the right to exercise

such requests or to give consent. He concluded that

parents "possess an unforfeitable right to all pertinent

information regarding their children" (p. 29). St. John

and Walden (1976) also emphasized the obligation to give

parents "information which will assist them in their

parental responsibilities" (p. 683).









Moore and McKee (1979) have offered case studies to

illustrate the complexity of the school counselor's role

and the rights of parents. They explored the difficulty

of deciding at what point to break a student's private

communications. Their case studies focused on child

abuse and neglect, including what constitutes suspicion

of abuse and how to differentiate between abuse and

discipline. Considering counselor responsibilities as

well as rights of students and their parents' rights, a

major counselor concern is how to decide whether to

breach student confidentiality in such cases.



Counselor Perceptions and Practices

Apparently school counselors have many questions

about their obligation to parents, students, school

personnel and outside agencies. Guildroy (1979) has

offered case studies to assist school counselors in

exploring their attitudes and judgements with regard to

issues of confidentiality; he also addressed the

ambiguities inherent in such cases.

Wagner (1981) studied the beliefs and behaviors of

school counselors in regard to confidentiality using a

questionnaire based on the American Personnel and

Guidance Association's 1974 ethical standards as the

referent. Results indicated that confidentiality was

valued by most school counselors. Seventy percent

strongly agreed that the same degree of counseling









confidentiality should be maintained with children as

with adults. Data revealed significant differences,

however, in behavior reported by counselors at different

levels.

The patterns in the data suggest the elementary
counselors show the least endorsement of this
behavior, and the secondary school counselors
the greatest endorsement. This suggests that
as clients get older, school counselors are
more likely to maintain the confidential nature
of counseling relationships. (p. 306)

The question of whether the counselor was

responsible only to parents or guardians for release of

information obtained in child counseling met with

"tremendous diversity." Neither was there agreement

among respondents on the issue of whether questions

regarding confidentiality with students could be resolved

by considering the child's maturity and specific

situations.

In terms of state laws pertaining to "privileged

communication," elementary school counselors were

significantly higher in their reports of being aware and

informed, although 70% of all respondents agreed that

they were satisfied with existing state laws. As far as

decision making, elementary counselors were the most

likely, and secondary the least likely, to involve

parents in decision making; this pattern was maintained

regardless of counselors' judgement about the value of

involving parents. The author noted that the younger the









client, the greater the counselor's allegiance to

parents. Wagner concluded the following:

When children and youth are the client, they
should have control over the release of
information that results from their choice to
engage in the therapeutic process. Exceptions
would result in cases in which they waived that
right by free choice in cases of documented
child abuse, or in cases of threat to self or
society. . The professional associations
(e.g., ASCA, ACES) and university trainers need
to provide preservice and inservice training to
school counselors so they may explore ethical
counselor behavior. (p. 310)

It was recommended that regular sessions for counselors

and related professionals to discuss troublesome cases

may help reduce isolation and encourage sharing of

intervention strategies.

A survey by Eisele (1974) examined the probable

behavior of school counselors regarding the disclosure of

confidential information. Ten real-life ethical

situations were included on a questionnaire to a random

sample of current members of the American School

Counselor Association (ASCA). The results of this study

showed that counselors would withhold confidential

information to protect their clients' welfare. Two

factors leading to the decision to reveal confidential

information were: The possibility of harm to someone

other than their client if they remain silent, and the

internal pressure from the counselor's own value system,

rather than external coercion. Once the decision to

reveal or withhold information was made, most counselors






77

felt a strong sense of conviction in the correctness of

their decision. Factors having little effect on the

counselors' decision were personal and social variables

and whether the counselor worked in a state with a

privileged communication law.

Curran (1969) conducted a survey of the policies and

practices of colleges and universities in the United

States and Canada concerning confidentiality in student

mental health services. The sample included various

types and sizes of schools. The great majority of

replies revealed that parents are not routinely informed

of counseling, contacts for consultation, or short-term,

outpatient, crisis-oriented treatment, though parents are

generally notified of emergencies, such as

hospitalization or suicide attempts. The majority of

schools held this position even when the college students

were minors. A few schools who do not notify parents of

minors noted that they were uncomfortable about the

policy. One large eastern university stated

We realize that certain legal objections may be
raised to our policy of not routinely notifying
parents of minors about treatment or referral
of their children . .; however, we feel our
present policy is advisable and justifiable.
(pp. 1522-1523)

Another school's position was to "put therapeutic

considerations first, and let other aspects, including

legal ones, come later" (p. 1523).









Perceptions of students themselves have not been

extensively studied but do provide an additional

perspective. Conclusions from studies of student

responses to declarations of childrens' rights suggests

that within the school setting, safeguarding children's

rights is the concomitant responsibility of children and

parents, as well as school employees such as teachers,

counselors and school psychologists (Nixon, 1982). As

far as self-disclosure, high school students vary in the

extent to which they make themselves known to significant

others at home and at school regarding various aspects of

their lives (Sparks, 1977).

Swager (1981), in reviewing how self-disclosure

findings may be applicable to school counseling,

concluded that counselors need to address specific

questions relating to students' age. Trachtman (1974)

suggested that the school psychologist or counselor

examine each instance of his/her behavior with an

elementary school child, then consider how he/she might

behave differently if the client were a college student.

Any differences in behavior must be defensible because

the therapist is clearly differentiating between

appropriate behavior with a child and an adult.

Trachtman further recommended that the therapist consider

whether the line should be drawn between elementary

school and junior or senior high school.









Expectations and Explanations

Client Assumptions and Expectations

One of the most important characteristics of

confidentiality is that the individual intended the

information to be confidential within the framework of

the relationship. In any therapeutic encounter, clients

bring with them preconceived expectations formed

idiosyncratically from life experiences. Fong and Cox

(1983) noted that while clients' expectations range from

blind trust of any counselor to distrust and suspicion

regardless of evidence to the contrary, most clients fall

in the middle range. That is, they are "willing to trust

a counselor until their trust is abused" (p. 163),

although some may first test the counselor's trust.

Plaut (1974) stated that people typically expect

confidentiality when they meet their therapist. Studies

have indicated that subjects do have implicit

expectations of confidentiality (Edelman & Snead, 1972)

and that they simply assume that whatever they say will

be held in confidence (Woods, 1977).

Using uncoerced and anonymous responses from a short

questionnaire administered to a junior-level psychology

class, Meyer and Smith (1977) explored what the term

"confidentiality" meant to the respondents. The

overwhelming majority (84%) assumed that confidentiality

included a refusal to testify about a case even if

validly ordered to do so by a court of law; only 16%









perceived confidentiality to mean therapist avoidance of

discussion of cases in general conversation or in

publications. Even professionals' perceptions of their

clients suggest this same implicit assumption of

confidentiality. In their survey of mental health

professionals, Jagim et al. (1978) found that 95% of

respondents indicated that they believed clients expected

that therapy communications would remain confidential

(64% very strongly agree, 29% strongly agree, 2% agree).

Pardue et al. (1970) pointed out that, historically,

confidentiality has been viewed as implicit in all

educational levels, apparently including both the

counseling relationship and the maintenance of case

records. Cass and Curran (1965) similarly focused on the

doctor-patient relationship, noting that the trust of

patients in their physicians rests in the concept of

expected silence. It appears that the confidential

relationship expected between the physician and patient

may contribute to clients' expectations of

confidentiality in any related advisory profession.

Perhaps patients in therapy confide more personally

than any other individuals in society because they expose

not only direct verbal expressions but also their entire

selves, including dreams, fantasies, "sins," and shame

(Guttsmacher & Welhofen, 1952). Typically, patients who

enter psychotherapy know that such revelations are

expected; without them, the clients cannot be helped. To







81

expect them to enter the relationship believing that what

they said may be revealed in public could hardly be

considered therapeutic.

Everstine et al. (1980) reminded that clients may

inadvertantly, and inadvisedly, waive their right to

privacy simply by entering in the psychotherapeutic

relationship. Hence, these authors postulated that

clients should be given sufficient opportunity for

reflection on whether or not to waive their rights. Some

authors (e.g., Seigal, 1979; Slawson, 1969; Szasz, 1967)

have gone so far as to state that to adequately protect

the client's confidentiality, therapists should have no

communications with any third party.

Beyond clients' expectations of implicit

confidentiality are the assumptions that help will be

forthcoming from the therapist. While the instillation

of hope is viewed as a facilitative condition for

effective therapy (Yalom, 1975), the client may

erroneously assume that the therapist can solve anything

and everything. This unrealistic expectation may lead to

unrealistic goals which could ultimately be deleterious

to the client. Karasu (1980) pointed out that misleading

expectations may be perpetrated by the therapist when the

need to instill hope becomes intertwined with the aura of

omniscience.

Even in group settings, members tend to expect

confidentiality. Research has suggested that group









participants assume that confidences divulged in group

therapy have the same protection as those made in

individual sessions (Meyer & Smith, 1977). This

assumption is questionable, however, because a privileged

communication may be voided through disclosure to a third

party, even where there is a statutory provision for

privileged communication (Meyer, 1974). In effect,

confidentiality is "lost" because the person has made the

communication public by revealing it. While there are

some exceptions to the third party rule, courts generally

do not easily recognize these.

Clients appear to have higher expectations of mental

health workers than of other professionals who might

delve into personal histories. In a study of avowed

self-disclosure, Edelman and Snead (1972) found that

subjects revealed more personal information to mental

health professionals in a simulated psychiatric interview

than to individuals in a controlled employment interview

situation. Moreover, this research revealed

statistically that mental health professionals differed

from the control group (personnel managers) in the extent

of confidential information they avowedly elicited.

Results clearly indicated that subjects would reveal more

intimate information to mental health workers than to

potential employers.

In general, then, clients seem to have an implicit

trust and expectation of confidentiality in counseling.









Perhaps the mental set of assured confidentiality is

based in our history or culture or rests in the

precedence of other professional advisory relationships.

Clients generally expect the mental health professional

to help, reveal more to him/her than to other

professionals, and assume that their disclosures will be

kept confidential.



Counselor Explanations and Assurances

If clients do indeed have implicit expectations of

confidentiality, certainly counselors have an obligation

to address such expectations. Moreover, research

suggests that counselors' verbal explanations and/or

assurances may affect clients' perceptions and indeed

their willingness to self-disclose. Findings, however,

are inconclusive.

The ethical codes of various helping professions

already examined consistently indicate that the

professional not only has an obligation to maintain

confidentiality of communications except in cases of

danger but also has a responsibility to explain to

clients the concept and limitations of confidentiality.

For the public school setting, counselors should be

particularly cognizant of the ASCA code which states that

the school counselor:

Informs the counselee of the purposes, goals,
techniques, and rules of procedure under which
she/he may receive counseling assistance at or









before the time when the counseling
relationship is entered. Prior notice includes
the possible necessity for consulting with
other professionals, privileged communication,
and legal or authoritative restraints. (ASCA,
1984, p. 7)

The earlier ASCA position statement also emphasized the

importance of explaining limitation of counseling

confidentiality as opposed to verbal assurances. School

counselors were expected to review with students "any

conflicting responsibilities as they relate to the legal

and/or individual limits to confidentiality" (ASCA, 1976,

p. 284). In addition, school counselors are expected to

inform significant others--students' parents and school

personnel--about the issues of confidentiality (ASCA,

1984).

Ware (1971) emphasized that when counseling minor

clients, spelling out the limits of confidentiality from

the beginning of the relationship has a major advantage.

It allows the counselor to avoid the uncomfortable

position of feeling forced to violate the youth's

confidence at a later date. Likewise, McDermott (1972)

stressed the importance of informing the minor client

that maintenance of confidentiality could not be

guaranteed, especially within a school setting.

For a group setting, Davis (1980) concluded that

leaders must give an accurate presentation of

confidentiality so members have the choice of how much

they disclose to others. This is particularly relevant

in that results of Davis' research indiated that members









who perceived that the leader was talking about them to

others thought they could do the same thing--talk to

their friends. The distinction, then, should be made

between discussing cases for professional purposes and

inappropriate violations of confidences.

In practice, school counselors seem to agree on the

necessity of explaining the limits of confidentiality to

their students. In Wagner's (1981) survey, all

respondents, regardless of setting (elementary or

secondary) stated that they do explain existing limits to

their clients. Furthermore, 80% answered that they

consider such factors as age, maturity and problem, when

defining those limits.
"Interestingly, little research actually addresses

the effects of explaining limitations, although a number

of studies have empirically investigated the effect of

verbal assurances of privacy or confidentiality. Early

research (Asch, 1951) suggested that people are much more

likely to disclose nonconforming opinions, attitudes and

judgements if requested to disclose in private rather

than in public. Similarly, Baizerman (1974) suggested

that anonymity offered to youths, such as over telephone

hotlines, greatly increases self-disclosure. In a study

of college women, Fidler and Kleinecht (1977) found that

when requesting sensitive and possibly stigmatizing

information, the interview technique which guaranteed

anonymity produced the most responses to highly sensitive









questions. Singer (1978) also studied the impact of

assurances of confidentiality upon response rate to

personal questions. A lower non-response rate and a more

favorable perception of requests for personal information

were found among subjects who had been assured absolute

confidentiality.

Woods and McNamara (1980) studied the effects of

variations in the confidentiality condition on depth of

self-disclosure of college students wherein the research

condition was specifically designed to be analogous to

the psychotherapeutic relationship. Open-ended

questions, derived from Jourard's (1971a) self-disclosure

questionnaire, were utilized, and subjects were randomly

divided into three experimental conditions: No

expectations, confidentiality assured, and no

confidentiality. Subjects' responses to individual

interviews were rated on depth of self-disclosure and

intimacy level. Results revealed that depth of

self-disclosure was significantly related to instructions

regarding assurances of confidentiality. The authors

concluded that lack of assured confidentiality was

related to reductions in self-disclosure.

Meyer and Smith (1977) concluded, after

administering a questionnaire to university students,

that without assurances of confidentiality,

self-disclosure in group therapy may be inhibited.

Eighty-two percent of the respondents stated they would







87

either choose not to enter a group, or would enter with

substantially less inclination to reveal information

within the group, when they had been told that the

information discussed would not be considered

confidential. Even when confidentiality was pledged by

the leader and group members, but the leader stated that

he would reveal specific information in the unlikely

event he were validly court ordered, 47% still would not

enter or would enter with substantially less inclination

to reveal information.

Other results have yielded less conclusive results.

Edelman and Snead (1972) found that subjects did not

require explicit assurances of confidentiality to

self-disclose. Rather, subjects who were given no

instruction revealed as much information as subjects who

were explictly informed that the information given was to

be held confidential. Similarly, in a study by Woods

(1977), subjects reported that they had assumed that

whatever they said would be held in confidence regardless

of confidentiality condition.

Even when advised differently, clients have refused

to accept "flawed" or limited confidentiality (possibly

unconsciously). In Meyer and Smith's (1977) study,

respondents who were read a statement explaining the

limits of confidentiality (that it is an ethical or

professional concept and does not carry legal power or

precedent) were asked to indicate whether or not they







88

expected the therapist to keep information confidential.

Responses were the following: Eighty-eight yes, 9%

undecided, and 3% no. As Noll (1974) has asserted, even

clients who have been informed of the conditions of

confidentiality are often not aware of the potential

consequences of release of information.

The study by Kobocow et al. (1983) also attempted to

measure the effects of varying degrees of assurance of

confidentiality on frequency of self-disclosure. A

self-disclosure questionnaire was administered to

junior-high students who had been divided into three

different conditions: Confidentiality explicitly

assured, no instructions regarding confidentiality, and

confidentiality explicitly not assured. Results did not

support the main hypothesis that adolescents would more

frequently disclose personal and possibly stigmatizing

information under conditions of explicit assurance of

absolute confidentiality. Rather, adolescents were found

to be "very self-protective regardless of the degree of

privacy given by an adult" (p. 441). The authors

suggested, however that client expectations may have been

related to subjects' failure to discriminate between

conditions.

The quiet, secluded interview situation
(perhaps similar to experiences with a guidance
counselor) may have aroused strong expectancies
of confidentiality, although instructions to
many participants were to the contrary. The
posttest questionnaire data, which reflect a
highly significant over-occurrence of recall of









confidential instructions and a
disproportionate underreporting of
non-confidential and neutral instructions, is
consistent with this interpretation. (p. 440)

Inconclusive results have been reported in a study

by Graves (1982), in which college students were given

low, moderate and high degrees of assured confidentiality

during a personal interview. The author concluded that
"although results were not statistically significant, a

trend consistent with this hypothesis [that amount of

client self-disclosure is directly dependent on the

degree of assured confidentiality] was supported by the

experimental results" (p. 68).

Even in the study by Singer (1978) in which a

confidentiality-assured condition produced the lowest

rate of nonresponding, the nonresponding occurred most

frequently on items referring to specific behaviors

rather than feelings or attitudes. It appears that

explicit verbal assurances of confidentiality are not

sufficient to overcome defensiveness in those areas

wherein severe social sanctions may be imposed for actual

deviance from accepted standards of conduct.

In a previous study by this author (Messenger &

McGuire, 1981), children age 6 to 15 who were in

counseling at a mental health center were individually

interviewed on a confidentiality questionnaire. Results

revealed that whether or not clients believe

confidentiality has been adequately explained to them

does not significantly affect their actual conception of




Full Text
108
room, and teacher and principal contact, was left to the
discretion of the participating counselor. However, each
of the three groups (two experimental and one control)
from each classroom were seen consecutively in one day.
All participating counselors attended a one-hour
training session which allowed for review of procedures
in detail and practice through role playing (see Appendix
F). The week before the study, the counselor briefly
spoke with all students in the participating classroom.
All subjects were told that the class had been specially
selected to particpate in a project with the counselor
which would entail separating into small groups different
from their previous "teams" for one more session and
answering some questions on paper-and-pencil tasks. At
this time, the parent permission forms (see Appendix G)
were distributed and explained to students.
In order to protect the anonymity of respondents,
students were each assigned a code number, with the
master list being available only to the researcher. Each
code number was four digits, whereby the first digit
represented the experimental condition (1-3), the next
two digits represented the student's placement in the
class list (01-32), and the final digit represented the
school number (1-8). For example 3075 would indicate
condition number 3 (control), student number 7, and
school number 5.


ACKNOWLEDGEMENTS
This project was truly an exercise in field-based
research, with major support for development,
implementation and data analysis received through
professionals in Orange County schools. Foremost,
appreciation is extended to Ms. Juanita Borysewich,
Director of Guidance, and Ms. Harriette Merhill,
Coordinator, for acting as outstanding female role models
in the field and for providing direction throughout the
project. Dr. Wesley Blamick of the Department of Program
Evaluation deserves special recognition for his generous
donations of time, energy and expertise in
computer-assisted data analysis. Thanks and a hat-tip go
to Ms. Annie Williams for assisting in the tedious task
of scoring responses, to Ms. Kathy Keating for reading
the first drafts, and to Ms. Cindy Green for typing the
final manuscript.
To the school counselors (Ron Duval, Debbie Griffin,
Joyce Henry, Cathy Pope, Susan Stephens, Sonia Warner,
Barry Weber and Mary Wyatt) and the sixth-grade classes
who participated, I am truly endebted. To my supervisor,
Dr. Kelland Livesaywho supported the efforts of a
full-time employee/studentand to my friends and
colleagueswho knew when to converse and when to give
iv


112
following data for each subject: (1) a total
confidentiality score? (2) subarea confidentiality
scores; (3) a group trust score; (4) subscale scores of
group trust; (5) sex; and (6) race.
The use of the Statistical Package for Social
Sciences, SPSS, (Nie et al., 1975) computer program was
arranged with Orange County school to assist with data
analysis. SPSS, which is an integrated system of
computer programs, was judged to have a number of
advantages for data analysis in this study. Nie et al.
(1975) identified that it allows many different types of
data analyses in a simple and convenient manner, it
allows much flexibility in the format of data, and it
offers the researcher a large number of statistical
routines commonly used in the social sciences.
As Isaac and Michael (1981) noted, "many times, in
studies suitable for analysis of variance, there will be
initial differences between groups on pretest criteria."
(p. 183). The pretest criteria in this case were
measures of students' attitude toward group environment,
that is, scores on the Group Environment Questionnaire.
As each subscale of this instrument (Cohesion and Leader
Support) has a maximum of 9 points, the total score of
the GEQ could range from 0 to 18. Analysis of variance
was performed using these scores to identify any
significant differences among groups for the independent
variables of experimental conditions, sex, and race. If


91
findings are inconclusive. Some research suggests that
expectations may be so strong, they do not change
regardless of degree of assured confidentiality, and
other research suggests that real-life experiences may be
more important to clients than verbal discussion.
Summary of the Related Literature
This review of the related literature has attempted
to bring clarification to the dynamics of trust in a
counseling relationship by suggesting that expressiveness
and self-disclosure are crucial to process and outcome
yet can be affected by a number of variables (e.g., sex,
age, ethnicity or technology). Intricately tied to the
aspect of trust is the counselor's responsibility to
protect client self-disclosures and maintain the
confidentiality of communications.
The issue of confidentiality has received
considerable attention in the published literature.
Practicioners appear increasingly concerned, and most
helping professions directly address confidentiality in
their ethical codes. Even so, legal statutes and
policies related to privileged communication and case
records vary considerably across the nation.
As in the case of one-to-one counseling, group
leaders have indicated confidentiality to be an essential
component in the entire group process, particularly in
regard to the development of trust among members and


15
Faith in the counselor is one of the
greatest aids to recovery. A doctor should
be careful never to betray the secrets of
his patients, for if a man knows that other
men's secrets are well kept, he will be
readier to trust him with his own. (cited
in Graves, 1982, p. 15)
In discussing counseling as a series of
interpersonal processes, Brammer (1973) described
trust/mistrust as a client perception which can help or
hinder the therapeutic relationship. Indeed, Fong and
Cox (1983) identified the client's perception of trust as
a dimension in the first stage of counseling which must
be developed in order for the "real work" of counseling
to begin.
Without the development of confidence and trust, two
undesirable outcomes are likely. The counselee may
become resistant and present nothing more than
superficial problems (Shertzer & Stone, 1976). Or the
counselee may prematurely terminate, sensing that it is
too threatening to risk significant self-disclosure with
the counselor (Fong & Cox, 1983).
Research supports predictions of negative
consequences of clients' distrust of their therapists.
Using tape-recorded, "semi-structured" interviews,
Schmid, Appelbaum, Roth and Lidz (1983) concluded that
psychiatric inpatients do highly value trust and
confidentiality in the therapeutic setting and are
concerned about the possibility of unauthorized
disclosures. Seventy-seven percent of the respondents


UNIVERSITY OF FLORIDA
3 1262 08555 2791


37
McDermott, 1972). Hollender (cited in Dubey, 1974) went
so far as to divide psychotherapy into two categories:
patient-oriented and society-oriented. In the latter
case, the therapist is "more or less the agent of people
or agencies other than the patient" (p. 1094). The
therapist does not necessarily promise confidence in such
a setting but may instead deliberately use the client's
information to exert power in influencing the patient's
social milieu.
J.H. Wigmore (1961) recommended four criteria for
the validity of a privileged communication.
1. The communications must originate in a
confidence that they will not be
disclosed [Schmidt (1962) clarified
that because a communication is made
in an expressed or implied confidence
does not necessarily allow it
privilege, however];
2. the element of confidentiality must be
essential to the full and satisfactory
maintenance of the relationship;
3. the relation must be one which in the
opinion of the community ought to be
sedulously fostered; and
4. the injury that would inure to the
relation by the disclosure of the
communication must be greater than the
benefit thereby gained for the correct
disposal of litigation.
The key words and phrases apparently qualify
psychotherapeutic consultations for the protection
offered by this privilege. Moreover, therapists have
some legal leeway in that they are under no obligation to
reveal information considered confidential unless under


25
(age 9 to 11 years) did not significantly differ; nor
were the scores of the middle group significantly
different from those of the oldest group (age 12 to 15
years). Interestingly, however, the total mean score of
the youngest age group was significantly lower than the
total mean score of the oldest group. The authors
concluded that children evolve a conception of
confidentiality in psychotherapy gradually as they grow
older. Very young children may misinterpret some of the
basic stipulates of confidentiality in the counseling
relationship. This conclusion was underscored by the
fact that the youngest children scored significantly
lower than either of the older groups on the specific
subarea concerning confidential information being
released only with the client's express permission.
Moreover, the young adolescents (oldest group) held
particularly conservative, negative attitudes regarding
the necessity of breaking confidentiality under any
circumstances. Similarly, Kobocow et al. (1983)
concluded that adolescents are extremely cautious about
confidentiality and disclosure issues. Such findings
suggest that children in counseling may have to be dealt
with differently, depending on age in order to maximize
self-disclosure.
Ethnicity. A number of demographic characteristics
of the discloser, particularly education, ethnicity,
race, religion, socio-economic status and vocational


77
felt a strong sense of conviction in the correctness of
their decision. Factors having little effect on the
counselors' decision were personal and social variables
and whether the counselor worked in a state with a
privileged communication law.
Curran (1969) conducted a survey of the policies and
practices of colleges and universities in the United
States and Canada concerning confidentiality in student
mental health services. The sample included various
types and sizes of schools. The great majority of
replies revealed that parents are not routinely informed
of counseling, contacts for consultation, or short-term,
outpatient, crisis-oriented treatment, though parents are
generally notified of emergencies, such as
hospitalization or suicide attempts. The majority of
schools held this position even when the college students
were minors. A few schools who do not notify parents of
minors noted that they were uncomfortable about the
policy. One large eastern university stated
We realize that certain legal objections may be
raised to our policy of not routinely notifying
parents of minors about treatment or referral
of their children . .; however, we feel our
present policy is advisable and justifiable.
(pp. 1522-1523)
Another school's position was to "put therapeutic
considerations first, and let other aspects, including
legal ones, come later" (p. 1523).


100
for other variables such as levels of socio-economic
status, school achievement, and intellectual functioning.
It is noteworthy that in the structured guidance
units, students had previously been divided into "teams"
for various activities. The researcher, however, mixed
these teams and redivided subjects into the treatment
conditions to control for the possibility that group
norms may have already been established in some of the
teams.
TABLE 3-3 DISTRIBUTION OF SUBJECTS INTO EXPERIMENTAL
CONDITIONS ACCORDING TO SEX AND RACE
SEX RACE
MALE FEMALE WHITE ETHNIC MINORITY
GROUP
N
%
N
%
N
%
N
%
Ei
28
50.9
27
49.1
35
63.6
20
36.4
E2
27
49.1
28
50.9
33
60.0
22
40.0
C
30
58.8
21
41.2
33
64.7
18
35.3
TOTAL
85
52.8
76
47.2
101
62.7
60
37.3
It is
also
probable
that
students
selected
for the
study
ran the range from non-participation in some of the six
class sessions (i.e. a new student to the school or one
with frequent absences) to involvement with the counselor
in a more intimate relationship than would occur during
the class session (i.e. a student in individual
counseling or one participating in a problem-focused
small group). Nonetheless, through random assignment,


55
Other authors have considered whether it is the parents*
or the child's right to waive the privilege (Shah, 1969b;
Geiser and Rheingold, 1964.)
This dilemma raises the further question of exactly
who the client is in psychotherapeutic treatment of a
minor. Some authors believe that the parent represents
the child-client while others contend that
confidentiality is just as essential in therapy with
children as with adults. This diversity of opinion is
greatly attributable to the fact that each therpist's
"idea of guarding secrets is considerably predetermined
not only by his personality structure but also by his
professional development" (Lowental, 1974, p. 236). A
further complication is the difficulty in defining
exactly "Who is a child?" when maturity levels vary so
greatly.
In discussing the individual's rights during
psychological treatment, Ackley (1974) stated that "the
services of the psychologist are rendered to a client and
belong to the client" and that "the client is the person
who has come to the psychologist for professional
services, whether he has come on his own initiative or
has been referred by another" (p. 21). He continued,
however, that "the parent of a minor who is a client has
the right of the client" (p. 21). He further maintained
that working independently of parents invades the
personal rights of both child and parent, the implication


88
expected the therapist to keep information confidential.
Responses were the following: Eighty-eight yes, 9%
undecided, and 3% no. As Noll (1974) has asserted, even
clients who have been informed of the conditions of
confidentiality are often not aware of the potential
consequences of release of information.
The study by Kobocow et al. (1983) also attempted to
measure the effects of varying degrees of assurance of
confidentiality on frequency of self-disclosure. A
self-disclosure questionnaire was administered to
junior-high students who had been divided into three
different conditions: Confidentiality explicitly
assured, no instructions regarding confidentiality, and
confidentiality explicitly not assured. Results did not
support the main hypothesis that adolescents would more
frequently disclose personal and possibly stigmatizing
information under conditions of explicit assurance of
absolute confidentiality. Rather, adolescents were found
to be "very self-protective regardless of the degree of
privacy given by an adult" (p. 441). The authors
suggested, however that client expectations may have been
related to subjects' failure to discriminate between
conditions.
The quiet, secluded interview situation
(perhaps similar to experiences with a guidance
counselor) may have aroused strong expectancies
of confidentiality, although instructions to
many participants were to the contrary. The
posttest questionnaire data, which reflect a
highly significant over-occurrence of recall of


128
research used in this study was addressed in Chapter III,
including a description of the hypotheses, population,
sample, criterion instruments, procedures, analyses of
data, and methodological limitations. Analyses of the
data were reported in Chapter IV.
Discussion of Results
Group Environment Questionnaire
Although the pretreatment assessment was not the
primary focus of the present study, the results are of
interest. For students who had participated in a
structured program of classroom guidance units with their
school counselor, no significant differences in attitude
toward group environment were identified for sex of
students (male/female) or race of students (white/ethnic
minority). Additionally, the random assignment of
students to experimental conditions by the researcher
appeared to be adequate control for any individual
variations in group attitude.
Child Confidentiality Questionnaire
As can be readily discerned from the data, this
study did not generate support for HC>2the hypothesis
that no relationship would exist between the combination
of counselors' explanations and members' role playing
case situations about confidentiality and subjects'
knowledge of confidentiality as measured by CCQ scores.


3
Why is confidentiality in counseling with students
and other minor clients such a hotly debated issue? The
reason is found in literature which consistently
emphasizes trust and self-exploration as critical
elements in the counseling process. Self-disclosure is a
client behavior heavily dependent upon the client's
perception of confidence and trust with the counselor.
Effective counseling depends largely on the disclosure of
highly private information, so that both counselor and
client can have increased insight and understanding,
ultimately leading to more effective functioning for the
client. Most successful clients increasingly explore
their problems as therapy progresses (Blau, 1953;
Braaten, 1958; Egan, 1975; Seeman, 1949; Steele, 1948;
Truax and Carkhuff, 1967; Wolfson, 1949), and the role of
the therapist, in both traditional psychotherapy and
contemporary counseling, has been to facilitate the
self-exploration process. Nonetheless, the
responsibility to protect clients' privacy and maintain
the confidentiality of their communications is of
increasing concern to counselors, with both ethical and
legal implications. In addition to the ambiguity of
professions' ethical standards, there are the complex and
controversial issues of privileged communication as a
legal statute and the status of student records.
Despite the numerous exhortations regarding the
various issues, few actual studies have been done in the


101
such extremes in existing level of counselor relationship
were expected to even out statistically and, moreover,
any differences in pretreatment perceptions of the group
environment (including members and counselor) were
assessed. In consideration of internal validity, the
sequence of groups varied at each school.
Experimental Group 1 (El) experienced the treatment
whereby counselors instructed the students on the
conception and limitations of confidentiality.
Counselors verbally explained and outlined in writing
their responsibilities regarding confidentiality and
encouraged group discussion of a time members kept a
secret. The limitation of confidentiality was then
explained and group discussion of a time members may have
broken a secret to help someone was encouraged.
Experimental Group 2 (E2) experienced the treatment
whereby counselors provided this identical verbal
emphasis and also reinforced the concept of
confidentiality by member role playing. After group
discussion, students were presented with two case
examples and enacted the roles of counselor, teacher,
principal and/or parent in each situation. For each
case, students were requested to discuss whether
confidentiality should be maintained or breached, giving
a rationale for their decision based on the stipulates of
confidentiality already instructed by the counselor.
Subjects in the Control Group (C) did participate in a


122
Analysis of variance for Area 2 (confidential
information revealed only when clear, imminent danger)
did reveal a signficant difference for experimental
condition (F = 3.564; df = 2/149; £ < .004). Further
analysis of this difference (Scheffe's test; alpha = 0.10
level) revealed that the E2 group scored significantly
higher than the C group, although there were no
significant differences between C and El groups or
between El and E2 groups.
For Area 4 (confidential information released only
with client's express permission), analysis of variance
again revealed a significant difference for experimental
condition (F = 3.394; df = 2/149; £ < .036). Similarly,
further analysis of this difference (Scheffe's test;
alpha = 0.10 level) revealed that the E2 group scored
significantly higher than the C group, although there
were no significant differences between C and El groups
or between El and E2 groups.
Finally, race appeared as a significant variable for
Area 3 (confidential information discussed only for
professional purposes, not with family and friends) based
on analysis of variance (F = 5.864; df = 1/149; £ <
.017). Further analysis of this difference (2-tailed
t-test; £ < .008) revealed that the ethnic minority
group, with a mean score of 2.9667, scored significantly


41
intended to protect students' interests, particularly
their privacy. McGuire and Borowy (1978), however,
discussed the pertinent literature and concluded that
"the Buckley Amendment may be interpreted as being
consistent with established ethical and legal practices
of protecting the privacy of professional counseling
records" (p. 555). They did note, though, that the
decision of whether to release professional
communications to a counselee or student should be based
on the purposes for which the material was obtained
(e.g., for personal counseling versus degree-program
requirements).
The other side of confidentiality of case records
concerns releasing information to personnel within the
institution and outside sources. Miller (1971) stressed
the importance of safeguarding test data in particular
against improper dissemination. He pointed out that the
threat of information misuse may be exaggerated with test
data because of "the illusion of 'hardness' created by
numerical test scores or percentile ratings" (p. 94).
Friedenberg (1964) examined the effect on the
students' inner life and emotional dynamics when school
records are revealed to outside agencies.
By permitting agencies outside the
student-counselor relationship to use its
records, the school strikes at the very
roots of clarity and growth. It invades
the unconscious . throwing up barriers
of anxiety against self understanding . .
that it has made it dangerous for the


142
authoritative restraints," what then is the best approach
to take? The finding that children gradually evolve a
conception of confidentiality with increased exposure to
and involvement with it, plus the finding that verbal
discussion alone may decrease willingness to disclose,
adds credence to the importance of a behavioral
component. Having students role play case situations to
reinforce counselors' verbal explanation appears to be
the optimal method. While verbal discussion might meet
the counselor's ethical responsibility, it does not
appear to be sufficient alone to allow students to
internalize the complexity of confidentiality issues.
It is important to recognize that for the case
situations which were role played, no "right" or "wrong"
answers were supplied. Rather, the students were asked
to make a decision whether to maintain or breach
confidentiality using the stipulates which had been
explained for a rationale. It is stressed that the
essential factor was involvement in application of the
conceptnot agreeing with a preexisting counselor
opinion.
This research also demonstrates that use of small
group sessions is an adequate, time-efficient way to
reach a large number of students. Pupils from an entire
class may all participate in separate small group
sessions without significant disruption in classroom
routine.


180
Eisele, J. H. (1974). A survey of the reported probable
behavior of school counselors regarding the
disclosure of confidential information (Doctoral
dissertation, University of Florida, 1973).
Dissertation Abstracts International, 35, 819A.
(University Microfilms No. 74-29, 374).
Everstine, L., Everstine, D. S., Heymann, G. M., True, R.
H., Frey, D. H., Johnson, H. G., & Seiden, R. H.
(1980). Privacy and confidentiality in
psychotherapy. American Psychologist, 35, 828-840.
Fidler, D. s., & Kleinecht, R. E. (1977). Randomized
response versus direct questioning: Two
data-collection methods for sensitive information.
Psychological Bulletin, 84, 1045-1049.
Fong, M. L., & Cox, B. G. (1983). Trust as an underlying
dynamic in the counseling process: How clients test
trust. Personnel and Guidance Journal, 62, 163-166.
Ford, D. H., & Urban, H. B. (1963). Systems of
psychotherapy. New York: John Wiley & Sons.
Franco, J. N., & Levine, E. (1981). An analogue study of
counselor ethnicity and client preference. Hispanic
Journal of Behavioral Sciences, 2, 177-183.
Frerqueron, M. E. (1974). A study of selected aspects of
privileged communication as related to school
counselors, with particular reference to Florida
(Doctoral dissertation, Florida State University,
1973). Dissertation Abstracts International, 35,
819A. (University Microfilms No. 74-29, 1098).
Friedenberg, E. Z. (1964). The vanishing adolescent.
Boston, MA: Beacon Press.
Gazda, G. M. (1978). Group counseling: A developmental
approach (2nd ed.). Boston, MA: Allyn & Bacon.
Geiser, R. L., & Rheingold, P. D. (1964). Psychology and
the legal process: Testimonial privileged
communications. American Psychologist, 19, 831-837.
Goldman, L., (1972). Psychological secrecy and openness
in the public schools. Professional Psychology, 3,
370-374. ~
Goldstein, A., & Katz, J. (1962). Psychiatrist-patient
privilege: The GAP proposal and the Connecticut
statue. American Journal of Psychiatry, 118,
733-739.


26
affiliation, have been reported to have a significant
relationship to self-disclosure (Cozby, 1973; Jourard,
1961). Greco and McDavis (1978) pointed out that culture
can affect clients' perceptions, behaviors and choices.
In a discussion of the black population, McDavis
(1980) reviewed the historical background and current
status of this minority group and identified specific
problems such as labeling, discrimination, and lack of
role models, which may adversely affect the counseling
relationship. Avila and Avila (1980) reviewed factors
impacting on the counseling relationship with
Mexican-Americans, concluding with recommendations to
facilitate communication. Sue (1978; 1980) explored the
personal and counseling needs of Asian Americans, noting
that their learned patterns of emotional restraint and
formality may interfere with self-disclosure in social
interactions, specifically in counseling. Anderson and
Ellis (1980) suggested self-disclosure may be inhibited
in American Indians because they may develop
misdirections and ambiguities to avoid having to disagree
or contradict another individual, such as the counselor.
Franco and Levine (1981) declared that Hispanics and
Blacks are less disclosing than Anglo-Americans.
However, in a series of three studies by these authors
(Levine & Franco, 1980), results were inconclusive.
Study 1 showed Anglo and Hispanic students to be equally
comfortable with Anglo or Hispanic counselors; Study 2


82
participants assume that confidences divulged in group
therapy have the same protection as those made in
individual sessions (Meyer & Smith, 1977). This
assumption is questionable, however, because a privileged
communication may be voided through disclosure to a third
party, even where there is a statutory provision for
privileged communication (Meyer, 1974). In effect,
confidentiality is "lost" because the person has made the
communication public by revealing it. While there are
some exceptions to the third party rule, courts generally
do not easily recognize these.
Clients appear to have higher expectations of mental
health workers than of other professionals who might
delve into personal histories. In a study of avowed
self-disclosure, Edelman and Snead (1972) found that
subjects revealed more personal information to mental
health professionals in a simulated psychiatric interview
than to individuals in a controlled employment interview
situation. Moreover, this research revealed
statistically that mental health professionals differed
from the control group (personnel managers) in the extent
of confidential information they avowedly elicited.
Results clearly indicated that subjects would reveal more
intimate information to mental health workers than to
potential employers.
In general, then, clients seem to have an implicit
trust and expectation of confidentiality in counseling.


134
Finally, the combination of verbal explanation with
role playing brought perception of group trust back up,
significantly higher than explanation alone, so that
scores here did not significantly differ from the control
group (although the total mean score was still lower).
One explanation is that members' role playing may have
allowed subjects to experience the complexities of
decision-making about maintaining or breaking
confidentiality from the counselors' perspective. That
is, the role playing allowed students to actually apply
the stipulates which had been explained, so that
defensiveness and suspiciousness was reduced. Another
explanation is that within this group, the guidance
sessions actually fostered self-disclosure. This
explanation is supported by the observation that the
majority of counselors reported that when leading this
group session, the students tended to spontaneously
disclose some extremely personal information regarding
family, friends or selves about which the presented case
situations reminded them. Consequently, there was
greater willingness to express and self-disclose despite
increased awareness of the limitations of
confidentiality. It should also be noted that on several
of the questionnaires of subjects in this group (and only
in this group) unelicited comments were written in the
margins stating that the participants had enjoyed their
group experience.


47
Similar to individualized sessions, trust affects
expressiveness and self-disclosure in group process.
While Gazda (1978) emphasized that self-disclosure is one
of the most basic components of group process, he
believed that the level of group self-disclosure is
greatly dependent upon the trust members have in each
other. If sufficient trust exists, members express
spontaneously and openly their thoughts and feelings.
Gazda further asserted that expressions of here-and-now
feelings, beliefs, and attitudes are highly desirable and
actively sought in most groups.
Yalom (1975) believed self-disclosure to be a
prerequisite for the formation of meaningful
interpersonal relations in the group situation. If
acceptance of others is preliminary to acceptance of
self, then the individual must gradually permit others to
know him as he really is, if he is to ever gain
self-acceptance. As far as self-help groups, Mowrer
(1973), in his philosophy of helping, asserted that
self-disclosure is central. The client, if he wants to
be helped, must reveal himself completely to the other
members in the self-help group; in this setting, the
leader's self-disclosure is also considered essential.
Immediate and total self-disclosure is characteristic of
many peer self-help groups, such as Alcholics Anonymous
(Hurvitz, 1970).


APPENDIX J
STANDARD INSTRUCTIONS FOR SUBJECTS
Initial Instructions
Hi 1 My name is Charlene Messenger-ward, and I want to
tell you about our project today 1 First of all, do you
know how many elementary schools there are in Orange
County? (67) This class is one class in only eight
schools that get to participate in this projectl Mostly,
we want to find out what students your age think about
school, and your counselor, and things like that.
Remember your counselor talked with you about the
small groups you had for study skills? Today we are
going to do something like that. First, we will answer
some questions about what you think about the groups you
already did. Do not mark on this paper until I tell you
(pass out the GEQ). Now take your name off the paper so
no one will know whose answers are whose. No one else
but me will see your answers. That way, you can be as
honest as you want about your opinions.
Now I will ready each item and you mark your answer
with an X. Mark "True" if you think the statement is
true or mostly true of the group. If you think the
statement is false or mostly false of the groups, make an
X on the word "False." Please be sure to answer every
item. I will repeat any that you wish if you raise your
hand.
174


187
Rogers, C. (1970). Carl Rogers on encounter groups. New
York: Harper & Row.
Rosen, C. E. (1977). Why clients relinquish their rights
to privacy under sign-away pressures. Professional
Psychology, 8, 17-24.
Rosenberg, A. H., & Katz, A. S. (1972). Legal issues of
consent in the psychiatric treatment of minors.
Mental Health Digest, 4, 54-56.
Ross, A. 0. (1966). Confidentiality in child therapy, a
reevaluation. Mental Hygiene, 42, 60-66.
Saint John, W., & Walden, J. (1976). Keeping student
confidences. Phi Delta Kappan, 57, 682-684.
Sampson, J. P., & Pyle, K. R. (1983). Ethical issues
involved with the use of computer-assisted
counseling, testing, and guidance systems.
Personnel and Guidance Journal, 61, 283-286.
Schmid, D., Appelbaum, P. A., Roth, L. H., & Lidz, C.
(1983). Confidentiality in psychiatry: A Study of
the patient's view. Hospital and Community
Psychiatry, 34, 353-355.
Schmidt, L. D. (1962). Some legal considerations for
counseling and clinical psychologists. Journal of
Counseling Psychology, £, 35-44.
Seeman, J. A. (1949). A study of the process of
non-directive therapy. Journal of Consulting
Psychology, 13, 157-168.
Sellers, J. (1983). The effects of stress innoculation
training and conversations skills training on shy
(communication-apprehensive) college students.
(Doctoral dissertation, University of Florida,
1982). Dissertation Abstracts International, 43,
289A. (University Microfilms No. 83-022, 99).
Shah, S. A. (1969a). Privileged communications,
confidentiality and privacy: Privileged
communications. Professional Psychology, 1^, 56-69.
Shah, S. A. (1969b). Privileged communications,
confidentiality and privacy: Confidentiality.
Professional Psychology, 1_, 159-164.
Shafer, J. D. (1974). Committee report: Privileged
communications. Paper presented at the convention
of the American Personnel and Guidance Association,
New Orleans, LA.


50
The very act of telling a client that he
may rightfully refuse to sign a consent
form can indicate to the client that he too
is, and has the right to be, a decision
maker. Such an act may be the type of
communication that many clients need to
hear in order for a substantial improvement
to occur in their self-image and feeling of
self-worth. (p. 23)
Ross (1966) concluded that trust, more than
confidentiality may be the "critical ingredient in
dealing with young patients.
Ethical Standards
The codes of ethical standards of the various
helping professions are considerably vague in reference
to minor clients. The AACD Ethical Standards never
specifically addresses minor clients but rather refers to
all clients in general terms. Statements in Sections A
and B specify
In the counseling relationship, the
counselor is aware of the intimacy of the
relationship and maintains respect for the
client. . The member must recognize the
need for client freedom of choice. Under
those circumstances where this is not
possible, the member must appraise clients
of restrictions that may limit their
freedom of choice. (AACD, 1981, unpaged)
Nowhere, however, does the code clearly differentiate
between the counselor's ethical responsibility to the
child-client versus an adult client.
The APA has shown an interesting pattern in their
various publications in regard to ethical codes, as if
members were struggling with the issue of where minor


10
Confidential communication is "a statement made
under circumstances that clearly show the speaker
intended the statement only for the ears of the person
addressed; thus if the communication is made to the
counselor in the presence of a third party whose presence
is not reasonably necessary in order to achieve the
pupil's counseling goals" (p. 11), the communication is
not confidential (California State Department of
Education [C.S.D.E.], 1982).
Group Trust is the "therapeutic atmosphere necessary
for openness and risk taking on the part of the members"
(Corey, 1981, p. 33). Operationally, group trust has
been considered to be assessed through the subscales of
Expressiveness and Self-Discovery of the Group
Environment Scale (Moos, 1981).
Informed consent is "a person's agreement to allow
something to happen that is based on a full disclosure
and presumed understanding of facts needed to make a
decision intelligently; i.e., knowledge of risks
involved, alternatives available, and so forth"
(C.S.D.E., 1982, p. 12).
Judicial means related to or connected with the
administration of justice; having the character of formal
legal procedure; proceeding from a court of justice.
Minor refers to being under legal age, which varies
from state to state; in Florida, legal age is
18-years-old.


95
sex and race and randomly assigned to one of two
experimental groups or a control group. Prior to actual
treatment conditions, all students in each class
completed an instrument assessing attitude toward group
environment, specifically perceptions of member cohesion
and leader support. While this was not a pretest to
measure treatment effects, it was used to determine
whether there were initial differences among groups prior
to treatment. If significant initial differences were
observed, analysis of covariance would have been utilized
with the posttest data.
The experimental design is depicted in the following
table:
TABLE 3-1 EXPERIMENTAL DESIGN
Group
Independent Variable
Posttest
(R)*
E1
X1
Y2
(R)
E2
X2
Y2
(R)
C

Y2
*(R) refers to random assignment.


116
A second threat to external generalizability
concerns reactive arrangements. Campbell and Stanley
noted "a most prominent source of unrepresentativeness is
the patent artificiality of the experimental setting and
the student's knowledge he is participating in an
experiment" (p. 20). This is considered to have been a
minimal threat by this researcher. Although the students
may have been alerted to the idea of a research situation
by the parent permission, the actual research guidance
session was designed to appear to students as an
extension of the classroom units in which they had
already participated. Further, as Campbell and Stanley
have noted, this threat is reduced when the treatment
conditions are "conducted by regular staff of the schools
concerned" (p. 21), as did occur in this study.
A third threat to external generalizability is the
possibility of pretest sensitization effects. However,
it was judged most appropriate to have a measure of
pretreatment equality or inequality of groups. The
pretest assessed only members/leader perception prior to
treatment in order to control for previous norms which
may have been established between counselors and
students. It was not used to measure changes due to
treatment conditions.
A fourth threat is that "the more obvious the
connection between the experimental treatment and the
posttest content, the more likely this effect becomes"


APPENDIX A
STUDENT LIST
School
Counselor
CHECK ONE
First Name (and Last Sex Race
Initial if necessary) Male Female Ethnic White
Minority
1 51


APPENDIX I
CASE SITUATIONS FOR ROLE PLAYING
I. A girl is in a group like this one, and the
students are talking about their families. Some
people are happy with their family and some are
not. The girl says she hates her father and
wishes her parents would get divorced, so she
could just live with her mother.
Later the girl's parents come into school for a
conference with the teacher. They ask the
counselor to come in. Then they ask the
counselor what the girl said in counseling.
They say they want to know because the girl is
starting to make bad grades in school.
What should the counselor do?
II. A boy is talking to the counselor. He says he
does not have any friends and is mad about it.
He is really mad at one boy who teases him. He
says he is going to beat him up at recess. The
boy tells the counselor he even brought a pocket
knife to school so that when they fight, he can
win.
No one comes to the counselor and asks what the
boy said. Everyone is just in their own room.
Only the counselor knows what the boy said.
What should the counselor do?
173


49
Generally, then, trust and confidentiality are
equally important in group settings as in individual
counseling. Self-expression, however, may be initially
inhibited by members' fear of disclosure of confidential
communications to others outside the group. Only within
an atmosphere of trust will expressiveness and
self-discovery be enhanced.
Minor Clients
The foregoing considerations of trust,
confidentiality and self-disclosure have presented a
number of aspects and implications for practicing
counselors. The discussion, however, has remained
focused on the therapist/client relationship in general,
in both individual and group settings. When the client
is a minor, numerous other issues become salient, many of
which represent diverse opinions.
As far as trust, research suggests that clients' age
does affect their conceptualization of confidentiality in
the therapeutic relationship (Kobocow et al., 1983;
Messenger & McGuire, 1981). It appears that young
clients, as well as adults, respond positively to their
recognition of a right to self-determination. This would
appear to include a full explanation of the counselor's
responsibilities for as well as limitations of
confidentiality in counseling. Interestingly, Rosen
(1977) has stated


75
confidentiality should be maintained with children as
with adults. Data revealed significant differences,
however, in behavior reported by counselors at different
levels.
The patterns in the data suggest the elementary
counselors show the least endorsement of this
behavior, and the secondary school counselors
the greatest endorsement. This suggests that
as clients get older, school counselors are
more likely to maintain the confidential nature
of counseling relationships. (p. 306)
The question of whether the counselor was
responsible only to parents or guardians for release of
information obtained in child counseling met with
"tremendous diversity." Neither was there agreement
among respondents on the issue of whether questions
regarding confidentiality with students could be resolved
by considering the child's maturity and specific
situations.
In terms of state laws pertaining to "privileged
communication," elementary school counselors were
significantly higher in their reports of being aware and
informed, although 70% of all respondents agreed that
they were satisfied with existing state laws. As far as
decision making, elementary counselors were the most
likely, and secondary the least likely, to involve
parents in decision making? this pattern was maintained
regardless of counselors' judgement about the value of
involving parents. The author noted that the younger the


189
Szasz, T. S. (1967). The ethics and politics of college
psychiatry. American Journal of Orthopsychiatry,
27, 288-289.
Thompson, S., & Kahn, J. H. (1970). The group process as
a helping technique: A textbook for social workers,
psychologists, doctors, teachers, and other workers
in community services. Oxford: Pergamon Press.
Trachtman, G. M. (1972). Pupils, parents, privacy, and
the school psychologist. American Psychologist, 27,
37-45.
Trachtman, G. M. (1974). Ethical issues in school
psychology. School Psychology Digest, _3, 4-15.
Truax, C. B. (1961). The process of group psychotherapy:
Relationships between hypothesized therapeutic
conditions and intrapersonal exploration
(Psychological Monograph No. 75). University of
Wisconsin: Wisconsin Psychiatric Institute,
Psychotherapy Research Group.
Truax, C. B., & Carkhuff, R. R. (1965). Client and
therapist transparency in the psychotherapeutic
encounter. Journal of Counseling Psychology, 12,
3-9.
Truax, C. B., & Carkhuff, R. R. (1967). Effective
counseling and psychotherapy: Training and
practice. Boston: Alpine Publishers.
Vondracek, F. W., & Marshall, M. J. (1971).
Self-disclosure and interpersonal trust: An
exploratory study. Psychological Reports, 28,
235-240.
Vorrath, B., & Bredtro, Z. (1974). Positive peer
culture. Chicago, IL: Adline Publishers.
Wagner, C. A. (1978). Elementary school counselor's
perceptions of confidentiality with children.
School Counselor, 25, 240-247.
Wagner, C. A. (1981). Confidentiality and the school
counselor. Personal and Guidance Journal, 59,
305-310.
Ware, M. L. (1971). The law and counselor ethics.
Personnel and Guidance Journal, 50, 305-310.


SCORING SHEET FOR
CHILD CONFIDENTIALITY QUESTIONNAIRE
Area 1
Area 2
Area 3
Area 4
Area 5
TOTAL


33
confidentiality is the protection of the client from
unauthorized disclosure by the professional, maintaining
confidentiality, particularly with the client's
expectations of protection, appears as one of the most
complicated yet pervasive issues facing the profession.
Each professional organization specifies its own ethical
codes designed to prevent unauthorized disclosure of
clients' communications.
The American Association for Counseling and
Development (AACD) clearly supports the practice of
maintaining confidentiality. In its Ethical Standards,
Section B, Counseling Relationship, subsections 2, 4, 5
and 7 stipulate that
The counseling relationship and information
resulting therefrom be kept confidential,
consistent with the obligations of the
member as a professional person . when
the client's condition indicates that there
is clear and imminent danger to the client
or others, the member must take reasonable
personal action or inform responsible
authorities. . Revelation to others of
counseling material must occur only upon
the expressed consent of the client. . .
The member must inform the client of . .
limitations that may affect the
relationship at or before the time that the
counseling is entered. (AACD, 1981,
unpaged)
The American Psychological Association's (APA)
Ethical Standards state a very similar position.
Principle 5, Confidentiality, reads that
Psychologists have a primary obligation to
respect the confidentiality of information
obtained from the persons in the course of


23
associated with less empathy, insight, and, consequently,
a shorter lifespan, than females.
Other authors have asserted that there are no
differences between males and females in levels of
self-disclosure. Cozby (1973), from his review of the
literature, claimed no study (to that date) verified
greater disclosure by one sex. A number of studies have
shown no sex differences on the variable (Dimond &
Hellkamp, 1969; Doster & Strickland, 1969; Plog, 1965;
Rickers-Ovsiankina & Kusmin, 1958; Vondracek & Marshall,
1971; Weigle, Weigle, & Chadwick, 1969).
Woods (1977) also found no sex differences in
disclosure by males and females under conditions of
confidentiality. Under conditions of nonconfidentiality,
however, females disclosed less. In Messenger and
McGuire's (1981) study, there were no sex differences in
total scores on the confidentiality questionnaire.
Nevertheless, it was found that male subjects scored
significantly lower on the subarea concerning the
therapist's responsibility to explain the limits of
confidentiality. The authors concluded that either
female children simply interpret this responsibility as
part of their counselor's job while boys are less
concerned with this aspect or female children more than
male children look for verbal assurances and explanations
during psychotherapy.


Area 5
The psychologist's responsibility to explain
limits of confidentiality:
1. Is your counselor supposed to tell you
what things he cannot keep secret from
other people?
2. Should your counselor tell you whether
or not he/she can keep your secrets
before you talk to him/her?
3. Suppose (pretend) your counselor has to
tell your parents certain kinds of
things. Should he/she let you know that
first so you can keep some secrets to
yourself?
4. Should your counselor let you know if
some things you say cannot be kept secret?


168
age might think is a kind of problem they
don't want a lot of people to know about?
Facilitate brief discussion. Give examples such
as failing at school or divorce at home if
necessary to get the discussion started.
State:
There might be a time even when someone in
this group wants to talk to me or to
another counselor about something kind of
personal. So that you will know more about
it, I want to teach you a little more about
this word 'confidentiality.'
List each of these three "rules," stopping after
each one to explain it briefly and answer any
questions.
1. It is my job to make sure that the things
people say to me in counseling are kept
secret. [Area 1]
2. I will not repeat the things someone says
in counseling to other people who do not
need to know about it. [Area 3]
3. If I do want to talk to someone else about
the things you said in counseling, I should
ask your permission first. [Area 4]
Facilitate discussion about a time each member
kept a secret of someone else'swhy they did,
what it felt like. After making certain that
students understanding this concept, state:
You know there are exceptions to every
rule. Just like in Spelling. You learn a
spelling rule and then find out there are
times that words don't follow the rule. So
about this confidentiality, we have to add
two more things.


131
differing in their cognitive understanding of the concept
of confidentiality. The current findings do, however,
support previous research utilizing this same
confidentiality instrument wherein no significant
differences were found between males and females for
total confidentiality scores and for four of the five
subarea scores (Messenger & McGuire, 1981).
Regarding HC>4the hypothesis that no significant
relationship would exist between race and knowledge of
confidentialitythe results are most interesting. As
far as total mean score, no significant differences were
evident for the two groups of subjects divided as ethnic
minority and white, non-hispanic. Neither were
significant differences evident for four of the five
subareas. For Area 3, however, statistical differences
beyond the .05 level revealed that ethnic minority
subjects scored lower than white subjects. Because this
area concerned information being discussed only for
professional purposes, closer examination of the
questions involved appears warrented. The four questions
in this subarea explore the client's belief that the
counselor should not reveal client self-disclosures to
others such as parents and friends simply as a matter of
course. One explanation may lie in the work of previous
writers (Anderson & Ellis, 1980; Avila & Avila, 1980;
McDavis, 1980; Sue, 1978, 1980) who conclude that various
ethnic minority groups have very strong bonds with family


18
defined self-disclosure as the central process in
personality change. He further observed that the amount
of personal information that one person is willing to
disclose to another can be considered an index of the
closeness of the relationship and of the affection, love
and/or trust that exists between the two individuals.
Generally speaking, self-disclosure and cathexis for the
person may be said to be correlated.
Both systematic research and clinical observation
support this proposition (e.g., Blau, 1953; Braaten,
1958; Jourard, 1959; Jourard, 1971a; Kotter, 1980;
Seeman, 1949; Steele, 1948; Sparks, 1977; Swager, 1981;
Wolfson, 1949). When indifference and antipathy exists
between two people, low disclosure to each other and
little knowledge about one another as persons are the
resulting consequences. In contrast, therapists have
noted that clients who feel warmth, trust and confidence
will self-explore and self-disclose more readily and
freely than when they perceive the therapist as hostile
or punitive. Jourard (1968) wrote, "My willingness to
disclose myself to you, to drop my mask is a factor in
your trusting me and daring then to disclose yourself to
me" (p. 125).
Truax and Carkhuff (1965) suggested that adequate
self-disclosing behavior is predictive of therapeutic
outcome. During psychotherapy, both client and therapist
are engaged in attempts at self-understanding. The


35
Another professional organization which has
attempted to specify, although in only the broadest of
terms, a provision for guarding the confidential
communication of clients in its Code of Ethics is the
National Association of Social Workers (NASW, 1967). The
code stipulates: "I respect the privacy of the people I
serve" and "I use in a responsible manner information
gained in professional relationships." Additionally,
other helping professions, such as the American Hospital
Association and the Group for the Advancement of
Psychiatry, have been actively studying issues of
confidentiality and its maintenance (Reynolds, 1976).
The ethical standards of these various organizations show
that a relationship of confidence and trust is essential
to psychotherapeutic treatment.
Privileged Communication
Where legal testimonial privilege exists, the
client is protected from the possibility that private
information will be used as testimony in judicial
proceedings without his permission (Shah, 1969a). Most
frequently, the purpose of privileged communication is to
encourage confidential communication essential to
effective treatment and to prevent unwarranted
humiliation from courtroom exposure of intimate
information (Davis, 1971).


141
students more closely conform to ethical codes
stipulating that the professional should be very cautious
in sharing client disclosures, ethnic minority student do
not seem to be as concerned with this restriction.
Rather, bonds with family and friends appear so important
that, even after instruction and role playing, minority
students perceive that family and friends may have access
to disclosure without violating client confidentiality.
Implications
Considering the data from this study, a number of
important implications are apparent. As suggested by the
ethical standards of various helping professions, this
research does support the need to directly address the
issue of confidentiality with clients. Without it, they
may misinterpret some of the basic stipulates. Were a
situation to arise that necessitated breaking a
confidence and the child had not been forewarned of such
a possibility, the effect on future therapy may be
devastating. Thus, the benefits of addressing in detail
the limits of confidentiality seem to outweigh potential
difficulties.
Implications for practicioners are specific. If the
ethical code of school counselors stipulates that they
should inform counselees of rules of procedure ... at
or before the time when the counseling relationship is
entered" (ASCA, 1984, p. 7) including possible "legal or


178
Burcky, W. D., & Childers, J. H., Jr. (1976). Buckley
Amendment: Focus on a professional dilemma. School
Counselor, 23, 162-164.
California State Department of Education (1982). A
handbook regarding confidentiality as a right of
pupils in counselor-pupil exchanges. Sacremento,
CA: Bureau of Publications.
Campbell, D. T., & Stanley, J. C. (1963). Experimental
and quasi-experimental designs for research.
Chicago, IL: Rank McNally.
Carkhuff, R. R., & Pierce, R. M. (1975). The art of
helping: An introduction to life skills. Amherst,
MA: Human Resource Development Press.
Cass, L. J. & Curran, W. J. (1965). Rights of privacy in
medical practice. The Lancet, 2_, 783-788.
Chelune, G. J. (1976). Self-disclosure situations
survey: A new approach to measuring
self-disclosure. JASM Catalog of Selective
Documents in Psychology, 111-112, (Ms. No 1367).
Christiansen, H. D. (1972). Ethics in counseling:
Problem situations. Tucson, AZ: University of
Arizona Press.
Clark, C. M. (1967). Confidentiality and the school
counselor. In C. H. Petterson (Ed.), The counselor
in the school. New York: McGraw-Hill.
Corder, B. B., Haizlip, T. M., & Spears, L. D. (1976).
Legal issues in the treatment of adolescent
psychiatric in-patients. Hospital and Community
Psychiatry, 27, 712-715.
Corey, G. (1981). Theory and practice of counseling and
psychotherapy (2nd ed.). Belmont, CA: Wadsworth,
Inc.
Cozby, P. C. (1973). Self-disclosure: A literature
review. Psychological Bulletin, 79, 73-91.
Curran, W. J. (1969). Policies and practices concerning
confidentiality in college mental health services in
the United States and Canada. American Journal of
Psychiatry, 125, 1520-1530.
Cutler, M. H. (1975). If the new student privacy law has
you confused, perhaps that's because you're sane.
The American School Board Journal, 162, 47-49.


APPENDIX F
TRAINING SESSION FOR COUNSELORS
Purpose: To familiarize counselors with the structured
guidance session and provide an opportunity for
practice of the standard instructions and
sequence.
Materials needed: Copies of Guidance Session Units
(Appendix H); chalkboard and chalk.
Approximate time required: One hour.
Preparation: Prior to the training session, counselors
will have received a packet of materials
including a description of the research
design a sample parent permission form for
review, and a Student List (Appendix A) to
have completed.
Procedures:
I. The researcher will distribute the copies of the
Guidance Session Units. As the counselors
review this, the researcher will explain in
general terms the three experimental conditions,
using the chalkboard for graphic representation.
II. The researcher will role play the school
counselor entering the classroom and explaining
to students that the class will be divided up
into small groups for one more session and
distributing the parent permission form letters
with an explanation to students.
164


96
Population
The population for this study was sixth-grade
students who had participated in optional introductory
classroom guidance units in Orange County Public Schools
(O.C.P.S.) for the 1983-1984 school year. The program,
developed by Dr. Robert Myrick, Professor, Counselor
Education Department, University of Florida, and Ms.
Harriette Merhill, Coordinator of Guidance, O.C.P.S.,
emphasizes counselor-led classroom guidance on student
attitudes, with six sessions for each grade level (Myrick
& Merhill, 1983). At the sixth-grade level, sessions
focus on improving study habits, with topics such as
"Planning your Study" and "Coping with Stress." For the
1983-1984 school year, 38 of 67 elementary schools had
counselors implementing the optional introductory unit
within at least one sixth-grade classroom.
The sixth-grade level was selected for research for
several reasons. Previous research (Messenger & McGuire,
1981) suggested that at this age, children are in a
transition phase in developing their conception of
confidentiality in counseling. Further, the classroom
guidance units at this level were judged by the
researcher to be the least personal and private of the
available units, with sessions being focused on school
and academic improvement. Consequently, there was less
likelihood that issues related to confidentiality would
have surfaced previously in this group.


27
showed Anglo males and females and Hispanic females to
prefer directive communication about some topics,
depending on the counselor's sex and ethnicity; and Study
3 showed that specific self-report, self-disclosure
patterns vary with the counselors' sex and ethnicity.
Jourard and Lasakow (1958) reported less
self-disclosure by blacks than by whites. Dimond and
Hellkamp (1969) replicated this finding and additionally
reported less self-disclosure by Mexican-Americans than
by Blacks. Jourard (1961) found that Jewish males were
significantly higher in self-disclosure than Baptist,
Catholics and Methodists, while none of the latter
significantly differed from one another. The various
findings, then, suggest that ethnicity may be a
significant variable in the development of counseling
trust and self-disclosure.
Technology. Recent technological advances
increasingly bring the client's protection of
confidentiality in conflict with society's right to know.
Plaut (1974) suggested that this escalting conflict
exists because of increasing government involvement in
areas which were previously considered private affairs;
electronic revolution in data collection, storage and
retrieval; and prevailing atmospheres of suspicion
between individuals and powerful authority figures. The
resultant inhibition of confidence by clients can be most


40
ethics of confidentiality in the counseling relationship,
particularly since the ethical standards of numerous
helping professions directly address that information
resulting from a counseling relationship is to be kept
confidential. The AACD Ethical Standards, Section B,
subsection 5, clearly specifies
Records of the counseling relationship,
including interview notes, test data,
correspondence, tape recordings, and other
documents, are to be considered
professional information for use in
counseling and they should not be
considered a part of the institution or
agency in which the counselor is employed
unless specified by state statute or
regulation. Revelation to others of
counseling material must occur only upon
the expressed consent of the client.
(AACD, 1981)
Wilson (1978) asserted that there is certain
information that does not belong in a case record,
regardless of type of recording method used. Reasons to
eliminate data from a student's record would include
potential use of such material being against the best
interest of the client and/or agency if it were to be
supbpoenaed and possible negative effects upon clients
themselves should they see the entries. In her opinion,
material such as narrative recordings, information
regarding a client's political, religious or other
personal views, and extremely intimate personal details
have no place in any case record.
Kazalunas (1977) has asserted that revealing
confidences is now made possible by an act which was


115
according to the stipulates for confidentiality for
psychologists' client, regardless of age. As far as the
GES, subscale reliability is not perfect, although it is
high. Moreover, both the CCQ and the GES are self-report
indices. As Sellers (1982) pointed out, "responses to
self-report indices may not be accurate since they rely
on the subjects' degree of self-awareness and willingness
to divulge aspects of their personal and interpersonal
behavior" (p. 52).
Strongest concerns may be with limitations of
external generalizability. Readily evident is the fact
that the eight participating counselors, from the
population of 38 doing the structured guidance units,
were volunteers. Campbell and Stanley (1963) note that
"generally speaking, the greater the amount of
cooperation involved, the greater the amount of
disruption of routine, . the more opportunity there
is for a selection-specificity effect" (p. 19). Such an
effect may well have occurred in this study. However, it
was judged by this researcher to be the best practice to
have interested, cooperative counselors since the study
was one focusing on the counselor/client relationship.
Moreover, sampling representativeness was increased by
randomly choosing participating counselors from the list
of all volunteers and by having a sufficient number of
different schools participating, rather than all subjects
from only one or two schools.


175
Posttreatment Instructions
Welcome back from your group 1 Some of you look like
you really enjoyed it. Now we are going to answer some
more questions like the ones before, only this will be a
little longer. You still mark your answers with an X
after I read you each statement. When we are all
through, you will get a little reward for your
participation (show sticker or coupon).
Most of these questions are about your teacher or
counselor. Some of the things may sound alike but just
answer them anyway. Remember it is all your own opinion,
and your name is not on the sheet. Try to answer
everything honestly, because no one else at the school,
nor your parents, will see your answers.
Try to think if the groups you had with your
counselor today can help you answer the questions better.
Remember to answer every question, and I will repeat any
you wish if you raise your hand (pass out GTQ and CCQ).


48
In a study of group psychotherapy, Peres (1947) had
found that successful and unsuccessful group
psychotherapy differed in that successful patients in
group therapy made significantly more personal references
over the course of therapy when compared to unsuccessful
patients. Indeed, the benefited patients made almost
twice as many personal references as did the
non-benefited patients. Research by Truax and Carkhuff
(1967) also has shown that patients' success in group
therapy correlated with their transparency during the
course of the group. Lieberman, Yalom and Miles (1972)
found that in encounter groups, individuals who had
negative outcomes revealed less of themselves than did
the other participants. Azima (1974), in describing a
useful strategy for group work with adolescents, noted
that one of the salient problems encountered is the fear
of self-disclosure.
Research by Drag (1969) suggested that the
two-person discussion group may self-disclose more than
eight-person groups, but not more than four-person
groups. Other findings, however, indicate that people
may disclose more or less readily in groups larger than
dyads, dependent upon the composition of the audience
(Chelune, 1976). Furthermore, the mode of communication
appears to affect the clients' perceptions of the
dilution they may expect for protection of personal
utterances (Spinner, 1978).


145
findings do not suggest this is a particularly critical
area of concern.
Outside the university level, similar implications
apply to supervisors of practicing counselors. Staff
development opportunitieswith sufficient motivation to
attend and participateshould be offered in order for
counselors to expand their knowledge (e.g., the new ASCA
guidelines), increase their skill (e.g., group techniques
such as role playing), and share their experiences (e.g.,
previous confidentiality dilemmas).
Recommendations for Further Research
Based on the results of this study, recommendations
for further research seem warranted. The following
studies are, therefore, suggested for use in conducting
research in the area of child-client confidentiality.
1. A longer-range study appears appropriate to
clarify issues of retention of information and
differences in perception after time. One possibility is
to conduct this confidentiality guidance session prior to
initiation of the classroom guidance units. Then, after
the six structured units, data could be obtained
regarding knowledge of confidentiality and perception of
group trust.
2. Larger units of subjects might be considered to
explore the efficacy of the confidentiality guidance
session as a classroom unit. Thus, instead of one class


Ill
Hypotheses
Knowledge of confidentiality and perception of group
trust were evaluated as a function of treatment
condition, subjects' sex, and subjects' race. The
following null hypotheses were investigated:
H0^: No relationship will exist between counselors'
explanation of confidentiality (ethical
responsibility and limitations) and subjects'
knowledge of confidentiality as measured by CCQ
scores.
HO^: No relationship will exist between the combination
of counselors' explanation and members' role playing
case situations about confidentiality and subjects'
knowledge of confidentiality as measured by CCQ
scores.
HO^: No relationship will exist between subjects' sex and
their knowledge of confidentiality as measured by
CCQ scores.
HO^: No relationship will exist between subjects' race
and their knowledge of confidentiality as measured
by CCQ scores.
HO^: No relationship will exist between counselors'
explanation of confidentiality (ethical
responsibility and limitations) and subjects'
perception of group trust as measured by GTQ scores.
H0^: No relationship will exist between the combination
of counselors' explanation and members' role playing
case situations about confidentiality and subjects'
perception of group trust as measured by GTQ scores.
HO^: No relationship will exist between subjects' sex and
their perception of group trust as measured by GTQ
scores.
HOg: No relationship will exist between subjects' race
and their perception of group trust as measured by
GTQ scores.
Data Analysis
In addition to the pretreatment scores of perception
of group environment, this research gathered the


61
condition of the client rather than chronological age in
determining the approach to be taken in dealing with
parents (Slovenko, 1966).
Ladd (1971) has presented the intriguing suggestion
of drawing formal distinctions between the ways in which
different age groups of children should be treated. He
suggested that those who deal with minors should
categorize them as young children (6 to 9), older
children (10 to 13), and youths (14 to 17) and should
delineate rights and prerogatives for each category.
Under such a plan, a 15-year-olds problem may be treated
with a confidentiality not appropriate to a 10- or
12-year-old. Ladd asserted that such a graded system
. . would have at least the merit of
forcing both parents and professionals to
take account of a young person's expanding
rights and to realize that . the time
is coming for him to be . entitled to
all the rights of adulthood. (p. 268)
Rosenberg and Katz (1972) pointed out that some
minors are capable of acting autonomously and are capable
of making decisions about psychotherapy. In considering
the rights of children in general, Arthur (1973) wrote
that the child should be given the freedom to choose
between alternatives once he is about to "recognize each
alternative, forecast its consequence, and compare the
advantages and disadvantages" (p. 137). Without such
maturity, however, the child's choice between available
alternatives may be needlessly harmful to self or to
others.


TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS iv
ABSTRACT ix
CHAPTER
I INTRODUCTION 1
Need for the Study 4
Purpose of the Study 6
Rationale of the Study 7
Research Questions 8
Definition of Terms 9
Organization of the Study 11
II REVIEW OF THE RELATED LITERATURE .... 13
Overview 13
Trust 14
Expressiveness and Self-Discovery . 17
Counselors' Professionalism 20
Other Variables 21
Sex 21
Age 24
Ethnicity 25
Technology 27
Confidentiality 30
Ethical Standards 32
Privileged Communication 35
Case Records 38
Group Settings 42
Minor Clients 49
Ethical Standards 50
Legal Issues 54
Practice and Trends 59
School Counseling 63
Ethical and Legal Aspects 64
Confused Alligiance 69
Counselor Perceptions and Practices 74
Expectations and Explanations 79
Client Assumptions and Expectations 79
Counselor Explanations and Assurances. 83
Summary of the Related Literature .... 91
vi


CHAPTER III
METHODOLOGY
While confidentiality has generally been considered
important to the development of trust during the
counseling process, maintaining the confidentiality of
child-client's communications has been of concern to
counselors in both private and public settings. Within
the school setting, more research is needed to determine
what effects the things counselors say and do about
confidentiality have upon students' knowledge and
perceptions. This study investigated whether the issue
of confidentiality as presented by counselors'
instructions, and by group members' role playing, had an
effect upon (1) knowledge of confidentiality in a
counseling relationship and (2) perception of group
trust.
Research Design
This study used a control group, posttest-only
design. To allow for continuity in development of a
counseling relationship, students selected for this
research previously participated in a six-session,
structured classroom guidance unit with their school
counselor. Students from each class were stratified by
94


Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philisophy
KNOWLEDGE OF CONFIDENTIALITY AND PERCEPTION OF GROUP TRUST:
THE EFFECTS OF COUNSELORS' EXPLANATIONS, STUDENTS
ROLE PLAYING, AND SUBJECTS' SEX AND RACE
By
Charlene Marie Messenger-ward
August 1984
Chairperson: Dr. Paul Fitzgerald
Major Department: Counselor Education
Despite the importance of trust and self-disclosure
in counseling process and outcome, there is a paucity of
research focusing on confidentiality with child-clients,
particularly students. This study investigated the
effects of school counselors' direct address of
confidentiality on sixth-grade students' knowledge of
confidentiality and perception of group trust. Small
groups were arranged by dividing into thirds each of
eight classrooms wherein a preexisting relationship had
been developed with the counselor through classroom
guidance. One group in each classroom had discussion of
confidentiality (explanation-only group); a second group
had discussion and role playing (explanation/role-playing
group); and a third group served as a control, receiving
ix


60
It should be noted that even though the therapists
tended to respect the confidentiality of the
minor-clients, their responses were quite variant. The
author hypothesized that much of the variance was
attributable to lack of agreement among professionals as
to how they should behave. Within this sample, some
individuals experienced considerable conflict regarding
the nature of their relationship with a minor in therapy
while others experienced virtually no conflict. This and
other studies (e.g., Curran, 1969; McRae, cited in Clark,
1967; Eisele, 1974) reveal a trend among psychologists
and counselors to maintain confidentiality of minors.
This trend to maintain confidentiality in
psychotherapeutic relationships with minor clients exists
despite ethical codes and legal standards which dictate
welfare of the child to the parents or guardians. It is
interesting that the prevailing practice of notification
of parents in the treatment of minors for mental illness
is just the opposite the procedure generally followed in
the treatment of minors for physical illnesses. In the
former case, notification is made only in emergencies,
while in the latter case, lack of notification or
informed consent in emergencies is legally excused
(Slovenko, 1966).
Until more definite standards are officially adopted
by mental health professionals, it would appear that the
therapist will have to use the psychological age or the


44
reveal themselves. Indeed, Ohlsen (1977) found that
group members must believe their expressions of feelings
and thoughts will not be told outside the group.
Without mutual trust among members and leader,
negative consequences are projected, just as for
individualized counseling. Corey (1981) identified the
following outcomes for groups without trust.
Group interactions will be superficial,
little self-exploration will take place,
constructive challenging of one another
will not occur, and the group will operate
under the handicap of hidden feelings.
(p. 32)
Meyer and Smith (1977) studied the issue that
threats of disclosure may prevent openness in group
therapy (i.e., that "confidentiality is crucial to the
effectiveness of group therapy," p. 638). After
administering a questionnaire to university students,
they concluded that without a belief in the
confidentiality of their communication, group
self-disclosure may be inhibited. Greene and Crowder
(1972) have stated that group psychotherapy with
adolescents can be effective only when confidentiality is
an essential part of the process. A specific group
therapy strategy for adolescents has been developed by
Vorrath and Bredtro (1974) in which the efficacy of
counseling is based in the very issue of confidentiality.
These authors asserted that the group must be convinced
of the confidentiality of the meetings, and, further,


8
latter fact carried a most positive aspect: Students and
counselors had established a working relationship prior
to this study, so that the disadvantages of an analogue
study (Woods, 1977) were greatly reduced. Finally, a
large number of students were accessible, a number of
representative schools could participate and external
validity was greatly enhanced by use of the school
setting.
Research Questions
The following research question were addressed in this
study:
1. Do school counselors' verbal instructions about
confidentiality (e.g., ethical responsibility and
limitations) have an impact on students' knowledge
of confidentiality?
2. Does the combination of school counselors'
instructions about confidentiality and members' role
playing situations related to this concept have an
impact on students' knowledge of confidentiality?
3. Do students differ by sex (male/female) regarding
their knowledge of confidentiality?
4. Do students differ by race (white/ethnic minority)
regarding their knowledge of confidentiality?
Do school counselors' verbal instructions about
confidentiality have an impact on students'
perception of group trust?
5.


140
confidentiality so that willingness to disclose is not
decreased and may indeed be enhanced.
In regards to students' sex, it does not appear to
make much difference whether the child is male or female
in terms of attitude toward group environment after
classroom guidance sessions or knowledge of
confidentiality after a directed guidance session.
Generally speaking, students' sex does not affect their
overall perception of group trust either. Results do
suggest, though, that under highly specific situational
conditions, sex can be an important variable. Without
any direct address of confidentiality, female children
may have a higher level of implicit trust and willingness
to self-disclose. In contrast, for male children, role
playing in a small group may be a most comfortable, even
fun, method of self-expression. For females, role
playing may seem somewhat threatening; while it does not
affect their cognitive understanding, it may reduce
willingness to express themselves.
Finally, in regards to race, whether students are in
an ethnic minority or not does not seem to affect their
initial group attitude or their perception of group trust
after a directed guidance session. Moreover, race does
not matter in overall understanding of the concept of
confidentiality. The one area where it does seem to make
a difference relates to sharing information only for
professional purposes. While white, non-hispanic


153
(3) 13.
(C) 14.
(2) 15.
(D) 16.
(5) 17.
(A) 18.
(4) 19.
(D) 20.
(2) 21.
(B) 22.
(5) 23.
(A) 24.
Is it part of your counselor's job YES
to keep your secrets from other
poeple, like your parents?
Is it part of your teacher's job YES
to help you solve problems?
If you told your counselor something YES
you were going to do to hurt some
one else, do you think he/she should
keep that a secret?
If you told your teacher something YES
private, should he/she tell someone
else as long as it is a good friend?
Suppose your counselor has to tell YES
your parents certain kinds of things.
Should he/she let you know first so
you can keep some secrets to yourself?
If your teacher thought you were being YES
bad, should he/she let you know first
so you can change your behavior before
you get a bad mark?
If your parents wanted your counselor YES
to tell your teacher something, but
you didnt want him/her to, do you
think he/she is supposed to tell anyway?
If you forget to study, is it OK to YES
make a bad grade sometimes?
***** HALF-WAY 11 *****
If you told your counselor something YES
just a little bad that you did, do
you think he/she is supposed to keep
that a secret?
Is your teacher supposed to help you YES
with your homework?
Should your counselor tell you whether YES
or not he/she can keep your secrets
before you talk to him/her?
If you do an extra good job on a test, YES
should you get something extra, like
free time?
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO


83
Perhaps the mental set of assured confidentiality is
based in our history or culture or rests in the
precedence of other professional advisory relationships.
Clients generally expect the mental health professional
to help, reveal more to him/her than to other
professionals, and assume that their disclosures will be
kept confidential.
Counselor Explanations and Assurances
If clients do indeed have implicit expectations of
confidentiality, certainly counselors have an obligation
to address such expectations. Moreover, research
suggests that counselors' verbal explanations and/or
assurances may affect clients' perceptions and indeed
their willingness to self-disclose. Findings, however,
are inconclusive.
The ethical codes of various helping professions
already examined consistently indicate that the
professional not only has an obligation to maintain
confidentiality of communications except in cases of
danger but also has a responsibility to explain to
clients the concept and limitations of confidentiality.
For the public school setting, counselors should be
particularly cognizant of the ASCA code which states that
the school counselor:
Informs the counselee of the purposes, goals,
techniques, and rules of procedure under which
she/he may receive counseling assistance at or


86
questions. Singer (1978) also studied the impact of
assurances of confidentiality upon response rate to
personal questions. A lower non-response rate and a more
favorable perception of requests for personal information
were found among subjects who had been assured absolute
confidentiality.
Woods and McNamara (1980) studied the effects of
variations in the confidentiality condition on depth of
self-disclosure of college students wherein the research
condition was specifically designed to be analogous to
the psychotherapeutic relationship. Open-ended
questions, derived from Jourard's (1971a) self-disclosure
questionnaire, were utilized, and subjects were randomly
divided into three experimental conditions: No
expectations, confidentiality assured, and no
confidentiality. Subjects' responses to individual
interviews were rated on depth of self-disclosure and
intimacy level. Results revealed that depth of
self-disclosure was significantly related to instructions
regarding assurances of confidentiality. The authors
concluded that lack of assured confidentiality was
related to reductions in self-disclosure.
Meyer and Smith (1977) concluded, after
administering a questionnaire to university students,
that without assurances of confidentiality,
self-disclosure in group therapy may be inhibited.
Eighty-two percent of the respondents stated they would


186
Ohlsen, M. M. (1977). Group counseling (2nd ed.). New
York: Holt, Rinehart & Winston.
O'Kelly, F., & Schuldt, W. J. (1981). Self-disclosure as
a function of experimenter's self-disclosure,
experimenter's sex, and subject's sex. Perceptual
Motor Skills, 52, 557-558.
Orange County Public Schools (1984). Enrollment summary
report by grade. Orlando, FL: The Author.
Pardue, J., Whichward, W., & Johnson, E. (1970).
Limiting confidentiality information in counseling.
Personnel and Guidance Journal, 49, 14-20.
Pederson, S. C., & Breglio, V. J. (1968). Personality
correlates of actual self-disclosure. Psychological
Reports, 22^, 495-501.
Pederson, D. M., & Higbee, K. L. (1969). Personality
correlates of self-disclosure. Journal of Social
Psychology, 78, 81-89.
Peres, H. (1947). An investigation of non-directive
group therapy. Journal of Consulting Psychology,
LI, 159-173.
Plaut, E. A. (1974). A perspective on confidentiality.
American Journal of Psychiatry, 131, 1021-1024.
Plog, S. S. (1965). The disclosure of self in the United
States and Germany. Journal of Social Psychology,
65, 193-203.
Proposed to January 1977 Council of APA (1977). Florida
Psychologist, 28, 82-84.
Reubenhausen, O. M.,& Brim, O. G. (1966). Privacy and
behavioral research. American Psychologist, 21,
423-437.
Reynolds, M. M. (1976). Threats to confidentiality.
Social Work, Zl, 108-113.
Reynolds, M. M. (1976). Privacy and privilege: Patients,
professionals, and the public's right. Clinical
Social Work Journal, _5, 35-44.
Rickers-Ovsiankina, M. A. Kusmin, A. A. (1958).
Individual differences in social accessibility.
Psychology Reports, 4, 391-406.
Rogers, C. (1961). On becoming a person. Boston:
Houghton Mifflin.


CHAPTER V
DISCUSSION
Summary
The importance of trust and confidentiality has been
emphasized in the literature as critical to process and
outcome of counseling; and it appears that clients
typically implicitly expect disclosures to be kept
confidential by counselors. Most of the research,
however, has focused on adults (either as the providers
or receivers of counseling services), and studies that
have included minors have focused on individual
client/counselor relationships outside the realm of the
public school setting. Whether school counselors' direct
address of the issue of confidentiality in counseling has
any impact on students' knowledge and perceptions has
remained relatively unexplored. Some research has
suggested that verbal assurances are less important than
the behavioral component. Additionally, research
concerning the impact of variables of subjects' sex and
race upon trust and self-disclosure in counseling has
yielded inconclusive findings.
The purpose of the present study was to investigate
whether subjects grouped by three independent variables
126


113
analysis of variance had revealed significant differences
on this pretreatment instrument among groups prior to the
treatment, then the analysis of covariance procedure
would have been used to adjust to the posttest scores to
permit the comparison of the groups.
Each subject had a total Child Confidentiality
Questionnaire score within the range of 0 to 20 and
subarea scores within the range of 0 to 4. Using both
total and subarea scores from the CCQ as dependent
variables, analysis of variance was performed to find
significant differences among groups for the independent
variables of experimental conditions, sex, and race.
Main effects (i.e., experimental condition, or sex or
race) as well as two-way interactions (e.g., experimental
condition and sex, or sex and race) and three-way
interactions (e.g., experimental condition and sex and
race) were investigated. A confidence level of p < .05
was considered significant. In cases were a significant
difference of the group main effects was evident, a
posteriori contrast test was conducted (using the SPSS
"One-Way" program) which allowed for a systematic
comparison of all possible pairs of group means. The
Scheffe Procedure (alpha = .10) was used for further
analysis to identify which group had significantly lower
or higher scores than the other groups. Scheffe's test
was selected as it is the most conservative one for this
type of analysis (Kirk, 1968; Winer, 1971). In cases


92
their willingness to self-disclose. Expressiveness may
be inhibited by fear of disclosure of confidential
communications to others outside the group.
When the client is a minor, confidentiality issues
are complex, and research indicates that children
gradually evolve a conception of confidentiality in
counseling as they mature cognitively. Studies which
have examined the attitudes and behaviors of
psychologists and counselors have found that
practicioners tend to respect the confidential
communications of their child-clients. Within the school
setting, counselors apparently value confidentiality but
have many questions about their obligations to parents,
students, school personnel and outside agencies. The
very recently revised ethical code for this group of
professionals indicates increasing awareness about the
responsiveness to the dilimmas often faced by school
counselors, although legal aspects remain vague.
A final concern is that, in any therapeutic
encounter, clients bring with them preconceived
expectations, and research indicates that most clients
typically assume their disclosures will be kept
confidential by counselors. Consequently, counselors
have an ethical responsibility to address such
assumptions. Empirical studies suggest that counselors'
verbalizations regarding confidentiality and privacy may
affect clients' perceptions and willingness to disclose.


107
Because the GES can be separated into subscales
which reflect adequate internal consistency and
test-retest reliability, the subscales can be uilized
independently. For the purpose of this research, a
pretreatment instrument, the Group Environment
Questionnaire (GEQ), was developed by combining the
subscales of Member Cohesion and Leader Support (see
Appendix D). While this instrument is not as
comprehensive as the entire GES, it was judged to be
adequate to assesss students' perceptions of their group
situation prior to experimental conditions. In this way,
any initial differences in students' attitude toward
group members and the leader could be assessed and, if
necessary, posttest measures could be statistically
corrected.
Similarly, two other subscales of the GES were
combined to yield the other posttreatment instrument:
the Group Trust Questionnaire, GTQ (see Appendix E). As
is consistent with findings in the relevant literature,
group trust was operationally defined by this researcher
to be a combination of Expressiveness (self-disclosure)
and Self-Discovery.
Procedures
This study was conducted over a two-week period,
with no two schools participating on the same day. The
scheduling of groups, in terms of time of day, counseling


45
that members must believe that they do not have the right
to reveal information outside the group.
Corey (1981) maintained that helping to build group
trust is a vital task for group leaders. The way in
which leaders approach the group was considered to be of
great importance, and he suggested that leaders attempt
to promote trust by describing the structure and goals of
the group and by explaining how the group process will
work. Corey recognized that practicioners of various
orientations utilize different approaches in establishing
a climate of trust during opening sessions, and he even
summarized some typical leader comments of the various
group models.
Davis (1980) emphasized the leader's responsibility
for group trust from a slightly different perspective.
She stressed that, because confidentiality and protection
of disclosures are necessary for a productive group, the
leader should directly address the topic of
confidentiality to group members. Her survey of members
of the Association of Specialists in Group Work (ASGW)
and their clients, however, indicated that, in fact,
members perceived that confidentiality of group
communications was not maintained.
Approximately 70% of the [group] members
thought they, other group members and the
leader, could talk or were talking freely
about the topics and activities from the
group. It was discouraging to discover
that more than one-third of the members
thought the leaders were talking about the


120
TABLE 4-2 MEAN GEQ SUBSCALE SCORES WITH ANOVA
STATISTICS ACCORDING TO SUBJECTS'
EXPERIMENTAL CONDITION
EXPERIMENTAL SUBSCALE: SUBSCALE:
CONDITION MEMBER COHESION LEADER SUPPORT
c
6.451
7.294
El
5.964
7.764
E2
6.164
7.327
Total Mean
6.186
7.466
ANOVA STATISTICS
F =
.521
F = 1.715
df =
2/158
df = 2/158
E <
. 595
£ < .183
As no significant differences were identified in student
attitude toward group environment prior to treatment, as
assessed by the GEQ, it was not necessary to utilize the
analysis of covariance procedure for additional
statistical analysis of posttest measures.
Child Confidentiality Questionnaire
The distribution of mean CCQ scores according to
experimental condition of subjects is shown in Table 4-3.
Analysis of variance of the total score means for
experimental condition indicated a significant difference
(F = 3.056; df = 2/149; p < .027). Further analysis
(Scheffe's test; alpha = 0.10 level) revealed that the


APPENDIX G
PARENT PERMISSION FORM
ORANGE COUNTY PUBLIC SCHOOLS
brM|1uaf(Mit Uunta/PmU<|lallnW SM 1 Mwr Ax.. OrUaA.. VUrtA. HHI
Dear Parent/Cuardlan:
As you say know, your child'a classroom hat participated In a six-week
atructured guidance unit led by the achool counaelor. Mow, the class will
be broken down Into aaaller groups for one wore session focusing on a
school-related topic. The purpose of the additional session will be to
research the relationship between the school counselor. All studenta will
take a brief questionnaire prior to the snail group and another
questionnaire after the group. The questionnaires will be used only to
collect lnforaatlon about the counseling relationship and will be destroyed
thereafter. Throughout this project, each student will resaln anonymous
through the uae of code nuabers, and Individual results will not be
available.
This project has been approved for Orange County Schools by the Department
of Progran Evaluation and the Coordinator of Guidance. The results of the
research are expected to benefit counselors in future work with students.
Pupils will benefit froa the experience through better understanding of the
counselor's role and through the opportunity to develop new social skilla!
(There will be no monetary compensation.)
If you give your consent, please sign and have witnessed one copy of this
letter and return It to the school counselor. You nay keep the other copy
for your records.You and/or your child are free to withdraw consent and
to discontinue your child's participation In the project at any tine
without prejudice.
If you have any questions, please contact ne at 293-6252 or 423-9231.
Thank you for your cooperation.
Charlene Messenger-Ward Date
School Psychologist
I HAVE READ AMD I UNDERSTAND THE PROCEDURE DESCRIBED ABOVE. I AGREE TO
ALLOW HY CHILD TO PARTICIPATE IN THE PROJECT AND I HAVE RECEIVED A COPY OF
THIS DESCRIPTION.
Signature
Relationship to Child
Date
Witness Signature
Date
CB0037


69
Confused Allegiance
Kottler (1980) noted that the school counselor
functions as a therapeutic model in many diverse roles,
and thus counselors must present an image of confidence
and competence to their clients. The unclarified
question remains who is the primary client--the student,
the parent, or the school? Various authors have taken
positions all along the continuum, and research suggests
that practicing counselors themselves have an
inconsistent perception of primary allegiance.
Shertzer and Stone (1976) examined both sides of the
question of whether the counselor should champion the
individual student or give primary loyalty to the school.
One side of the argument is that counselors' primary
obligations are to respect the integrity and promote the
welfare of counselees, even if they are students.
Further, if the school counselors cannot provide the
essential component of confidentiality while counseling
students, then their effectiveness is severely and
perhaps irreparably curtailed. On the other hand, the
argument could be made that the counselor is a member of
the school faculty and consequently has basic loyalty to
the employing institution. Moreover, privileged
communication for school counselors has not been given
legal status in many states. The authors concluded
Within the school setting, where the counselor
deals with minors' sexual behavior, delinquent
acts, and the like, there are no easy


6
Several needs were thus identified. Because of the
importance of confidentiality and trust in the counseling
relationship, the ethical and legal complexities involved
in counseling at school, and school counselors' confused
allegiance to students, parents, and institution, there
was a need to determine if counselors' explanation of the
issue of confidentiality actually impacted students'
knowledge of this complex concept in a therapeutic
relationship and/or their perception of group trust.
Moreover, there was a need to determine if student
involvement in the process further impacted such
knowledge and perception. Finally, it appeared that
variables of subjects' sex and subjects' race should be
further explored in relation to confidentiality and
trust.
Purpose of the Study
Confidentiality in counseling has been researched
largely regarding personal perceptions of adults (mental
health professionals, school personnel, adult subjects in
studies). There is a paucity of research exploring the
impact counselors have on minor clients' knowledge of
confidentiality and perception of trust, specifically
within the school setting. It was the purpose of this
study to determine whether a guidance session directly
addressing confidentiality would have an effect upon
students' knowledge and perception. Specifically, this


87
either choose not to enter a group, or would enter with
substantially less inclination to reveal information
within the group, when they had been told that the
information discussed would not be considered
confidential. Even when confidentiality was pledged by
the leader and group members, but the leader stated that
he would reveal specific information in the unlikely
event he were validly court ordered, 47% still would not
enter or would enter with substantially less inclination
to reveal information.
Other results have yielded less conclusive results.
Edelman and Snead (1972) found that subjects did not
require explicit assurances of confidentiality to
self-disclose. Rather, subjects who were given no
instruction revealed as much information as subjects who
were explictly informed that the information given was to
be held confidential. Similarly, in a study by Woods
(1977), subjects reported that they had assumed that
whatever they said would be held in confidence regardless
of confidentiality condition.
Even when advised differently, clients have refused
to accept "flawed" or limited confidentiality (possibly
unconsciously). In Meyer and Smith's (1977) study,
respondents who were read a statement explaining the
limits of confidentiality (that it is an ethical or
professional concept and does not carry legal power or
precedent) were asked to indicate whether or not they


36
Dubey (1974) made the point that if testimony were
confined only to the medical issues of diagnosis and
treatment, there would be no problem. However, if the
testimony can be forced concerning content of
communications during psychotherapy, a therapist cannot
assure patients of confidentiality and hence the proper
setting for psychiatric work cannot prevail. Slovenko
(cited in Haines, 1962) asserted that there should be
"complete immunity" from cross examination for the
therapist. Without it, effective therapeutic examination
of the client (defendant) cannot exist unless the
therapist, in some way deludes the examinee. It would
seem an absurd position for the therapist to warn the
accused not to give him/her information in confidence and
then expect to receive information. Similarly, a
judically forced rupture of confidentiality would be
counterproductive for the court itself. As stated by the
Florida Appellate Court in the case of Morgan vs. State,
June 13, 1962,
To strip a pre-sentence report of its
confidentiality would be to divest it also
of its importance and value to the
sentencing judge because there might be
lacking the frankness and completeness of
disclosure made in confidence. (cited in
Graves, 1982, p. 20)
Some authors, however, have brought up the possible
conflict between the client's right to privacy and
societys right to proper administration of justice
(Arnold, 1970; Dubey, 1974; Schmidt, 1962; Shah, 1969a;


124
subgroup (i.e., El males, El females, E2 males, etc.)
mean scores to the total group mean scores for each
experimental condition, indicated the significant
interaction to be within the E2 group, wherein females
scored significantly low (t = 1.458; (3f = 27; £ < .10).
TABLE 4-5 MEAN GTQ TOTAL SCORES FOR EXPERIMENTAL
CONDITION BY SEX
EXPERIMENTAL
CONDITION MALE FEMALE TOTAL MEAN
C 10.57 11.57 10.980
El 9.25 9.52 9.382
E2 11.41 9.82 10.600
Total Mean 10.40 10.20 10.304
Separate analyses of variance across groups for both
subscales of the trust questionnaire were completed. For
the subscale Expressiveness, no significant differences
were identified for main effects. However, there was a
significant two-way interaction for the variables of
experimental condition and sex (F = 15.582; df = 2/149;
£ < .008). Table 4-6 shows the breakdown of means for
experimental condition by sex for this subscale. Further
analysis, comparing the subgroup (i.e., El males, etc.)
mean scores to the total group mean for each experimental
condition, indicated the following: In the E2 group,
males scored significantly high (t = 2.107; df = 26; £ <
.025); in the Control group, females scored significantly


9
6. Does the combination of school counselors'
instructions about confidentiality and members' role
playing situations related to this concept have an
/
impact on students' perception of group trust?
7. Do students differ by sex regarding their perception
of group trust?
8. Do students differ by race regarding their
perception of group trust?
Definition of Terms
Some terms used in this study have been associated
with various meanings based on different authors'
viewpoints. Clarification of the generally recognized
elements under the rubic of "confidentiality," or
protection of private utterances, will be advantageous
for two reasons. First, there appears to be confusion
and a general lack of understanding for these concepts in
both principle and application, and second, these issues
affect virtually all practicing counselors and
psychotherapists in some way.
Confidentiality is "an explicit promise, protecting
the client from unwarrented disclosure, of any sort, by
the professional, except under conditions agreed to by
the source" (Graves, 1982, p. 7). Operationally,
confidentiality has been considered to be assessed
through the Child Confidentiality Questionnaire
(Messenger & McGuire, 1981) based on the APA Ethical
Standards of Psychologists (1977).


APPENDIX H
GUIDANCE SESSION UNITS
Experimental Group 1
Purpose: To instruct students about the meaning and
limitations of confidentiality in a counseling
relationship.
Materials: Chalkboard and chalk or large pad and
markers.
Approximate time: 30 minutes.
Procedures:
I. Introduction. State: "Today we need to break
up our teams so that we could do something a
little different. You will be with some people
who were not in your other teams, so we'll get
used to some new people in the group." Briefly
ask for oral recall of previous class sessions.
II. Discussion. State: "One thing we did not talk
about in our class groups is this word." Write
the word confidentiality on the board or pad.
Facilitate discussion as to what they think it
means.
Then state:
In our class groups, we did not talk about
too many really private or personal things,
although we did talk about our feelings
sometimes. There are times when people
talk to their counselor, though, when they
want things kept secret. Usually that is
when they might need some help on a problem
and don't want other people to know about
it. Can you think of anything kids your
167


APPENDIX C
QUESTIONS BY AREA OF CONFIDENTIALITY
Area 1
YES NO
The psychologist's responsibility to safeguard
information:
1. Is it part of your counselor's job to keep
things secret that you ask him/her to: 1
2. Is your counselor supposed to talk with
you about things you don't want anyone
else to know about? 1
3. Are you sometimes afraid to tell some
things to your counselor because he/she
may not keep them secret? 0
4. Do you think your counselor keeps your
secrets as well as he/she would keep a
grown-up's secrets? 1
Area 2
Information revealed only when clear,
imminent danger:
1.
If you told your
were going to do
you think he/she
a secret?
counselor something you
to hurt someone else, do
is supposed to keep that
0
2. Suppose (pretend) your counselor thought
there was an emergency and that telling
another person what you said would help
you best. Do you think he/she should tell
the person? 1
3. If you told your counselor something just
a little bad you did, do you think he/she
is supposed to keep that a secret? 1
4. If he/she really thinks he/she is helping
you to stay out of trouble, is it OK for
your counselor to tell your parents what
you tell him/her? 1
0
0
1
0
1
0
0
0
157


57
The confidentiality of communications of minor
clients has, then, been considered by these various
authors as secondary to the priority of informing
parents. Goldman (1972), while recognizing that children
of varying ages have varying degrees of judgement and
competence, nonetheless argued that the mental health
worker is not in a position to decide whether a
particular child is or is not competent to refer himself.
He referred to the decision as "a kind of God-playing"
which "really has taken the ultimate responsibility away
from parents, courts, everyone, and placing it in one's
own hands" (p. 373)
Considering the importance of trust, other authors
raise the question that if confidentiality is so critical
in therapy, why are children exluded? A number of
authors have maintained that the minor client is indeed
entitled to confidentiality of communications in
counseling.
Rosenburg and Katz (1972) noted that, "though the
law generally demands that parents have a right to
informed consent," it is not always therapeutically
desirable to provide details of the causes and nature of
treatment. These authors wrote that limiting the
psychotherapeutic treatment of minors "will not further
our traditional concern of providing for the protection
and welfare of minors" (p. 56).


21
gives unauthorized disclosures could face disciplinary
action and professional sanctions by the American
Psychological Association or by the state certifying or
licensing authority (in relation to the practicioner1s
certificate or license). Furthermore, the therapist
might be faced with legal action and could be sued in a
civil action if some damage to the client resulted or if
the breach of confidence could be construed as a
defamatory statement.
Other Variables
Although trust appears to be an index of the level
of therapeutic process between client and therapist,
other variables have been suggested as affecting the
amount of client expressiveness with the counselor.
Sex A number of studies have explored differences
in client expressiveness as a function of client and/or
counselor sex. In Graves' (1982) study, it was found
that
not only did males disclose significantly
more across all conditions of assured
confidentiality than did females, the
differences were such that even the highest
mean amount of disclosure by females under
any given condition was less than the
lowest amount disclosed by males under any
condition. . This would seem to
clearly indicate that males are either more
open or more easily made trusting, or both.
(p. 72)
Likewise, in the study by Kobocow, McGuire, and Blau
(1983), adolescent females were significantly lower than


163
17. People here think things out before saying
anything.
TRUE
FALSE
This group is a good place to "let off
steam."
TRUE
FALSE
This instrument is comprised of Expressiveness and
Self-Discovery subscales of the Group Environment Scale. It
is reproduced by special permission of the Publisher,
Consulting Psychologists Press, Inc., Palo Alto, CA 94306,
from the Group Environment Scale by Rudolf Moos, Ph.D.,
Copyright 1974. Further reproduction is prohibited without
the Publishers consent.


192
Charlene was accepted into the doctoral program in
counselor education at the University of Florida,
Gainesville, in August 1982, with her specialization area
in group work; she became a candidate for the Doctor of
Philosophy degree in October 1983. She is presently a
member of numerous national, state and local professional
organizations for counselor educators, school
psychologists, group work specialists, exceptional
educators, and mental health and school counselors.
Addtionally, she serves on the executive board of the
Orange County Association for Counseling and Development,
on the research committee for Florida Association of
School Psychologists, and on the Orange County
psychologists' committee for the emotionally handicapped.
Hopes for the future include the continued close
relationship with her husband as well as beginning of a
family together. Charlene strives to integrate the
professions of counseling and psychology and would like
to expand her role into consultation with both private
organizations and public systems and to assist and teach
newcomers to the profession at an institution of higher
education. Personal growth of others has always been
important and meaningful, so that bringing knowledge and
skills to others, while at the same time maintaining some
direct contact with children and adolescents, would be
most rewarding.


54
assumption. A child's trust in a counselor
may be betrayed as well as an adult's. A
child is very much a person and the
integrity of his personality must be
protected while at the same time admitting
that parents consent must be obtained for
treatment or referral, (p. 172)
In his proposed guidelines, Wrenn suggested that the
counselor must obtain his client's permission before
communicating any information about that client that has
been given in the counseling relationship, even to
parents.
Legal Issues
The legal aspects associated with the
psychotherapeutic treatment of minors, including
privileged communication and parental rights present
particularly thorny issues. Rosenberg and Katz (1972)
examined legal issues of consent in the psychiatric
treatment of minors. They considered the implications of
laws which provide that minors, even mature ones, do not
have the right to contract for or undergo psychiatric (or
psychological) treatment without the specific permission
of parents or guardians. It should be noted that the age
of the minor and complexity of treatment may affect what
situations the courts would likely favor making an
exception to this general principle. These authors
pointed out the privileged communication statutes fail to
establish to whom the privilege belongs in the case of a
minorto the minor or to his/her parents or guardians.


135
In regard to HO^the hypothesis that no
relationship would exist between subjects' sex and
perception of group trustan interesting pattern was
apparent. In considering only subjects' sex as a main
effect, this study supported the hypothesis of no
relationship. A great deal of previous research has also
identified no relationship between sex and
self-disclosure (Cozby, 1973; Doster & Strickland, 1969;
Plog, 1965; Vondracek & Marshall, 1971; Weigel, Weigel, &
Chadwick, 1969).
Nonetheless, it should be noted that a statistical
difference beyond the .05 level indicated a two-way
interaction for the variables of experimental conditions
and sex for both total group trust score and subscale
Expressiveness score. In the experimental condition
where role playing was performed in addition to the
counselors' verbal explanation, females scored
significantly low in general trust perception, yet males
scored significantly high in subscale Expressiveness.
Moreover, in the experimental condition which was a
control, females scored significantly high in
Expressiveness, while males scored significantly low.
This finding leads back to the issue of implicit trust
and factors which may affect it. Thus, without any
address of confidentiality issues, females appear more
implicitly trusting, which is not inconsistent with
previous research that concludes females are more


179
Davis, D. G. (1971). Privileged communications: A
psychiatrist has no constitutional right to assert
an absolute privilege against disclosure of
psychotherapeutic communications. Texas Law Review,
49, 929-942.
Davis, K. L. (1980). Is confidentiality in group
counseling realistic? Personnel and Guidance
Journal, 59, 197-201.
Dimond, R. E., & Hellkamp, D. T. (1969). Race, sex, and
ordinal position of birth and self-disclosure in
high school students. Psychological Resports, 25,
235-238.
Dimond, R. E., & Munz, D. D. (1967). Ordinal position in
birth and self-disclosure in high school students.
Psychological Reports, 21, 829-833.
Dion, K. K., & Dion, K. L. (1978). Defensiveness,
intimacy, and heterosexual attraction. Journal of
Research in Personality, 12, 479-487.
Doster, J. A. & Strickland, B. R. (1969). Perceived
child-rearing practices and self-disclosure
patterns. Journal of Counseling and Clinical
Psychology, 33, 382.
Drag, R. M. (1969). Experimental behavior and group size
as variables influencing self-disclosure (Doctoral
dissertation, University of Florida, 1968).
Dissertation Abstracts International, 30, 5B.
(University Microfilms No. 69-17016, 2416).
Dubey, J. (1974). Confidentiality as a requirement of
the therapist: Technical necessities for absolute
privilege in psychotherapy. American Journal of
Psychiatry, 131, 1093-1096.
Edelman, R. L., & Snead, R. (1972). Self-disclosure in a
simulated psychiatric interview. Journal of
Consulting and Clinical Psychology, 38, 354-358.
Education Amendments of 1974, Pub. L. No. 93-380, 88
Stat. 484 (1974).
Egan, G. (1975). The skilled helper: A model for
systematic helping and interpersonal relating.
Monterey, CA: Brooks/Cole.


158
YES NO
Area 3
Information discussed only for professional
purposes:
1. Is it part of your counselor's job to keep
your secrets from other people, like your
parents?
2. Do you think your counselor is supposed to
talk to his/her friends about the things
you tell him/her in secret?
3. Do you think your counselor is supposed to
tell other people what you said in coun
seling if they ask him/her?
4. Should your counselor make sure your
parents know the things you tell him/her
just because they want to know?
Area 4
Necessity of obtaining client's express
permission:
1. If your parents ask your counselor what
you talked about, should he/she tell them
if you don't want him/her to? 0 1
2. Should your counselor get your permission
before he/she tells someone else
something you told him/her? 1 0
3. If your parents wanted your counselor to
tell your teacher something but you
didn't want him/her to, do you think
he/she is supposed to do it anyway? 0 1
4. If you didn't want other people to know
about what you said in counseling, do you
think your counselor would tell them
anyway?
0
1


85
who perceived that the leader was talking about them to
others thought they could do the same thingtalk to
their friends. The distinction, then, should be made
between discussing cases for professional purposes and
inappropriate violations of confidences.
In practice, school counselors seem to agree on the
necessity of explaining the limits of confidentiality to
their students. In Wagner's (1981) survey, all
respondents, regardless of setting (elementary or
secondary) stated that they do explain existing limits to
their clients. Furthermore, 80% answered that they
consider such factors as age, maturity and problem, when
defining those limits.
Interestingly, little research actually addresses
the effects of explaining limitations, although a number
of studies have empirically investigated the effect of
verbal assurances of privacy or confidentiality. Early
research (Asch, 1951) suggested that people are much more
likely to disclose nonconforming opinions, attitudes and
judgements if requested to disclose in private rather
than in public. Similarly, Baizerman (1974) suggested
that anonymity offered to youths, such as over telephone
hotlines, greatly increases self-disclosure. In a study
of college women, Fidler and Kleinecht (1977) found that
when requesting sensitive and possibly stigmatizing
information, the interview technique which guaranteed
anonymity produced the most responses to highly sensitive


90
confidentiality. Rather, variables which were
significantly related to conception of confidentiality
were the child's perception of whether confidentiality
had been maintained or violated, that is, the counselor's
behavior. Children who believed that their
confidentiality had been violated scored significantly
low, whether the variable concerned experiences with the
current counselor or with any counselor. Thus, verbal
explanations of confidentiality "are not as important to
children as real-life experiences with it" (p. 129).
Similarly, Kobocow et al. (1983) projected that "early
adolescents respond more to interpersonal/behavioral and
visual cues proved by the interviewer/therapist than to
verbal assurances of confidentiality when gauging their
degree of self-disclosure" (p. 441).
The relevant literature indicates that clients
typically assume their disclosures will be kept
confidential by counselors. While most clients typically
trust counselors implicitly, they apparently have an
unclear understanding of the meaning of confidentiality.
Consequently, counselors have a responsibility to address
such client expectations. Indeed, ethical codes clearly
stipulate the professional's obligation to explain the
concept and limitations of confidentiality. Research
exploring counselors verbal explanations and/or
assurances of privacy suggest that clients' perceptions
and willingness to disclose may be affected; however,


58
Similarly, Hyman and Schreiber (1975) listed a
number of recommendations in their discussion of child
advocacy. Though these authors maintained that the
parent should be interviewed and explained his legal
rights, they specifically stated that "Children and
adolescents should be provided confidentiality with the
exception of the 'future crime limitation' which would
include plans to commit any crime, including suicide" (p.
56). The position statement for psychiatrists warns
against "divulging details about the youth's problems to
the parentsa practice that can be detrimental to the
young person" (American Psychiatric Association, 1970, p.
1546).
In a recent discussion of treatment of adolescent
psychiatric inpatients, Corder, Haizlip and Spears (1976)
specified that standards of sharing information should be
outlined in the treatment contract. They asserted that
parents should be informed only of issues such as the
goals and progress in general, but specific details of
the therapy session are to be kept confidential unless
they pertain to some area of danger to the patient or
others.
Along this line, Wilkerson (1973) wrote that at
certain ages and under certain circumstances, the child
is unable to care for or protect himself or make prudent
choices in his own best interests. Here the child has a
right to "parental responsibility," implying social


I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.
Paul Fitzgerald, Chairperson
Professor of Counselor Education
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.
Professor of Foundations of Education
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.
This dissertation was submitted to the Graduate Faculty
of the Department of Counselor Education in the College
of Education and to the Graduate School, and was accepted
as partial fulfillment of the requirements for the degree
of Doctor of Philosophy.
August 1984
Dean for Graduate Studies and Research


123
lower than the white, non-hispanic group, with a mean
score of 3.3366.
Group Trust Questionnaire
The distribution of mean GTQ scores according to
experimental condition of subjects is shown in Table 4-4.
Analysis of variance of the total score means by
experimental condition indicated a significant difference
(F = 5.491? df = 2/149; £ < .0005). Further analysis
(Scheffe's test; alpha = 0.10 level) revealed that the
mean of the El group was significantly lower than both
the control group and the E2 group, while these last two
groups did not differ significantly.
TABLE 4-4 MEAN GTQ TOTAL AND SUBSCALE SCORES ACCORDING TO
EXPERIMENTAL CONDITION
C El E2 TOTAL MEAN
SCALE (N=51) (N=55) (N=55) (N=161)
Self-Discovery
5.235
4.382
5.073
4.888
Expressiveness
5.745
4.982
5.527
5.410
Total Mean
10.980
9.364
10.600
10.304
Moreover, there was a significant two-way
interaction for the variables of experimental condition
and sex for total GTQ (F = 4.029; df = 2/149; £ < .020).
Table 4-5 shows the breakdown of means for experimental
condition by sex. Further analysis, comparing the


UNIVERSITY OF FLORIDA
3 1262 08555 2791


104
questionnaire yields a total confidentiality score as
well as subsection scores for each of the five areas of
confidentiality. The child's answers to the
questionnaire are scored as either "1" or "0" where "1"
indicates a response in line with the APA Ethical
Standards and "0" does not (see Appendix C). As there
are twenty scored questions, a total confidentiality
score can range from 0 to 20; each of the five subarea
scores can range from 0 to 4.
Group Environment Scale
The Group Environment Scale (GES) is comprised of
ten subscales that "measure the social-environmental
characteristics of task-oriented, social, and
psychotherapy and mutual support groups" (Moos, 1981, p.
1). While the GES has three forms, the Real Form (Form
R), was used for this research as it assesses people's
perceptions of actual group settings.
Content validity is demonstrated by the construction
of the scale. Items were developed from information
gathered in structured interviews and observations of
members and leaders in various groups. Additional items
from the Social Climate Scales (Moos, 1974b) were also
adapted. Originally, Form A contained 211 items which
were administered to participants in 30 groups. A
variety of settings were tapped: Task-oriented groups


BIOGRAPHICAL SKETCH
Charlene Messenger-ward is the daughter of Glenn H.
and Marie L. Messenger of Satellite Beach, Florida. She
was born on October 6, 1956, at Fort Dix, New Jersey.
She attended public school in Brevard County, Florida,
and through advanced examinations and early college
entrance, was awarded her Associate of Arts degree
simultaneously with her high school diploma. She earned
a Bachelor of Arts degree, summa cum laude, in special
and elementary education from University of South
Florida, Tampa, and a Master of Science degree, summa cum
laude, in community psychology from University of Central
Florida, Orlando, in 1978.
In the fall of 1978, Charlene was hired by the
Orange County Public School as a school psychologist
where she served in an itinerant capacity for several
years. She then accepted responsibilities of a full-time
position at a self-contained exceptional school which
offered the opportunity to provide assessment,
consultation and therapy services for children with
severe learning disabilities and emotional handicaps. In
early 1980, she married William (Mike) Ward, and for the
past several years, each has been both a full-time
employee and student.
191


32
Hanlon (1976) found that of the mental health centers
they surveyed, the majority (51%) report the client's
name, address and/or social security number to various
government agencies, and 36% of these do so without
informing their clients that they did. Further, 61% of
the mental health centers reported clients were not
advised that identifying information might be reported.
In considering the ethical standards of the various
helping professions, reporting of such information
appears unethical, particularly when the information is
given without the clients' informed consent.
In light of such a practice, considering the
interplay of confidentiality and trust, a review of
ethical standards of helping professions appears
warranted. Moreover, two other factors which have been
identified as pertinent to a discussion of
confidentiality are privileged communication and case
records (Trachtman, 1972).
Ethical Standards
Confidentiality at the professional level refers to
the ethical standards of counselors or other
professionals not to reveal private communications from a
client to others except under certain circumstances.
Shertzer and Stone (1976) stated that matters of
confidentiality and counselor ethics in general are
extremely complex. While the purpose of professional


5
additional (fairly inconclusive) research suggests that
varibles such as sex (Graves, 1982; Kobocow et al., 1983;
O'Kelly & Schuldt, 1981; Rosen, 1977; Singer, 1978) and
race (Franco & Levine, 1981; Jourard & Lasakow, 1958;
Dimond & Hellkamp, 1969) may significantly impact the
amount of self-disclosure.
Most of the actual empirical attempts to assess the
importance of confidentiality have been limited to
samples of adults: therapists and counselors (e.g.,
Davis, 1980; Jagim et al., 1978; McGuire, 1974; Wagner,
1978, 1981); adults in counseling (e.g., Davis, 1980;
Schmid et al., 1983); or adult subjects in surveys or
analogue studies (e.g., Graves, 1982; Meyer & Smith,
1977; Woods, 1977). The importance attributed to
confidentiality by minor clients has been relatively
unexplored. Two studies which have focused on minors
(Kobocow, McGuire & Blau, 1983; Messenger & McGuire,
1981) have been outside the realm of the public school
setting and have been limited to individual
client/counselor relationships. The area of group
counseling with students remains a viable one for
research, particularly in relation to counselors
explicitly addressing confidentiality issues. Such is
especially relevant in that some research (Messenger &
McGuire, 1981) suggests that simple verbal explanations
or assurances have less of an impact on the counseling
relationship than a behavioral component.


103
way, the minor's understanding of confidentiality was
assessed in relation to the ethical standards of
confidentiality stipulated for clients of psychologists.
That is, the child's concept of confidentiality was
examined according to the stipulates for confidentiality
for psychologists' clients, regardless of age. The five
areas of confidentiality identified from the APA ethical
standards are the following:
1. It is the psychologist's responsibility to
safeguard information about the client that has
been obtained during psychotherapy (Principle
5);
2. information received in confidence should be
revealed only when there is clear, imminent
danger (Principle 5, Section A);
3. the confidential information is discussed only
for professional purposes and only with those
clearly concerned with the case (Principle 5,
Section B);
4. the confidential information should be released
only when the client has given his/her express
permission (Principle 5, Section D); and
5. it is the psychologist's responsibility to
inform the client of the limits of
confidentiality (Principle 5, Section D).
Other questions besides those designed for assessing
the child's conception of confidentiality were included
in the questionnaire for the purpose of avoiding boredom,
confusion, or suspicion in the child. While the
confidentiality questions focus on the counselor, the
"blind" questions focus on school-related topics,
especially the teacher, the classroom and homework. The


84
before the time when the counseling
relationship is entered. Prior notice includes
the possible necessity for consulting with
other professionals, privileged communication,
and legal or authoritative restraints. (ASCA,
1984, p. 7)
The earlier ASCA position statement also emphasized the
importance of explaining limitation of counseling
confidentiality as opposed to verbal assurances. School
counselors were expected to review with students "any
conflicting responsibilities as they relate to the legal
and/or individual limits to confidentiality" (ASCA, 1976,
p. 284). In addition, school counselors are expected to
inform significant othersstudents' parents and school
personnelabout the issues of confidentiality (ASCA,
1984).
Ware (1971) emphasized that when counseling minor
clients, spelling out the limits of confidentiality from
the beginning of the relationship has a major advantage.
It allows the counselor to avoid the uncomfortable
position of feeling forced to violate the youth's
confidence at a later date. Likewise, McDermott (1972)
stressed the importance of informing the minor client
that maintenance of confidentiality could not be
guaranteed, especially within a school setting.
For a group setting, Davis (1980) concluded that
leaders must give an accurate presentation of
confidentiality so members have the choice of how much
they disclose to others. This is particularly relevant
in that results of Davis' research indiated that members


70
solutions. Each situation must be considered
on its own merits, and each decision must be
based upon the client's welfare and not upon
the counselor's welfare. . when they are
forced to break confidence, they destroy the
counseling relationship probably for all time.
(p. 184)
Christiansen (1972) also explored both sides of the
issue, noting there are instances wherein it may be
advisable to break students' confidences to other school
personnel. Kaplan (1974), however, wrote that the
ethical duty to protect the confidences of pupil-clients
would force counselors to deny some requests of teachers.
He suggested counselors explain their feelings concerning
ethical behavior, especially confidentiality, in a
nonthreatening manner, personally and directly to the
staff. Slovenko (1966) took a similar, though more
extreme, position by stating that it is not the
responsibility of teachers to delve into a pupil's
emotional problems and the pupils "are not patients in
relation to the teacher while they are being taught
(p. 66).
Gunnings (1971) declared strongly that the school
counselor should in no way act as "an arm of the
administration." To do so would sacrifice his/her
effectiveness. Rather, the only definitive manner in
which to ensure confidentiality is to insist that no
information be passed on to any one without the written
permission of the student involved. Gunnings concluded
that the responsibility of any counselor should be only


143
The finding that students' sex or race did not have
a main effect on group environment attitude, overall
knowledge of confidentiality, or perception of group
trust suggests that counselors should not be overly
concerned with whether students with whom they are
working are male or female, white or ethnic minority.
The present research adds credence to the practice that
one can cross demographic and cultural variables to
provide effective services to clients regardless of sex
or race.
Counselors should, however, be sensitive to some
highly specific situational differences. The finding
that role playing may decrease expressiveness in females
while it fosters expressiveness in males suggests that
counselors may need to handle this aspect differently for
boys and girls. Thus, even though role play along with
discussion has been found to be the most effective
approach to explaining confidentiality, girls may require
more time and encouragement to feel comfortable with role
play.
The finding that ethnic minority students may be
less conforming on the specific subarea of not sharing
client disclosures to others such as family and friends
suggests counselors should be cognizant of differing
values. It is not expected that counselors would impose
their values. Still, awareness may help avert future
misunderstandings in work with minority students.


4
area of child-client confidentiality. Those studies
available show that counselors tend to respect the
confidentiality of minors' communications. Suggestions
have also been made that distinctions could be drawn
between the rights and prerogatives of children according
to psychological age or condition of the client (Ladd,
1971; Slovenko, 1966). If the counselor is expected to
facilitate self-disclosure, and thus self-exploration,
within an atmosphere of confidence and trust, school
counselors must be cognizant of how they affect students
in counseling. With all the furor as to what counselors
should do or are indeed doing in relation to the issue of
confidentiality, there remains the question of whether
school counselors' direct address of the issue of
confidentiality in counseling has any impact on students'
knowledge and perceptions.
Need for the Study
The importance of trust and confidentiality has been
emphasized as critical to outcome of counseling and
psychotherapy by various writers (e.g., Egan, 1975; Ford
& Urban, 1963; Jagim, Wittman & Noll, 1978; Morwer,
1968a, 1968b; Reynolds, 1976; Shah, 1969a, 1969b; Siegal,
1976; Truax and Carkhuff, 1965, 1967). Typically,
clients implicitly expect confidentiality in the
counseling relationship (Edelman & Snead, 1972; Meyer &
Smith, 1977; Plaut, 1974; Woods, 1977), although


CHAPTER I
INTRODUCTION
More than three decades ago, Wrenn (1952) proposed
ethical guidelines advocating confidentiality in the
counseling relationship with children. He maintained
that a child's trust in the counselor is as critical as
that of an adult and that the child's integrity must be
protected within the relationship. In his proposed
guidelines, Wrenn suggested that parents' consent be
obtained for treatment or referral but that before
disclosing information given during counseling, the
child's permission must first be obtained.
Since that time, various writers and professional
organizations have taken stands all along the continuum
regarding amount of confidentiality that should
be afforded the minor client. Some question whether it
is desirable, even possible, to maintain an attitude of
strict confidentiality with adult clients in counseling
but not with minor clients. Others contend that parents
represent the child-client and thus should have full
access to all disclosures. This diversity of opinion is
greatly attributable to the fact that each therapist's
perception is influenced by his/her personality structure
and professional development (Lowental, 1974), as well as
1


identified for the trust measure and its subscales,
suggesting that the impact of subjects' sex may be highly
situation specific. Additionally, for knowledge of
confidentiality, in one specific subareacounselors
revealing client disclosures to family and
friendsethnic minorities scored significantly lower
than nonminorities.


117
(p. 21). In defense, however, two factors should be
considered: The CCQ has an equal number of blind
questions focusing on the teacher and school as it does
confidentiality questions focusing on the counselor; and
delay of the posttest would be a significant confounding
variable, as subjects from different experimental
conditions would have had the opportunity to intermingle
and discuss their group experiences before assessment.
Finally, Woods (1977) pointed out that in some aspects, a
study such as this may appear a bit artificial. Students
were not asking for help with their problems, and the
experiment was a one-time session instead of a series of
sessions which would more closely parallel on-going
counseling. Nevertheless, the arguments stand that the
identified population is one that has established some
counselor/client relationships through the structured
classroom units and that the purpose of the study was to
determine whether direct address of confidentiality in a
guidance unit does indeed impact students.


81
expect them to enter the relationship believing that what
they said may be revealed in public could hardly be
considered therapeutic.
Everstine et al. (1980) reminded that clients may
inadvertantly, and inadvisedly, waive their right to
privacy simply by entering in the psychotherapeutic
relationship. Hence, these authors postulated that
clients should be given sufficient opportunity for
reflection on whether or not to waive their rights. Some
authors (e.g., Seigal, 1979; Slawson, 1969; Szasz, 1967)
have gone so far as to state that to adequately protect
the client's confidentiality, therapists should have no
communications with any third party.
Beyond clients' expectations of implicit
confidentiality are the assumptions that help will be
forthcoming from the therapist. While the instillation
of hope is viewed as a facilitative condition for
effective therapy (Yalom, 1975), the client may
erroneously assume that the therapist can solve anything
and everything. This unrealistic expectation may lead to
unrealistic goals which could ultimately be deleterious
to the client. Karasu (1980) pointed out that misleading
expectations may be perpetrated by the therapist when the
need to instill hope becomes intertwined with the aura of
omniscience.
Even in group settings, members tend to expect
confidentiality. Research has suggested that group


considerations, particularly in regard to
confidentiality, are difficult to untangle.
64
Ethical and Legal Aspects
The American School Counselors Association (ASCA)
has an ethical standard which specifies different
responsibilities to pupils, parents, school personnel,
community, self and profession (1984). The code was just
adopted by the ASCA Delegate Assembly in March 1984 and
represents some significant adoptions from the previous
ASCA Code of Ethics (1972).
The present code, in Section A, Responsibility to
Pupils, stipulates that the school counselor
Has a primary obligation and loyalty to the
pupil . ., protects the confidentiality of
information received in the counseling process
as specified by law and ethical standards,
[and] informs the appropriate authorities when
the counselee's condition indicates a clear and
imminent danger to the counselee or others.
This is to be done after careful deliberation
and, where possible, after consultation with
other professionals. (p. 7)
Moreover, the current code specifically addresses
the issue of confidentiality in responsibility to parents
and colleagues. Significantly, the school counselor:
Informs parents of the counselor's role with
emphasis on the confidential nature of the
counseling relationship between the counselor
and counselee, . treats information
received from parents in a confidential and
appropriate manner, shares information about a
counselee only with those persons properly
authorized to receive such information, . .
[and] promotes awareness and adherence to


127
(experimental condition, subjects' sex and subjects'
race) significantly differed on two dependent variables
(knowledge of confidentiality and perception of group
trust) in a sample of sixth-grade students who had a
preexisting relation with their counselors through
classroom guidance units. The experimental conditions
addressed in small groups were the following:
Counselors' verbal explanation regarding confidentiality,
specifically, ethical responsibility and limitations
(El); the combination of counselors' explanation and
members' role playing case situations (E2); and no
exposure to the issue of confidentiality (C).
Pretreatment data (subjects' attitude toward group
environment) were also obtained to assess equivalence of
groups prior to intervention (or to statistically correct
for inequality of pretreatment groups if necessary).
Chapter I dealt with the need, purpose and rationale
of the study, as well as specified research questions,
defined relevant terms and described the organization of
the remainder of the study. The research related to
counseling confidentiality and trust was reviewed in
Chapter II. Those two areas were examined in relation to
self-disclosure, demographic and other variables, ethical
standards, privileged communication, and case records.
Other significant areas explored were group settings,
minor clients, school counseling, and clients'
expectations/counselors' assurances. The method of


CHAPTER IV
RESULTS
The purpose of this study was to investigate whether
subjects grouped by three independent variables
(experimental condition, subject sex and subject race)
significantly differed on two dependent variables
(knowledge of confidentiality and perception of group
trust) in a sample of sixth-grade students who had a
preexisting group counseling relationship with their
school counselors. Pretreatment data (attitude toward
group environment) were also obtained. One hundred and
sixty-one students participated in this study, with all
subjects having complete data on all variables. Data
analyses were conducted as outlined in Chapter III.
Group Environment Questionnaire
Analyses of variance on the pretreatment instrument,
the GEQ, yielded no significant differences for subjects
grouped by any of the independent variables--subjects'
assigned experimental condition, subjects' sex or
subjects' race. Table 4-1 shows the mean total GEQ
scores for each of the groups, including statistics of
the analyses of variance (ANOVA). As equivalence of
118


67
status and client confidentiality. He concluded that
professional associations need to assume leadership roles
in a push for uniform legislation.
A decade ago, the AACD (then the American Personnel
and Guidance Association, APGA) addressed the issue of
privileged communication at a national conference. The
committee report stated that privileged communication
refers to information that belongs to the student. While
it is shared with the counselor, it may be released only
upon authorization by the student involved. The document
also identified those states which had a communications
privilege for school students and counselors (Shafer,
1974).
Haney (1970) asserted that privileged communication
may not be what school counselors need, as it would
protect the pupil-client, not the counselor. Further,
information could not then be used to benefit the
counselee. The recommendation was made that each state
construct guidelines to give assistance in understanding
issues of protection of confidential information to
schools, especially school counselors. It should be
noted that "at least half of the states in the nation"
(p. v) have passed legislation giving pupils twelve years
of age and older the right of limited confidentiality in
their communication with school counselors (C.S.D.E.,
1982).


53
Where a legal minor is the primary client,
the interests of the minor shall be
paramount. The child's best interests to
do so [sic]. In such cases, psychologists
make a serious attempt to obtain the
child's consent. ("Proposed to," 1977,
p. 84)
Nevertheless, when the revisions were actually
adopted, the minor client's rights had been diluted,
although at least they were specified. Sections A and D
of Principle 5 of the current code state:
Information obtained in clinical or
consulting relationships, or evaluate data
concerning children, students, employees,
and others, is discussed only for
professional purposes and only with persons
clearly concerned with the case. . When
working with minors or other persons who
are unable to give voluntary, informed
consent, psychologists take special care to
protect these persons' best interests.
(APA, 1981, unpaged)
Thus, the current APA code recognizes the "best
interests" of minor clients but designates them as
"unable to give informed consent."
The issue thus becomes whether it is desirable, even
possible, to maintain an attitude of strict privacy and
confidentiality with adult clients in counseling but not
with minor clients. More than three decades ago, in an
article entitled "The Ethics of Counseling," Wrenn (1952)
proposed ethical guidelines advocating confidentiality in
the counseling relationship with children.
It has been suggested that the confidential
nature of the interview is less to be
stressed when the client is a child and
that permission to transmit is not
necessary for children. I doubt this


19
opportunity must exist to know the client through his/her
disclosures in order for the therapist to empathize with
him/her. Moreover, through clients' self-understanding,
they can gain power, and therefore freedom.
Egan (1975) clarified that "no claims are made here
that self-disclosure 'cures,' for it is a stage in a
developmental process" (p. 115). He asserted that
self-disclosure should be functional and pragmatic, and
thus the client would be helped to uncover concrete and
relevant feelings, experiences, and behavior. Egan
further emphasized the importance of self-revelation as a
means to effective psychotherapeutic outcome. It is "not
a goal in itself ... it usually is subsidiary to other
goalsthat is, dynamic self-understanding and action"
(p. 154).
Overall, then, expressiveness and self-disclosure
are considered essential parts of the process of
self-actualization (Jourard, 1971a; 1971b). Mowrer
(1968a, 1968b) asserted that self-disclosure can release
a great deal of "healing" force or resources in any
client. Sullivan (1953) described the critically
important function of self-discovery through "consensual
validation" as a self-stablizing phenomenon within the
psychotherapeutic process.


34
their work. . They reveal such
information to others only with the consent
of the person or the person's legal
representative, except in those unusual
circumstances in which not to do so would
result in clear danger to the person or to
others. (APA, 1981, unpaged)
Like counselors, psychologists are expected to inform
their clients of the legal limits of confidentiality
where appropriate. Similarly, a statement by the
American Psychiatric Association (1970) described
confidentiality as a bond between therapist and patient
which is both "sacred" and "mandatory" (p. 1549).
The National Education Association's NEA Handbook
(1975-76) also emphasizes professional responsibility to
honor and protect confidences. Principle 1, Commitment
to the Student, reads, in part, that the educator, "shall
not disclose information about students obtained in the
course of professional service, unless disclosure serves
a compelling professional purpose or is required by law
(NEA, 1975-76, p. 235). Likewise, the National
Association of School Psychologists (NASP) has
established guidelines for professional relationships in
regard to confidentiality. Principles Illb of its
ethical code emphasizes the school psychologist's
responsibility to explain to students the uses to be made
of information obtained and any obligation the
psychologist has for reporting specific information;
principle Vd points out the psychologist's responsibility
to "safeguard the personal and confidential interests of
those concerned" (NASP, 1976, p. 103).


184
McDavis, R. J. (1980). The Black client. In N.A. Vacc &
J.P. Wittmer (Eds.), Let me be me: Special
populations and the helping professional. Muncie,
IN: Accelerated Development.
McDermott, P. A. (1972). Law, liability, and the school
psychologists: Systems of law, privileged
communications and access to records. Journal of
School Psychology, 10, 299-305.
McDermott, P. A. (1974). Law and the school
psychologist: Privileged communication, malpractice
and liability. School Psychology Digest, 3_, 25-31.
McGuire, J. M. (1974). Confidentiality and the child in
psychotherapy. Professional Psychology, 5, 374-379.
McGuire, J. M., & Bowory, T. D. (1978). Confidentiality
and the Buckley-Pell amendment: Ethical and legal
considerations. Personnel and Guidance Journal, 56,
554-557.
Messenger, C., & McGuire, J. M. (1981). The child's
conception of confidentiality in the therapeutic
relationship. Psychotherapy: Theory, Research and
Practice, 18, 123-130.
Meyer, R. G. (1974). Issues on the interface of law and
psychology. In A. Robin (Ed.), Clinical psychology:
Issues of the seventies. East Lansing: Michigan
State Press.
Meyer, R. G., & Smith, R. (1977). A crisis in group
therapy. American Psychologist, 32, 638-643.
Miller, A. R. (1971). The assault on privacy. Ann
Arbor: The University of Michigan Press.
Moore, H. B., & McKee, J. E. (1979). Child abuse and
neglect: The contemporary counselor in conflict.
School Counselor, 26, 288-92.
Moos, R. (1974a). Combined preliminary manual for
family, work and group environment scales. Palo
Alto, CA: Consulting Psychologists Press.
Moos, R. (1974b). The social climate scales: An
overview. Palo Alto, CA: Consulting Psychologists
Press.
Moos, R. (1981). The group environment scale manual.
Palo Alto, CA: Consulting Psychologists Press.


177
Asch, S.E. (1951). Effects of group pressure upon the
modification and distortion of judgments. In H.
Guetskow (Ed.), Groups, leadership and men.
Pittsburgh, PA: Carnegie Press.
Avila, D. L., & Avila, A. L. (1980). The
Mexican-American. In N. A. Vacc & J. P. Wittmer
(Eds.), Let me be me: Special popultions and the
helping professional. Muncie, IN: Accelerated
Development.
Azima, F. J. (1974, August). Effective communication in
adolescent group psychotherapy. Paper presented at
the annual meeting of the American Psychological
Association, New Orleans, LA.
Baizerman, M. (1974). Toward analysis of the relations
among the youth counterculture, telephone hotlines,
and anonymity. Journal of Youth and Adolescence, 3,
293-306.
Blaine, G. B., Jr. (1964). Divided loyalties: The
college therapist's responsibility to the student,
the university, and the parents. American Journal
of Orthopsychiatry, 34, 481-485.
Blau, B. S. (1953). A comparison of more-improved with
less-improved clients treated by client-centered
methods. In W. U. Snyder (Ed.), Group report of a
program of research in psychotherapy. State
College, PA: State College Research Group.
Blue, R. (1973). Pupils rights and the paper invasion.
Elementary School Journal, 74, 2-8.
Boyd, R. E., & Heinsen, R. D. (1971). Problems in
privildged communications. Personnel and Guidance
Journal, 50, 276-279.
Boyd, R. E., Tennyson, W. W., & Erickson, R. (1973).
Counselors and client confidentiality. Counselor
Education and Supervision, 12, 278-288.
Braaten, L. J. (1958). The movement from non-self to
client-centered psychotherapy. Unpublished doctoral
disseration, University of Chicago.
Brammer, L. M. (1973). The helping relationship:
Process and skills. Englewood Cliffs, NJ:
Prentice-Hall.
Brodsky, S. (1972). Shared results and open files with
the client. Professional Psychology, 3^, 362-364.


The researcher will role play the group leader
while the counselors act as group members.
Throughout, the Guidance Session Units will be
followed closely. Each counselor will then take
a turn as the group leader, with various
sections being practiced.
Deviations from the written unit will be
identified and correctly practiced. Any
counselor questions will be answered.


39
There have been two notable attempts to protect the
rights and privacy of students in recent years. In 1971,
the National Education Association, which has
traditionally argued for comprehensive record keeping,
approved a code of students' rights and responsibilities
(Burcky & Childers, 1976). According to this act,
students' interests supersede all other interests for
record-keeping purposes.
In 1974, federal legislative action--the Buckley
Amendment, Public Law 93.380became effective. This act
requires that eligible students (generally defined as
eighteen years of age or older) or the parents of
students have the right of access to all official files,
records and data concerning their children (Education
Amendments, 1974).
McGuire and Borowy (1978) have focused on the
question of whether records in guidance offices,
counseling centers and diagnostic or evaluative service
centers are applicable. Typically, the statute is
interpreted to mean that the counselor's records are
confidential and do not become part of the student's
cumulative record (Cutler, 1975), yet some university
officials interpret the Buckley Amendment to mean that
counseling records of students ought to be made available
at least on a conditional basis (Kazalunas, 1977).
Perhaps more basic than the status of files is the
question of whether the Buckley Amendment violates the


73
parental rights tend to be acknowledged, although with
varying degrees of intensity. When the psychotherapeutic
relationship exists between student and counselor or
school psychologist, Blue (1973) and Goslin (1971) both
emphasized the importance of obtaining parental consent
and only secondarily mention that the consent of the
students is sometimes desirable. Along this same line,
Trachtman (1974) has clearly stated that he perceives the
parent as the client when the child is undergoing
counseling at school. The school, then, was viewed as an
instrument for the satisfaction of the parent.
McDermott (1972), however, acknowledged that
decisions as to whether or not to inform parents of facts
or professed facts revealed by pupil-clients are
difficult to make. While recognizing the importance of
confidentiality, he asserted that the pupil-client should
be informed that withholding confidence is not
guaranteed. He stated that the school employee
(counselor or psychologist) has neither the ethical or
legal prerogative to make an absolute confidential
agreement, nor does the child have the right to exercise
such requests or to give consent. He concluded that
parents "possess an unforfeitable right to all pertinent
information regarding their children" (p. 29). St. John
and Walden (1976) also emphasized the obligation to give
parents "information which will assist them in their
parental responsibilities" (p. 683).


KNOWLEDGE OF CONFIDENTIALITY AND PERCEPTION OF GROUP TRUST
THE EFFECTS OF COUNSELORS' EXPLANATIONS, STUDENTS'
ROLE PLAYING, AND SUBJECTS SEX AND RACE
BY
CHARLENE MARIE MESSENGER-WARD
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL
FOR THE
FULFILLMENT OF THE REQUIREMENTS
DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1984


89
confidential instructions and a
disproportionate underreporting of
non-confidential and neutral instructions, is
consistent with this interpretation. (p. 440)
Inconclusive results have been reported in a study
by Graves (1982), in which college students were given
low, moderate and high degrees of assured confidentiality
during a personal interview. The author concluded that
"although results were not statistically significant, a
trend consistent with this hypothesis [that amount of
client self-disclosure is directly dependent on the
degree of assured confidentiality] was supported by the
experimental results" (p. 68).
Even in the study by Singer (1978) in which a
confidentiality-assured condition produced the lowest
rate of nonresponding, the nonresponding occurred most
frequently on items referring to specific behaviors
rather than feelings or attitudes. It appears that
explicit verbal assurances of confidentiality are not
sufficient to overcome defensiveness in those areas
wherein severe social sanctions may be imposed for actual
deviance from accepted standards of conduct.
In a previous study by this author (Messenger &
McGuire, 1981), children age 6 to 15 who were in
counseling at a mental health center were individually
interviewed on a confidentiality questionnaire. Results
revealed that whether or not clients believe
confidentiality has been adequately explained to them
does not significantly affect their actual conception of


79
Expectations and Explanations
Client Assumptions and Expectations
One of the most important characteristics of
confidentiality is that the individual intended the
information to be confidential within the framework of
the relationship. In any therapeutic encounter, clients
bring with them preconceived expectations formed
idiosyncratically from life experiences. Fong and Cox
(1983) noted that while clients expectations range from
blind trust of any counselor to distrust and suspicion
regardless of evidence to the contrary, most clients fall
in the middle range. That is, they are "willing to trust
a counselor until their trust is abused" (p. 163),
although some may first test the counselor's trust.
Plaut (1974) stated that people typically expect
confidentiality when they meet their therapist. Studies
have indicated that subjects do have implicit
expectations of confidentiality (Edelman & Snead, 1972)
and that they simply assume that whatever they say will
be held in confidence (Woods, 1977).
Using uncoerced and anonymous responses from a short
questionnaire administered to a junior-level psychology
class, Meyer and Smith (1977) explored what the term
"confidentiality" meant to the respondents. The
overwhelming majority (84%) assumed that confidentiality
included a refusal to testify about a case even if
validly ordered to do so by a court of law; only 16%


REFERENCES
Ackley, S. (1974). Psychologists and individual rights.
School Psychology Digest, 3_, 21-25.
American Association for Counseling and Development
(1981). Ethical standards. Washington, DC: The
Association.
American Psychiatric Association (1970). Position
statement on guidelines for psychiatrists: Problems
in confidentiality. American Journal of Psychiatry,
126, 1543-1549.
American Psychological Association (1968). Ethical
standards of psychologists. American Psychologist,
23, 357-361.
American Psychological Association (1977). Ethical
standards of psychologists. Washington, DC: The
Association.
American Psychological Association (1981). Ethical
standards of psychologists. Washington, DC: The
Association.
American School Counselors Association (1972). Code of
ethics. Washington, DC: The Association.
American School Counselors Association (1976). Students
rights: A developing right to know. School
Counselor, 23, 281-288.
American School Counselors Association (1984). Ethical
standards for school counselors. The ASCA
Counselor, 21, 7-8.
Anderson, M. J., & Ellis, R. H. (1980). Indian American:
The reservation client. In N.A. Vacc & J. P.
Wittmer (Eds.). Let me be me: Special populations
and the helping professional. Munice, IN:
Accelerated Development.
Arnold, S. (1970). Confidential communication and the
social worker. Social Work, 15, 6-67.
Arthur, L. G. (1973). Should children be as equal as
people? In A. E. Wilkerson (Ed.), The rights of
children. Philadelphia: Temple University Press.
176


74
Moore and McKee (1979) have offered case studies to
illustrate the complexity of the school counselor's role
and the rights of parents. They explored the difficulty
of deciding at what point to break a student's private
communications. Their case studies focused on child
abuse and neglect, including what constitutes suspicion
of abuse and how to differentiate between abuse and
discipline. Considering counselor responsibilities as
well as rights of students and their parents' rights, a
major counselor concern is how to decide whether to
breach student confidentiality in such cases.
Counselor Perceptions and Practices
Apparently school counselors have many questions
about their obligation to parents, students, school
personnel and outside agencies. Guildroy (1979) has
offered case studies to assist school counselors in
exploring their attitudes and judgements with regard to
issues of confidentiality; he also addressed the
ambiguities inherent in such cases.
Wagner (1981) studied the beliefs and behaviors of
school counselors in regard to confidentiality using a
questionnaire based on the American Personnel and
Guidance Association's 1974 ethical standards as the
referent. Results indicated that confidentiality was
valued by most school counselors. Seventy percent
strongly agreed that the same degree of counseling


spaceI extend my gratitude. At the University of
Central Florida, appreciation is extended to Dr. Bob
Bollett and Dr. Lance Percy for demonstrating the essence
of counseling technique; and to Dr. Jack McGuire and Dr.
Hal Pringle for acting as consultants during different
phases of this project.
Professors at the University of Florida deserve much
credit for helping develop my competencies throughout the
program. Thanks are extended to the following: Dr. Paul
Fitzgerald for acting as my chairperson and fostering
independence and flexibility; Dr. Hannelore Wass for
generously giving empathy, honesty and expertise; Dr. Joe
Wittmer and Dr. Larry Loesch for responding to
individualized student needs; and Dr. Robert Myrick for
providing sufficient challenge along the way.
Finally, heartfelt gratitude is extended to my
family. I thank my parents for fostering the desire to
learn and excell and for encouraging me as I did so.
Most of all, my husband, Mike, deserves highest honors
for his love and support. During the past several years,
he has survived endless piles of papers and books and
numerous ups-and-downs; throughout, he has demonstrated
infinite patience--a quality that I am still developing.
v


71
to the clientschool counselors and student clients
inclusive.
The degree of allegiance to the student versus the
school has been explored in research of professionals'
attitudes. A study by McRae (cited in Clark, 1967)
entailed a survey of the attitudes of both counselors and
school administrators toward confidentiality with
pupil-clients. The results of this study indicated that
almost all the counselors (95%) and a majority of the
administrators (68%) agreed that a counselor should treat
information obtained in a counseling interview (and the
records of such information) as confidential to be
discussed with no one except the student in counseling.
Furthermore, the counselors were united in their
disagreement (92% disagree)though a majority of
administrators were in agreementregarding the position
that a counselor ought to furnish any information
obtained in a counseling situation to parents or the
principal upon legitimate request. Clark made a point
that the official position of the counseling profession
is one of limited confidentiality to minors; that is,
when a pupil is a minor with the attendant legal, moral,
and other responsibilities on the parent and school, such
information must be shared with them in some form or
manner. Nonetheless, these counselors did not support
the official position, instead taking the position that


38
oath or before a grand jury or court of law (Wrenn,
1952). Goldstein and Katz (1962) have stated that
treatment of the mentally ill is too
important and the assurance of
confidentiality too central to it, to risk
jeopardizing the whole because of the
relevance of some patients' statements to
some legal proceedings, (p. 735)
Legal testimonial privilege is not assured to
clients of therapists, however, and some states have no
privileged communication statute for clients of
psychologists and counselors. The California Supreme
Court, while endorsing the principle of
psychotherapist/client privilege has concluded that
absolute confidentiality was not needed to
protect the psychotherapeutic relationship
and that the judge could determine what
confidential information has to be
disclosed to ensure the carrying out of
justice. (Plaut, 1974, p. 1023)
Similarly, Hollender (cited in Dubey, 1974), concluded
that many of the diverse operations of psychotherapy do
not require confidentiality at all.
Case Records
The aspect of confidentiality of case records
presents a number of controversies: the right of outside
agencies to have access to the records, the availability
of records to various personnel within the institution
and the right of parents to inspect the records of their
children. This last area of confidentiality represents a
unique situation, since parents are ostensibly acting on
behalf of an individual who is a minor.


56
apparently being that the child's communications to the
counselor are open to the parent.
Slovenko (1966) wrote that "child therapy can never
be a strictly two person arrangement" (p. 57). He
encouraged parental involvement in child therapy,
specifically noting that "environmental manipulation" may
be essential in the treatment of children. Slovenko and
Usdin (1961) took a similar position. These authors
emphasized the sanctity of confidentiality in the
patient/psychiatrist relationship, stating that for the
good of the patient "the psychiatrist is indeed forced to
keep the patient's confidence" (p. 428). Nonetheless,
they made the clear distinction that children (along with
the physically handicapped and alcoholics) are exceptions
to this psychotherapeutic approach because others are
directly responsible for them.
Goldman (1972) derogated the assumption that
children or adolescents should be given a confidential
counseling relationship because of his belief that
parents know what is best for their child. Only in cases
where the parent is ignorant, disturbed, hostile, or
negligent should the counselor supersede the usual
parental prerogatives.
Legally and morally parents are responsible
for their children, and no professional
person . has any business placing
himself in loc parentis. After all, it is
the parent who will have to live with the
outcome and will be responsible for what
happens thereafter. (pp. 371-372)


125
high (t = 1.707; df = 20; £ < .05) and males scored
significantly low (t = 1.452; df = 29; £ < .10).
TABLE 4-6 MEAN EXPRESSIVENESS SCORES FOR EXPERIMENTAL
CONDITION BY SEX
EXPERIMENTAL
CONDITION MALE FEMALE TOTAL MEAN
C 5.30 6.38 5.75
El 5.14 4.81 4.98
E2 6.04 5.04 5.53
Total Mean 5.48 5.33 5.41
For the subscale Self-Discovery, analysis of
variance revealed a significant difference for main
effect of experimental condition (F = 4.143; d_f = 2/149;
£ < .018). Further analysis of this difference
(Scheffe's test; alpha = 0.10 level) revealed that the El
group scored significantly lower than the C group and the
E2 group, with neither of the latter groups significantly
differing from each other (see Table 4-4). This subscale
of Self-Discovery, then, yielded statistical results in
the same pattern as the total GTQ scores.


149
of trust, or involvement of significant others in the
groups, such as parents, teachers and/or school
administrators.
13. Race and sex may be investigated as significant
variables not only for subjects but for the counselor and
the classroom teacher as well. In such a study,
interaction effects might be particularly interesting.
14. Subject variables besides sex and race may be
studied. Knowledge of confidentiality and perception of
group trust could be assessed in relation to variables
such as concurrent academic grades, scores on
standardized achievement tests, previous or concurrent
counseling experience, and/or present family
constellation.
Summation
Studies by other investigators which have explored
the issue of confidentiality in counseling have focused
largely on adults. Studies which have included children
have focused on individualized counseling relationships
outside the school system and have not examined the
impact of a direct address of confidentiality with
minor-clients. Using a posttest only, control-group
design, the current study attempted to explore
sixth-grade students' knowledge of confidentiality and
perception of group trust as functions of counselors'
verbal explanation and the combination of explanation and
members' role playing. Variables of subjects' sex and


66
nonvaluative evaluations on student records and
documents. The association also clearly specifies the
importance of enlightening students about rights and
limitations by promoting
Student orientation to all rights and due
processes open to him/her, i.e., how to get
one's rights as a student; what to do if
searched, seized, or interrogated; reviewing
one's school records (or parental review of
same); resources of assistance available to
students; freedom to express one's views.
(pp. 281-282)
While the promoted practices are geared towards
advocacy of the student, ASCA also recognized the rights
of parents. The ethical code states that the school
counselor
Respects the inherent rights and
responsibilities of parents for their children
and endeavors to establish a cooperative
relationship with parents to facilitate the
maximum development of the counselee. (p. 7)
As far as the legal aspects, Nolte (1976) emphasized
that students' rights and guidance counselors'
responsibilities differ under various state laws.
Although some topics may be addressed by some federal
laws, issues which may vary for school counselors from
state to state include privileged communication statutes,
rights of parents, rights of school authorities, .
confidentiality of student records, freedom of
information, due process, and legal ramifications of
various kinds of counseling (e.g., drug, medical, sexual,
moral). Litwack (1969) briefly reviewed the literature
regarding state laws concerning school counselors' legal


144
Furthermore, when leading small group counseling
sessions, the counselor may want to emphasize this
stipulate to minority students so that they do not
misinterpret group norms to mean that it is acceptable to
talk about group members' disclosures to others outside
the group.
Taken a step further, from practice to training,
several additional implications are apparent. At the
university level, future counselors should clearly study
the issue of confidentiality with its ethical
responsibilities and limitations. It is too important a
concept to be left to chance, to be considered to be
implicitly understood, or to be cursorily addressed in an
introductory overview course. As there would likely be
no course focused solely upon counselor ethical codes,
this topic should be sufficiently studied in a course of
professional concerns.
This research also indicates that future counselors
should be skilled in group work as part of their
comprehensive package of services. As most institutions
do require at least one course in groups, the current
findings highlight the importance of role play as an
essential group technique to be developed. It is also an
essential responsibility of counselor educators, either
through course work or supervision, to make sure that
future counselors are sensitive to value differences in
their clients due to sex or race, although the current


185
Mowrer, 0. H. (1968a). Loss and recovery of community:
A guide to the theory and practice of integrity
therapy. In G. M. Gazda (Ed.), Innovations to group
psychotherapy. Springfield, IL: Charles C. Thomas.
Mowrer, O. H. (1968b). New evidence concerning the
nature of psychopathology. In M. J. Feldman (Ed.),
Studies in psychotherapy and behavior change.
Buffalo, NY: University of New York at Buffalo.
Mowrer, 0. H. (1973). Integrity groups today. In R. M.
Jurjevich (Ed.), Direct psychotherapy: Twenty-eight
American originals. Vol. II. Coral Gables, FL:
University of Miami Press.
Muro, J. J., & Dinkmeyer, D. C. (1977). Counseling in
the elementary and middle schools. Dubuque, IW:
William Brown.
Myrick, R., & Merhill, H. (1983). Elementary guidance
counselor-led classroom guidance units on student
attitudes. Orlando, FL: Orange County Public
Schools.
National Association of School Psychologists (1976).
Principles for professional ethics. NASP handbook.
Washington, DC: The Association.
National Association of Social Workers (1967). Code of
ethics. Washington, DC: The Association.
National Education Association (1975-76). NEA handbook.
Washington, DC: The Association.
Nie, N. H., Hull, C. H., Jenkins, J. G., Steinbrenner,
K., & Bent, D. H. (1975). Statistical package for
the social sciences (2nd edTJ New York:
McGraw-Hill.
Nixon, M. (1982). The psychological rights of the child
and schooling. Viewpoints in Teaching and Learning,
58, 99-112.
Noll, J. (1974). Needed: A bill of rights for clients.
Professional Psychology, 5^, 3-11.
Noll, J., & Hanlon, M. J. (1976). Patient privacy and
confidentiality at mental health centers. American
Journal of Psychiatry, 133, 1286-1289.
Nolte, M. C. (1976). Legal aspects of guidance and
counseling in Colorado. Denver: Colorado State
Dept of Education.


106
Expressiveness the extent to which freedom of action
and expression of feelings are
encouraged; and
Self-Discovery the extent to which the group encourages
members' revelations and discussions of
personal information. (Moos, 1981, p.
2)
Reliability of subscales is addressed in Table 3-4.
This shows the internal consistency (Cronbach's Alpha)
for each of the subscales and test-retest (one month
interval) reliability of individual scores. The manual
states that the internal consistencies and test-retest
reliabilities "are all in an acceptable range" (Moos,
1981, p. 6). Moreover, another important characteristic
is the stability of the profile. Stability measures
reported in the manual (on research by various authors)
indicate "mean profile stability was .92 after 4 months,
.91 after 8 months, .84 after 12 months, and .78 after 24
months" p. 6).
TABLE 3-4 SUBSCALE INTERNAL CONSISTENCIES AND
TEST-RETEST RELIABILITIES FOR THE GES, FORM R
Subscale*
Internal Consistency
(Cronbach's
Alpha)
(N=246)
1-Month
Test-Retest
Reliability
(N=63)
Cohesion
.86
.79
Leader Support
.74
.73
Expressiveness
.70
.67
Self-Discovery
.83
.83
* Each subscale has nine items.


12
The results of the study are presented in Chapter IV,
including analysis of the data. A summary of the study,
discussion of results, conclusions drawn from the
research, and recommendations for further research are
addressed in Chapter V.


APPENDIX B
CHILD CONFIDENTIALITY QUESTIONNAIRE
Code Number
(1)
1.
It is part of your counselor's job to
keep things secret that you ask
him/her to?
YES
NO
(A)
2.
Is it part of your teacher's job to
give you homework?
YES
NO
(4)
3.
Should your counselor get your per
mission before he/she tells another
person something you told him/her?
YES
NO
(D)
4.
Should you have to help clean the
classroom, even if you are not the
one who made it messy?
YES
NO
(3)
5.
Do you think your counselor is
supposed to talk to his/her friends
about what you say?
YES
NO
(B)
6.
Do you think your teacher is supposed
to make school fun even if you don't
like it?
YES
NO
(2)
7.
Suppose your counselor thought that
there was an emergency and that
telling another person what you said
would help you best. Should he/she
tell the person?
YES
NO
(c)
8.
If your teacher really cares about
you, is it OK if he/she gives you
hard work?
YES
NO
(5)
9.
Is your counselor supposed to tell
you which things he/she cannot keep
secret from other people?
YES
NO
(B)
10.
Is your principal supposed to paddle
those students who are behavior
problems?
YES
NO
(1)
11.
Do you think your counselor keeps
your secrets as well as he/she
would keep a grown-up's secrets?
YES
NO
(A)
12.
Do you think more time should be
spent in P.E. than in Reading?
YES
NO
152


31
interaction is highly confidential, and since counselees
discuss themselves in an intimate fashion, it is highly
private" (p. 16). Likewise, Shertzer and Stone (1976)
indicated that the counseling relationship "requires
privacyboth auditory and visualand confidentiality,
because of the self-revealing and intimate experiences
related by the counselee to the counselor" (p. 177).
In a survey of mental health professionals in North
Dakota, Jagim, Wittman, and Noll (1978) found that the
responding professionals were unified in their agreement
of an ethical obligation to keep the therapist-client
information confidential. Indeed, confidentiality was
perceived as a significant element in the maintenance of
a positive therapeutic relationship. Additionally, there
was consensus that confidentiality was an important and
integral aspect in the therapeutic encounter. More
specifically, confidentiality was seen as essential in
maintaining a positive therapeutic relationship by 98% of
the professionals (56% very strongly agree, 25% strongly
agree, 17% agree). In addition to the necessity of
confidentiality for the therapeutic relationship, 98% of
the mental health professionals agreed that there was a
professional-ethical obligation to keep information
concerning a client confidential (72% very strongly
agree, 14% strongly agree, 6% agree).
Interestingly, an earlier study indicated that
institutions in which the professionals practice do not
necessarily value confidentiality as highly. Noll and


138
Final, but very important, considerations relate to
the restrictiveness of the sample chosen for this
research project. All participants were in the sixth
grade, so that generalizations to younger elementary or
older secondary students should be made cautiously. Too,
all subjects had a preexisting relationship with their
school counselors through structured classroom guidance
units. Consequently, there is hesitation in applying the
findings to students without a similar background, for
example, students with no previous contact with the
counselor, students in concurrent individual and/or
family therapy, students who have previously had some
experience with another counselor, or students who have
initiated contact with the counselor, seeking resolution
of a personal conflict.
Keeping these factors in mind, some conclusions may
be drawn in answer to the proposed research questions.
School counselors' direct address of confidentiality in
small group sessions does have an impact on students'
knowledge of confidentiality and their perceptions of
group trust. Results can be interpreted to mean that
students evolve a conception of confidentiality gradually
with increased exposure to and involvement with it.
Children with no exposure may misinterpret some of the
basic stipulates of confidentiality in the counseling
relationship. This conclusion is underscored by the
pattern of obtained scores on the subareas concerning


22
males in self-disclosure across conditions, even though
the females demonstrated a greater willingness than males
to participate in the study. The authors concluded that
"females are more cautious and have a higher level of
self-protective needs than males" (p. 441). O'Kelly and
Schuldt (1981) also found males to disclose more than
females, and Rosen (1977) found that females were more
likely than males to refuse to sign release of
information forms. Singer (1978) found that although
women enjoyed talking more, men were more willing to face
the risks associated with being interviewed for surveys
requesting personal and sensitive information.
In contrast to these findings, other investigations
have suggested that females disclose more than males. In
a study by Jourard and Lasakow (1958), results were
reported in which females had higher self-disclosure
scores than males. This finding has been replicated by
Dimond and Munz (1967), Himelstein and Lubin (1965), Hood
and Back (1971), Jourard and Landsman (1960), Jourard and
Richman (1963), Pederson and Breglio (1968), and Pederson
and Higbee (1969). Using written self-descriptions,
Pederson and Breglio (1968) found that females did not
use more words to describe themselves than males, but
they disclosed more intimate information about themselves
than did males. Jourard (1961) attributed considerable
importance to the obtained sex differences. The low
disclosure of males was perceived to be directly


46
respondent and other group members outside
the meeting. . The people most
frequently attributed with receiving
information from the leaders were someone
at the university or agency, the member's
teacher, and/or the leader's friends.
(p. 200)
In his interpretation of self-disclosure in a
counseling group, Christiansen (1972) questioned whether
confidentiality could truly be guaranteed because the
information is told to all group members. He contended,
however, that in effective group interaction,
confidentiality of communications is a by-product.
As group members begin to trust one another
and feel more secure, the group loses all
concern about the possibility that another
member of the group may tell an outsider
about something that has been said in the
group meetings. Until they gain this
security, nothing much really happens in
the group. (p. 127)
Another facet of group work relates to
"self-selected" groups, wherein members may forsee the
confidentiality problem and thus exclude potential
informers (or "ratters") from their group (Christiansen,
1972). An advantage of a self-selected group has been
identified as a more quickly and freely moving counseling
process. Taping of sessions is another aspect of group
sessions in which success is dependent upon trust among
group members; if accepted, its advantages include
allowing members to listen to previous sessions or to
missed sessions and allowing the leader to improve
counseling skills by reviewing the tapes (Christiansen,
1972).


190
Weigel, R. G., Weigel, V. M., & Chadwick, P. C. (1969).
Reported and projected self-disclosure.
Psychological Reports, 24, 283-287.
Wheeler, P. T., & Loesch, L. (1981). Program evaluation
and counseling: Yesterday, today and tomorrow.
Personnel and Guidance Journal, 59, 573-376.
Wigmore, J. H. (1961). Evidence in trials at common law.
Vol. 8. (McNaughton rev.) Boston: Little-Brown.
Wilkerson, A. E. (1973). The rights of children.
Philadelphia, PA: Temple University Press.
Wilson, S. J. (1978). Confidentiality in social work:
Issues and principles. New York: Free Press.
Winer, B. J. (1971). Statistical principles in
experimental designs (2nd ed.). New York:
McGraw-Hill.
Wolfson, K. S. (1949). Clients explorations of their
problems during client-centered therapy.
Unpublished master's thesis, University of Chicago.
Woods, K. M. (1977). The effects of instructions
regarding confidentiality on depth of
self-disclosure and behavior indicants on anxiety in
an analogue. (Doctoral dissertation, Ohio
University, 1977). Dissertation Abstracts
International, 38, 6186B. (University Microfilms
No. 7807532).
Woods, K. M., & McNamara, J. R. (1980). Confidentiality:
Its effects on interviewee behavior. Professional
Psychology, 11, 714-721.
Wrenn, C. G. (1952). The ethics of counseling.
Educational and Psychological Measurement, 12,
161-177.
Yalom, I. D. (1975). The theory and practice of group
psychotherapy. New York: Basic Books.


68
A study by Frerqueron (1974) examined school
counselors' ability to justify a need for statutory
protection of privileged communication of their clients.
The main arguments supporting privileged communication
for students working with school counselors were that
students would be reluctant to seek the school
counselors' services if they feared their communications
would be disclosed; the counselor needs the ability to
guarantee confidentiality in order to function in his
professional role; Wigmore's (1961) criteria for
privileged communication are satisfied by the counseling
relationship; and the very nature of the counseling
relationship necessitates the assurance of
confidentiality. Further arguments were cited in
comparing the school counseling relationship to
established privileged professional relationships (i.e.,
attorney/client, physician/patient, and
psychologist/client). Arguments opposing privileged
communication were: the school counselor lacks
professional standards; privileged communication acts as
an obstruction to justice and also restricts the
counselor's ability to consult with other individuals;
and a strong code of ethics is better protection than
legislation.


148
believe their children perceive the counseling
relationship. These scores could in turn be compared to
the scores of counselors and/or students. Such a study
would have important implications for the school
counselor and may give insight into the perceptions of
significant others when the client is a minor.
11. Utilization of different posttreatment
assessment methods may yield valuable information not
obtained through the present questionnaires. One
possibility is to utilize a questionnaire asking for
personal disclosures in low, medium and high levels of
inti acy; subjects would be assessed on their willingness
to self-disclose responses. Another possibility, since
the behavioral component was found to be important in
treatment, is to utilize a behavioral assessment method,
such as tape recording segments of later group sessions
and having independent judges rate the tapes for level of
self-disclosure. Another option is to assess different
variables important in group process besides trust, for
example, independence, anger/aggression, or task
orientation.
12. Additional research may investigate whether the
guidance session unit utilizing role playing may be
improved. Instead of these three experimental
conditions, other conditions may include role playing
prior to and after explanation, two or more session on
the topic of confidentiality, direct address of the topic


150
race were also investigated.
Results of this study indicate that students
gradually evolve a conception of confidentiality that is
consistent with professional guidelines as they become
more involved with it. Thus, a behavioral component,
that is, role playing, is important. Results also
emphasize that a verbal explanation alone may increase
defensiveness and reduce willingness to disclose.
Finally, while sex and race were not significant
variables overall, they may be situation specific, so
that counselors do need to be aware of individual
differences.
Such results have important implications for theory,
training, practice and future research. This study
supported the need to directly address confidentiality
with minor-clients, as otherwise they may misinterpret
some of its basic stipulates. Moreover, an optimal
approachone involving behavioral as well as verbal
aspectsis suggested to accomplish this. Practicing and
future counselors need to be aware of ethical guidelines
and need to have adequate skills in group work,
particularly role play techniques. Future studies may
address replication of the procedures with different
populations, with additional independent variables, or
with different assessment approaches, or may address
variations wherein significant others, such as
counselors, teachers or parents, are the subjects.


105
(e.g., a student executive council); social and
recreational groups (e.g., chess clubs or boys' and
girls' sports teams); and psychotherapy and mutual
support groups. The length of time of the groups ranged
from one week to five years. Group size ranged from
eight to 50 members. Leadership ranged from no
identified leaders, leaders elected by the membership and
leaders appointed by others outside the group. Five
psychometric criteria (described in detail in the manual)
were used to select items for the final form of the GES,
and all criteria were met (Moos, 1974a). Normative data
(described in detail in the manual) were collected for
members in 130 groups and leaders in 112 groups.
While ten subscales are available from the GES, only
four were utilized for this research. Permission was
granted by the publisher, Consulting Psychologists Press,
Inc., Palo Alto, CA, to reproduce these copyrighted items
in briefer questionnaires for the purpose of this
research study only. The following four subscales were
utilized:
Cohesion the degree of members' involvement in
and commitment to the group, and the
concern and friendship they show for one
another;
Leader Support the degree of help, concern, and
friendship shown by the leader for the
members;


182
Hurvitz, N. (1970). Peer self-help psychotherapy groups
and their implication for psychotherapy.
Psychotherapy: Theory, Research, and Practice, 7,
41-49.
Hyman, I., & Schreiber, K. (1975). Selected concepts
and practices of child advocacy in school
psychology. Psychology in the Schools, 12, 50-58.
Ivey, a. E. (1980). Counseling and psychotherapy:
Skills, theories, and practice. Englewood Cliffs,
NJ: Prentice-Hall, Inc.
Jagim, R. D., Wittman, W. E., & Noll, J. D. (1978).
Mental health professionals' attitudes toward
confidentiality, privilege, and third party
disclosures. Professional Psychology, 9, 458-464.
Jourard, S. M. (1959). I-thou relationship versus
manipulation in counseling psychotherapy. Journal
of Counseling Psychology, 15, 174-179.
Jourard, S. M. (1961). Religious denomination and
self-disclosure. Psychological Reports, 8, 446.
Jourard, S. M. (1968). Disclosing man to himself.
Princeton, NJ: Van Nostrand.
Jourard, S. M. (1971a). Self-disclosure: An
experimental analysis of the transparent self.
London: Wiley Interscience.
Jourard, S. M. (1971b). The transparent self (Rev. ed.).
New York: Van Nostrand Reinhold.
Jourard, S. M., & Landsman, M. J. (1960). Cognition,
cathexis and the "dyadic" effect in men's
self-disclosing behavior. Merrill-Palmer Quarterly,
6, 178-186.
Jourard S. M., & Lasakow, P. (1958). Some factors in
self-disclosure. Journal of Abnormal and Social
Psychology, 56, 91-98.
Jourard, S. M., & Richman, P. (1963). Disclosure output
and input in college student. Merrill-Palmer
Quarterly, 9, 141-143.
Kaplan, P. S. (1974). Counselor ethics and the faculty.
School Counselor, 21, 232-235.
Karasu, T. B. (1980). The ethics of psychotherapy.
American Journal of Psychiatry, 137, 1502-1512.


20
Counselors' Professionalism
Trust is basic not only to the therapeutic process
but to the very image of counselors in society as well.
Unless people feel they can rely on the professional to
keep what they say in confidence, many who need
counseling will not seek it. Dubey (1974) stated that
if the therapist cannot maintain privilege,
the inherent (social) power of his medical
position and judgement can render him so
muscle bound as to be therapeutically
crippled while conducting patient-centered
therapy. The treatment situation is bound
to be destroyed if confidentiality cannot
be maintained. (p. 1094)
Several notable judicial opinions have supported the
relationship of confidence and trust as essential to the
image of the psychotherapist. Judge Alverson of the
Supreme Court of Atlanta has stated that "Psychotherapy,
by its very nature, is worthless unless the patient feels
from the outset that whatever he may say will be forever
kept confidential" (Reynolds, 1976, p. 109). Judge
Edgerton, of the Court of Appeals of the District of
Columbia, has pointed out that a patient may respond to a
physician's treatment for many physical illnesses even
though she/he may not trust the doctor or have confidence
in him/her; in contrast, for the treatment of mental
problems, a relationship of trust and confidence is
essential (Reynolds, 1976).
Additionally, violations of clients' confidences
outside the courtroom may give rise to several possible
consequences. Shah (1969b) wrote that a psychologist who


2
ambiguity in the ethical codes of professional
organizations (McGuire, 1974). Current principles of
ethical standards of various helping professions directly
address the issue of confidentiality, with some making a
distinction between minors and other clients (e.g.,
American Psychological Association [APA], 1981) and some
being considerably more vague, referring to all clients
in general terms (e.g., American Association for
Counseling and Development [AACD], 1981).
Within the public school setting, the issues
regarding confidentiality and disclosure of personal
information are even more complex. Allegiance to
students, parents or institution as primary client is
often a dilemma for school counselors. School counselors
have geared their efforts toward advocacy of students
(American School Counselors Association [ASCA], 1976),
yet parental rights are also recognized and, further,
some professionals maintain that as a public employee,
the school counselor is responsible to teachers and
administrators as well (Ciar, 1967; Hart & Price, 1970;
Szasz, 1967). Studies indicate that although counselors
appear to have ambiguous or inconsistent perceptions
regarding issues of confidentiality with students
(Wagner, 1981), in actual practice, counselors and
psychologists do maintain the confidentiality of
communications of minors (Curran, 1969; Eisele, 1974;
McRae, cited in Ciar, 1967; McGuire, 1974; Wagner, 1981).


181
Goslin, D. A. (1971). Ethical and legal aspects of
school record keeping. National Association of
Secondary School Principals Bulletin, 55, 119-126.
Graves, S. L. (1982). Depth of self-disclosure as a
function of assured~~confidentiality and video
recording. Unpublished master's thesis, University
of Central Florida, Orlando, FL.
Greco, M., & McDavis, R. (1978). Cuban-American college
students: Needs, cultural attitudes, and vocational
development program suggestions. Journal of College
Student Personnel, 19, 254-258.
Greene, R., & Crowder, D. (1972). Group psychotherapy
with adolescents. Journal of Contemporary
Psychotherapy, i>, 55-61.
Guildroy, J. (1979). Counselor-student-parent
relationships: Ethical quandaries and legal
quagmires. College Board Review, 113, 8-13.
Gunnings, T. S. (1971). Counselors and confidentiality.
School Counselor, 18, 153-156.
Guttsmacher, M. D., & Welhofen, H. (1952). Psychiatry
and the law. New York: Norton and Company.
Haines, D. (1962). Psychiatry. Criminal Psychology, 2,
268.
Haney, G. (1970, March). Confidentiality and the school
counselor: Comments on inspection of public school
records and counselor privileged communications.
Paper presented at the convention of the American
Personnel and Guidance Association, Emporia, KS.
Hart, D. H., & Price, D. J. (1970). Role conflict for
school counselors: Training versus job demands.
Personnel and Guidance Journal, 48, 374-379.
Himelstein, P., & Lubin B. (1965). Attempted validation
of the self-disclosure inventory by the peer
nomination technique. Journal of Psychology, 61,
13-16.
Hollender, M. (1965). Privileged communication and
confidentiality. Pis. Nerv. System, 26, 169-175.
Hood, T. C., & Back, K. W. (1971). Self-disclosure and
the volunteer: A source of bias in laboratory
experiments. Journal of Personality and Social
Psychology, VT, 130-136.


APPENDIX D
GROUP ENVIRONMENT QUESTIONNAIRE
Code Number
1.
There is a feeling of unity and cohesion
(togetherness) in this group.
TRUE
FALSE
2.
The leader spends very little time
encouraging members.
TRUE
FALSE
3.
There is very little group spirit among
members.
TRUE
FALSE
4.
The leader goes out of his/her way to
help members.
TRUE
FALSE
5.
There is a strong feeling of belongingness
in this group.
TRUE
FALSE
6.
The leader doesn't know the members
very well.
TRUE
FALSE
7.
Members of this group feel close to each
other.
TRUE
FALSE
8.
The leader explains things to the group.
TRUE
FALSE
9.
Members put a lot of energy into this
group.
TRUE
FALSE
10.
The leader helps new members get aquainted
with the group.
TRUE
FALSE
11.
A lot of members just seem to be passing
time in this group.
TRUE
FALSE
12.
The leader takes a personal interest
in the members.
TRUE
FALSE
13.
The members are very proud of this group.
TRUE
FALSE
14.
The leader doesn't expect much of the
group.
TRUE
FALSE
15.
This is a rather apathetic (uncaring)
group.
TRUE
FALSE
16.
The leader tells members when they're
doing well.
TRUE
FALSE
160


132
and friends, possibly much stronger than the relationship
they develop with their counselor, expecially initially.
Thus, these minority subjects, who knew their school
counselors through classroom group interactions, may have
scored lower due to a belief that there is no valid
reason to keep disclosure from family and friends. As no
significant interaction effect was revealed between race
and experimental condition, this belief was apparently
not impacted by either counselors' explanation of
confidentiality or members' role playing.
Group Trust Questionnaire
In light of the data analysis, HO^the hypothesis
that no relationship would exist between counselors'
explanation of confidentiality and subjects' perception
of group trustand HO^the hypothesis that no
relationship would exist between the combination of
counselors' explanation and members' role playing
situations about confidentiality and subjects' perception
of group trustcan be discussed together. HO^ was
supported by this study while HC>5 was not. Indeed,
statistical difference well beyond the .05 level revealed
that subjects who received only a verbal explanation
scored lower than either those subjects with no exposure
to confidentiality issues or those subjects who both
received an explanation and participated in role playing.
Similar results were apparent for the subscale of


133
Self-Discovery, wherein statistical differences beyond
the .05 level revealed that the subjects with only a
verbal explanation scored significantly lower than either
of the other two groups.
Thus, subjects with an explicit explanation of
confidentiality demonstrated a lower perception of group
trust. Perhaps, cognitive awareness alone may have
heightened defensiveness and suspiciousness in the
subjects. Because counselors included an emphasis of
limitations of confidentiality in their explanation,
subjects' willingness to express themselves and
self-disclose in the group decreased. The awareness of
the limitations may thus have appeared as a "lack of
guarantee" of counseling confidentiality, and previous
studies have shown that the fear of unauthorized
disclosures decreases self-disclosure (Meyer & Smith,
1977; Schmid et al, 1983). On the other hand, the
control group, without any exposure to confidentiality
issues, showed a significantly higher perception of group
trust and willingness to express personal information
than the El group. This is consistent with research
findings that clients implicitly expect confidentiality
in a counseling situation (Edelman & Snead, 1972; Meyer &
Smith, 1977; Plaut, 1974), and counselor verbalizations
alone do not necessarily significantly impact level of
self-disclosure (Graves, 1982, Kobocow et al., 1983;
Woods, 1977).


29
Sampson and Pyle (1983) noted that at present the AACD
Ethical Standards (1981) and the Ethical Standards of
Psychologists (APA, 1981) do not specifically address the
ethical issues of computer applications in counseling,
testing, and guidance. They insisted that ethical
standards should be revised to include guidelines for the
appropriate use of computers, with one specific topic
being confidentiality of client data maintained on a
computer. The authors also identified unique problems
which exist in maintaining confidentiality of client data
stored in a computer and proposed ethical principles.
The suggested principles emphasize ensuring that
confidential data maintained in a computer
are limited to information that is
appropriate and necessary for the services
being provided, . are destroyed after
it is determined that the information is no
longer of any value in providing services
. . [and] are accurate and complete.
(p. 285)
Access to the confidential data were addressed in that
"best computer security methods available" should be
used, and it should not be possible "to identify, with
any particular individual, confidential data maintained
in a computerized data bank that is accessible through a
computer network" (p. 285).
Support for the impedance of self-disclosure by
technological devices is given in several studies. Woods
(1977) found that audio tape recordings of an interview
significantly affected anxiety level of the interviewee


171
Procedure:
I. Introduction: Make the same opening statement
as El but do not ask for recall.
II. Discussion: Introduce a "brainstorming" game,
asking students to recall as many of the
activities as possible from the class sessions.
List these as students name them. Facilitate a
similar list of "Things I Learned," which can
include new vocabulary words, study skills,
interpersonal skills, etc. Then show the first
chart to students and ask them to vote on which
are the most important activities. Go through
the list three times, with each student getting
one vote each time, so that the most important
activities are identified by the most votes.
Allow discussion of why people voted the way
they did. Then show the second chart. Ask
students to select which thing they learned that
was most important to them and why (what made it
important). Each student takes a turn talking
about his/her selection.
Ask students: "If I was going to do this again
with a different class, what would you advise
me? What things should I do the same? What
different?"


146
being randomly divided into thirds, each counselor would
work with three classrooms, each one receiving a
different experimental condition.
3. Investigation of the applicability of the
present guidance session to students in small group
counseling other than the classroom developmental units
appears warrented. Students in more intimate small group
counseling (i.e., personal crisis, social skills, problem
solving or personal growth) could be the subjects.
4. While it would certainly be more time-consuming,
replication of the present study with children in
individualized sessions may yield interesting results.
Modifications would be necessary in that case situations
would be role played by the counselor and student only,
and posttreatment assessment would have to measure
counselor trust rather than group trust in addition to
knowledge of confidentiality.
5. The current study could be replicated without
reliance on volunteers and with higher numbers of
participants. That is, the research could be implemented
as part of a district-wide project, so that all
elementary counselors attended a training session and
implemented the confidentiality guidance session.
6. Similar research could be extended to other
grade levels. A study could focus on either younger or
older students, or one could be conducted comparing
subjects in various grade levels, such as primary


76
client, the greater the counselor's allegiance to
parents. Wagner concluded the following:
When children and youth are the client, they
should have control over the release of
information that results from their choice to
engage in the therapeutic process. Exceptions
would result in cases in which they waived that
right by free choice in cases of documented
child abuse, or in cases of threat to self or
society. . The professional associations
(e.g., ASCA, ACES) and university trainers need
to provide preservice and inservice training to
school counselors so they may explore ethical
counselor behavior. (p. 310)
It was recommended that regular sessions for counselors
and related professionals to discuss troublesome cases
may help reduce isolation and encourage sharing of
intervention strategies.
A survey by Eisele (1974) examined the probable
behavior of school counselors regarding the disclosure of
confidential information. Ten real-life ethical
situations were included on a questionnaire to a random
sample of current members of the American School
Counselor Association (ASCA). The results of this study
showed that counselors would withhold confidential
information to protect their clients' welfare. Two
factors leading to the decision to reveal confidential
information were: The possibility of harm to someone
other than their client if they remain silent, and the
internal pressure from the counselor's own value system,
rather than external coercion. Once the decision to
reveal or withhold information was made, most counselors


52
The next APA (1977) code of ethics did not even make
the implied distinction of its predecessor. While
Principle 5, Confidentiality, emphasized the obligation
of the psychologist to safeguard information, it did not
clearly differentiate between minors and adults. Section
B of this principle stipulated
Information obtained in clinical or
consulting relationships, or evaluative
data concerning children . are
discussed only for professional purposes
and only with persons clearly connected
with the case. (unpaged)
Ambiguity arises here over whether "persons clearly
connected with the case" would include parents of minor
clients and whether "professional purposes" would include
sharing communications with parents in the case of minor
clients. Section D of this principle stated
The confidentiality of professional
communications about individuals is
maintained. Only when the originator and
other persons involved give their express
permission is a confidential communication
shown to the individual concerned.
(unpaged)
The vagueness of the term "other persons involved" left
The question of whether parents or guardians were to be
included when "the originator" was a minor client.
Significantly, a proposed revision to the principle
concerning confidentiality in the APA ethical standards
recognized the importance of confidentiality in the
psychologist/minor-client relationship. Section J of the
proposed guidelines stated


102
guidance session unit, but the topic of confidentiality
was not addressed.
Criterion Instruments
Two instruments were used in this study: (1) the
Child Confidentiality Questionnaire and (2) the Group
Environment Scale.
The Child Confidentiality Questionnaire
The Child Confidentiality Questionnaire (CCQ)
assesses the child-client's conception of confidentiality
within a therapeutic relationship (see Appendix B). It
had been designed by this author for previous research
purposes (Messenger & McGuire, 1981), and had been found
to have adequate reliability using a split-half
procedure. For the entire population of subjects, the
measure of internal consistency was r = .79. When
reliability coefficients were calculated for age groups,
differences among groups were apparent. These measures
were as follows: (a) age 6-8 years, r = .74; (b) age
9-11 years, r = .72; and (c) age 12-15 years, r = .90.
The questionnaire demonstrates content validity in
that items tap the basic aspects of confidentiality found
in the ethical standards of the American Psychological
Association (APA, 1977). Five areas of confidentiality
were identified using the standards, and four questions
were designed for each area (see Appendix C). In this


24
Findings regarding differences in sex of interviewer
have also been inconclusive. O'Kelly and Schuldt (1981)
found that no significant effect occurred as a result of
the interviewer's sex. On the other hand, Dion and Dion
(1978), in a study of sixth-grade students, found that
girls were more willing than boys to disclose to a female
teacher.
In attempting to interpret the contradictory
findings in regard to sex differences affecting
self-disclosure, Cozby (1973) noted that some authors
(Jourard, 1964; Plog, 1965) have suggested the
conflicting results may be the result of samples from
different geographical areas which have different sex
role expectations. However, analysis of the studies
which tested for sex differences as a significant
variable yielded no consistent pattern which would
explain the conflicting findings to be based in
geographic locale or type of instrument used.
Age. Level of cognitive development, as a function
of chronological age, is a significant variable in
clients' conception of confidentiality, and thus would
impact their level of self-disclosure. Messenger and
McGuire (1981) found that older children have a
significantly better understanding of confidentiality in
psychotherapy than younger children. Statistical
analysis revealed that the scores of the youngest group
(age 6 to 8 years) and the scores of the middle group


Shertzer, B., & Stone, S. C. (1976). Fundamentals of
guidance (3rd ed.). Boston: Houghton Mifflin.
188
Shertzer, B., & Stone, S. C. (1980). Fundamentals of
counseling. Boston: Houghton Mifflin.
Siegal, M. (1979). Privacy, ethics, and confidentiality.
Professional Psychology, 10, 249-258.
Singer, E. (1978). The effect of informed consent on
respondents' reaction to surveys. Journal of
Consumer Research, i>, 49-57.
Slawson, P. F. (1969). Patient-litigant exception: A
hazard to psychotherapy. Archives of General
Psychiatry, 21, 347-352.
Slovenko, R. (1966). Psychotherapy, confidentiality and
privileged communications. Springfield, IL:
Charles C. Thomas.
Slovenko, R., & Usdin, G. L. (1961). The psychiatrist
and privileged communication. Archives of General
Psychiatry, 4, 431-444.
Sparks, D. C. (1977). Student self-disclosure and the
school counselor. Humanistic Educator, 16, 87-94.
Spinner, B. (1978, August). Privacy, maintenance, and
self-disclosure. Paper presented at the convention
of American Psychology Association, Toronto, Canada.
Steele, B. L. (1948). The amount of explanation into
causes, means, goals, and agent: A comparison of
successful and unsuccessful cases in client-centered
therapy^ Unpublished master's thesis, University of
Chicago.
Sue, D. (1978). World views and counseling. Personnel
and Guidance Journal, 56, 458-465.
Sue, D. (1980). Asian Americans. In N. A. Vacc and J.
P. Wittmer (Eds.), Let me be me: Special
populations and the helping professional. Muncie,
IN: Accelerated Development.
Sullivan, H. S. (1953). The interpersonal theory of
psychiatry. New York: W. W. Noron.
Swager, R. G. (1981). Self-disclosure and the school
guidance counselor. School Counselor, 29, 28-33.


Page
III METHODOLOGY 94
Research Design 94
Population 96
Sampling Procedure 97
Criterion Instruments 102
Child Confidentiality Questionnaire 102
Group Environment Scale 104
Procedures 107
Hypotheses Ill
Data Analysis Ill
Methodological Limitations 114
IV RESULTS 118
Group Environment Questionnaire 118
Child Confidentiality Questionnaire . 120
Group Trust Questionnaire 123
V DISCUSSION 126
Summary 126
Discussion of Results 128
Group Environment Questionnaire . 128
Child Confidentiality Questionnaire 128
Group Trust Questionnaire 132
Conclusion 137
Implications 141
Recommendations for Further Research . 145
Summation 149
APPENDICES
A STUDENT LIST 151
B CHILD CONFIDENTIALITY QUESTIONNAIRE ... 152
C QUESTIONS BY AREA OF CONFIDENTIALITY . 157
D GROUP ENVIRONMENT QUESTIONNAIRE 160
E GROUP TRUST QUESTIONNAIRE 162
F TRAINING SESSION FOR COUNSELORS 164
G PARENT PERMISSION FORM 166
H GUIDANCE SESSION UNITS 167
I CASE SITUATIONS FOR ROLE PLAYING .... 173
J STANDARD INSTRUCTIONS FOR SUBJECTS ... 174
vii


Copyright 1984
by
Charlene Messenger-ward


CHAPTER II
REVIEW OF THE RELATED LITERATURE
Overview
Effective counseling depends largely on the
disclosure of highly private information and feelings,
and the client usually assumes that disclosures will not
be passed on to others without his/her knowledge and
consent. However, when the client is a minor, the
responsibility to protect the child-clients' privacy and
maintain confidentiality of communications becomes of
much greater concern to counselors functioning in both
public and private settings. While confidentiality has
generally been understood to refer to intimacy or privacy
of communication, in reality, confidentiality also has
legal and ethical implications.
Within the counseling relationship, confidentiality
is a critical issue because of the inherently personal
nature of the client's communications. These personal
disclosures focus on clients' innermost feelings,
thoughts, and fantasies (Karusu, 1980). Indeed, some
approaches (e.g., Hollender's (1965) "patient-centered"
contractual psychotherapy) are dependent on the
establishment of a confidential professional
relationship.
13


121
scores of the Control Group (C) and Experimental Group 1
(El) were not significantly different; nor were the
scores of the El group and the Experimental Group 2 (E2)
significantly different. Interestingly, however, the
total mean score of the control group was significantly
lower than the total mean score of the E2 group. Except
for this main effect of experimental condition, no other
significant differences were identified for main effects
of sex or race or for two-way or three-way interaction
effects upon total CCQ mean score.
Separate analyses of variance across groups for each
subarea of the confidentiality questionnaire were
completed. For Area 1 (counselor responsibile for
safeguarding information about client) and Area 5
(counselor responsible for explaining limits of
confidentiality), analyses of variance revealed no
significant differences among experimental conditions,
between sexes or between races.
TABLE 4-3 MEAN CCQ TOTAL AND SUBAREA SCORES ACCORDING
TO EXPERIMENTAL CONDITION
AREA
C
(N=51)
El
(N=55)
E2
(N=55)
TOTAL MEAN
(N=161)
1
2.980
3.073
2.836
2.963
2
2.902
3.182
3.473
3.193
3
3.059
3.255
3.273
3.199
4
2.902
3.127
3.364
3.137
5
3.353
3.400
3.309
3.354
Total
Mean
15.196
16.036
16.255
15.845


80
perceived confidentiality to mean therapist avoidance of
discussion of cases in general conversation or in
publications. Even professionals' perceptions of their
clients suggest this same implicit assumption of
confidentiality. In their survey of mental health
professionals, Jagim et al. (1978) found that 95% of
respondents indicated that they believed clients expected
that therapy communications would remain confidential
(64% very strongly agree, 29% strongly agree, 2% agree).
Pardue et al. (1970) pointed out that, historically,
confidentiality has been viewed as implicit in all
educational levels, apparently including both the
counseling relationship and the maintenance of case
records. Cass and Curran (1965) similarly focused on the
doctor-patient relationship, noting that the trust of
patients in their physicians rests in the concept of
expected silence. It appears that the confidential
relationship expected between the physician and patient
may contribute to clients' expectations of
confidentiality in any related advisory profession.
Perhaps patients in therapy confide more personally
than any other individuals in society because they expose
not only direct verbal expressions but also their entire
selves, including dreams, fantasies, "sins," and shame
(Guttsmacher & Welhofen, 1952). Typically, patients who
enter psychotherapy know that such revelations are
expected; without them, the clients cannot be helped. To


147
elementary, intermediate elementary, junior high and
senior high.
7. It is possible that some populations of children
may react to experimental conditions quite differently
than children in this sample who were all in regular
sixth-grade classes. Replication studies using different
populations of children, such as hospital in-patients,
children in group homes, and students in exceptional
education schools, appear appropriate.
8. Investigation could focus not only on
experimental conditions, sex and race as variables but on
the counselor who implements the sessions as well. One
option is to incorporate, as part of pretreatment
assessment, a counselor personality questionnaire or
attitude survey.
9. It might be interesting to utilize counselors
as subjects and note differences in knowledge of
confidentiality and perception of trust as functions of
attending a training session such as the one described in
this project. An alternate idea is to have counselors
answer the confidentiality and trust questionnaires as
they believe their students should perceive a counseling
experience. Comparison of counselor and student
responses may distinguish areas of misunderstanding of
which the counselor was previously unaware.
10. Similarly, teachers and/or parents could
complete the confidentiality questionnaire as they


16
(23 of 30) stated it was important to them that the
hospital staff not tell anyone else that they revealed
about themselves. Eighty percent indicated that knowing
their communications would be kept confidential improved
their relationship with the staff. Most patients (77%)
responded that they trusted their confidential
communications were being kept; that is, members of the
staff did not talk to others without their permission.
Sixty-seven percent of respondents said they would by
angry or upset if they discovered that staff members had
told other people what patients had revealed without
their permission. Indeed, 17% said they would leave
treatment or stop talking with the staff member involved.
Meyer and Smith (1977) reported that clients would be
less likely to enter counseling or self-disclose once
there if they had been told that the information
discussed would not be considered confidential.
One client behavior heavily dependent upon the
client's perception of trust within the counseling
relationship is self-disclosure. Clients must be able to
"express their innermost 'secrets' and make themselves
vulnerable to the counselor" (Fong & Cox, 1983, p. 163).
The efficacy of the therapeutic encounter appears highly
related to the degree of disclosure of private
information, including feelings and attitudes, the client
shares with the counselor.


154
(3) 25.
(B) 26.
(1) 27.
(D) 28.
(4) 29.
(B) 30.
(3) 31.
(A) 32.
(1) 33.
(C) 34.
(5) 35.
(D) 36.
Do you think your counselor is YES
supposed to tell other people what
you said in counseling if they ask
him/her?
Do you think it is OK to ask a YES
friend to help you do homework, as
long as he/she does not do it all
for you?
Are you sometimes afraid to tell YES
some things to your counselor because
he/she may not keep them secret?
Do you think it is bad to hit YES
someone at school, even if he/she
hit you first?
If you didn't want other people to YES
know about what you said in counseling,
do you think your counselor would tell
them anyway?
Do you think you should be able to YES
talk in the lunchroom and in the
halls at school?
Should your counselor make sure YES
your parents know the things you
tell him/her just because they
want to know?
Is it part of your job to help clean YES
up the classroom, even if someone else
made it dirty?
Is your counselor supposed to talk YES
with you about things you don't want
anyone else to know about?
Should your teacher make sure you YES
have homework every night?
Should your counselor let you know YES
if some things you say cannot be
kept secret?
If you don't want your friends to YES
know your grade on a test, should
your teacher tell them anyway?
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO


THIS PROJECT IS DEDICATED TO
. . all children and adolescents who ever
have had or will have the opportunity to
receive counseling services;
. . all counselors who provide such
services; and
. . all professionals who teach, assist
and inspire these counselors.


78
Perceptions of students themselves have not been
extensively studied but do provide an additional
perspective. Conclusions from studies of student
responses to declarations of childrens' rights suggests
that within the school setting, safeguarding children's
rights is the concomitant responsibility of children and
parents, as well as school employees such as teachers,
counselors and school psychologists (Nixon, 1982). As
far as self-disclosure, high school students vary in the
extent to which they make themselves known to significant
others at home and at school regarding various aspects of
their lives (Sparks, 1977).
Swager (1981), in reviewing how self-disclosure
findings may be applicable to school counseling,
concluded that counselors need to address specific
questions relating to students' age. Trachtman (1974)
suggested that the school psychologist or counselor
examine each instance of his/her behavior with an
elementary school child, then consider how he/she might
behave differently if the client were a college student.
Any differences in behavior must be defensible because
the therapist is clearly differentiating between
appropriate behavior with a child and an adult.
Trachtman further recommended that the therapist consider
whether the line should be drawn between elementary
school and junior or senior high school.


14
While the client's disclosures within the counseling
relationship may be traumatic, the professional has a
right and a need to encourage them; the client has a
similar obligation to be frank in responding (Graves,
1982). It is the indispensable quality of trust that
allows both parties to know that confidentiality will be
preserved unless the well-being of themselves or of
society is at stake. McCormick (1978) noted that this
attitude of trust is supported not only by personal
commitment but by ethical codes or "private systems of
law" which are built into the professional structure by
its own members.
Trust
The aspect of trust may be considered a familiar
dimension within the counseling process, but it is
nonetheless, an essential element. From the viewpoint of
helping and interpersonal relating as part of social
influence process, Egan (1975) stated, "if he (the
client) is to stay with him (the helper) in any creative
way . this means self-explorationhe must come to
trust the helper" (p. 110). Throughout, it appears that
the perceptions of the client are paramount. Brodsky
(1972) referred to this as "the world, as the client
experiences it" (p. 362). The importance of clients'
perceptions was noted centuries ago by Chaucer, who
wrote:


136
self-disclosing than males (Dimond & Munz, 1967;
Himelstein & Lubin, 1965? Hood & Back, 1971; Jourard &
Landsman, 1960; Jourard & Lasakow, 1958; Jourard &
Richman, 1963; Pederson and Breglio, 1968). On the other
hand, given the opportunity to behaviorally enact
situations in a small group, males' willingness to trust
the group and express themselves to others increased,
while females' willingness to self-dislose decrease^ In
this regard, then, the findings are not inconsistent with
conclusions drawn by other researchers that males are
more self-disclosing than females (Graves, 1982; Kobocow
et al., 1983? O'Kelly & Schuldt, 1981; Rosen, 1977;
Singer, 1978). Overall, findings from previous research
regarding the impact of subjects' sex upon
self-disclosure have been inconclusive, and the current
research did not identify a main effect of sex on
perception of group trust. The two-way interaction
effect is, though, most significant in that the impact of
subjects' sex may be highly situation specific.
Finally, this study generated support for HOgthe
hypothesis that no relationship would exist between
subjects' race and their perception of group trust. This
is a most interesting finding in that previous
researchers have concluded that ethnic minority groups
are less likely to self-disclose (Dimond & Hellkamp,


99
TABLE
3-2 DISTRIBUTION OF SAMPLE BY SEX, RACE
EXPERIMENTAL CONDITION
AND
CUMULATIVE
RELATIVE
CUMULATIVE
SEX
FREQUENCY FREQUENCY
FREQUENCY (%)
FREQUENCY (%)
M
85 85
52.8
52.8
F
76 161
47.2
100.0
RACE
W
101
101
62.7
62.7
EM
60
161
37.3
100.0
GROUP
E1
55
55
34.2
34.2
55
110
34.2
68.3
c2
51
161
31.7
100.0
all students in each class were assigned to a group, some
did not participate on the day of the study due to
absenteeism or failure to return the permission form. In
such cases, students were simply dropped out of the
study, and no attempt was made to reassign students among
groups. Table 3-3 depicts distribution of subjects
according to treatment condition. As random assignment
of subjects is the most powerful method to control for
confounding variables (Campbell & Stanley, 1963), in this
study, random assignment of pupils to groups, after
stratifying sex and race, was considered adequate control


183
Kazalunas, J. R. (1977). Conscience, the law, and
practical requirements of the Buckley Amendment.
School Counselor, 24, 243-247.
Kerlinger, F. N. (1973). Foundations of behavioral
research (2nd ed.). New York: Holt, Rinehart, and
Winston.
Kirk, R. (1968). Experimental designs: Procedures for
the behavioral sciences. Belmont, CA: Brooks.
Kobocow, B., McGu'', J. M., & Blau, B. I. (1983). The
Influence of confidentiality conditions of
self-disclosure of early adolescents. Professional
Psychology: Research and Practice, 14, 435-443.
Kottler, J. A. (1980). Expanded uses of therapeutic
modeling in counseling. School Counselor, 28,
26-30.
Ladd, E. T. (1971). Counselors, confidences, and the
civil liberties of clients. Personnel and Guidance
Journal, 50, 261-268.
Levine, E., & Franco, J. (1980, December). New
dimensions in cross-cultural counseling: Some
Anglo/Hispanic comparisons^ Paper presented in the
Education Dialogue Series at the New Mexico State
University, Las Cruces, NM.
Lewis, E. C. (1970). The psychology of counseling. New
York: Holt, Rinehart and Winston.
Lieberman, M. A., Yalom, I. E., & Miles, M. D. (1972).
Encounter groups: First facts. New York: Basic
Books.
Litwack, L. (1969). Testimonial privileged communication
and the school counselor. School Counselor, 17,
108-111.
Lowental, U. 1974). The vicissitudes of descretion in
psychotherapy. American Journal of Psychotherapy,
28, 235-242.
Malmquist, C. P. (1965). Problems of confidentiality of
child psychiatry. American Journal of
Orthopsychiatry, 35, 787-792.
McCormick, M. J. (1978). Privacy, a new American
dilemma. Social Casework, 59, 299-305.


161
17. The group is a good place to make friends.
18. Members can count on the leader to help
them out of trouble.
TRUE FALSE
TRUE FALSE
This instrument is comprised of Member Cohesion and Leader
Support subscales of the Group Environment Scale. It is
reproduced by special permission of the Publisher,
Consulting Psychologists Press, Inc., Palo Alto, CA 94306,
from the Group Environment Scale by Rudolf Moos, Ph.D.,
Copyright 1974. Further reproduction is prohibited without
the Publisher's consent.


28
counterproductive in regard to the effectiveness of
treatment the client might rightfully expect.
The dilemma for the professional has been examined
by Slovenko and Usdin (1961). In some situations, to
release confidential information when it is not necessary
could result in actions for damages for defamation or
invasion of privacy; on the other hand, to not release
information in other situations may lead to a charge of
contempt of court. Simultaneously, the client is faced
with the dilemma of erosion of the therapeutic effort by
not self-disclosing versus opening him/herself to either
advertent or inadvertent relevation of personal
disclosures to varied unauthorized agents of numerous
government and private organizations.
As an increasing amount of information is being
stored in computers, it becomes more accessible to
individuals other than those for whom it was originally
intended. Concern exists about inadequate control of
accessibility, particularly since data can be directly
cross-fed from interconnected electronic systems.
McCormick (1978) wrote that
There is validity in the argument that the
use of mechanical techniques is unavoidable
in a bureaucratic society. There is also
validity in the fact that such approaches
pose a threat to human beings. It is
necessary to reckon with human error . .
but the difficulty is that no agency can
predict the eventual impact of personal
disclosure on individual lives. Helpful at
the moment, they may be disasterous in the
future. (p. 211? 220)


137
1969; Franco & Levine, 1981; Jourard & Lasakow, 1958;
McCormick, 1978).
Conclusions
It is recognized that there are certain factors
which limit the generalizability of findings of the
present study to all school counselors and their clients.
Of major significance is reactivity to arrangementsthat
is, all participants, including counselors and pupils,
were aware that the guidance sessions were part of a
research project. Furthermore, all participation was
voluntary. Counselors who volunteered could conceivably
have different counseling skills and personality traits
than those who did not; similarly, students who returned
their parent permission forms might have differed in some
respects from those who did not, the latter group being
required out of necessity to drop out of the study.
Other factors concern the assessment instruments.
While the pretreatment assessment was considered
essential to appropriate data analysis by the researcher,
and it differed from posttreatment assessment measures,
its very administration may have sensitized subjects in
some way to certain aspects of the guidance session or
posttests which followed. As far as the assessment tools
themselves, all data was obtained via questionnaires, and
issues such as long-term retention or changes in overt
behavior were not addressed.


119
groups assigned to experimental conditions is considered
particularly important, Table 4-2 further breaks down the
GEQ into mean scores by subscales for these groups.
TABLE 4-1 MEAN GEQ TOTAL SCORES WITH ANOVA STATISTICS
FOR GROUPS BY SUBJECTS' EXPERIMENTAL
CONDITION, SEX AND RACE
EXPERIMENTAL MEAN GEQ
CONDITION SCORE ANOVA STATISTICS
c
13.7451
El
13.7273
F = .104
E2
13.4909
df = 2/158
Total Mean
13.6522
£ < .9013
SEX
M
13.3294
F = 1.819
F
14.0132
df = 1/159
Total Mean
13.6522
£ < .1794
RACE
W
13.8218
F = .751
EM
13.3667
df = 1/159
Total Mean
1376522
p < .388


172
III. Closure; Briefly review the most important
activities, the things students said they
learned and recommendations for next time.
Request students not to discuss the group with
anyone else back in the classroom.


51
clients fit in relation to professional responsibility.
The earlier APA Ethical Standards of Psychologists (1968)
made some implied distinctions between the child and the
adult client by referring to the "the responsible
person." Principle 7, Client Welfare, Section D, stated
that
the psychologist who asks that an
individual reveal personal information to
be divulged to him does so only after
making certain that the responsible person
is fully aware of the purposes of the
interview, testing, or evaluation and of
the ways in which the information may be
used. (unpaged)
Somewhat more strongly, Principle 8, Client
Relationships, Section B, stated that "when the client is
not competent to evaluate the situation (as in the case
of a child), the person responsible for the client is
informed of the circumstances which may influence the
relationship." Thus, as vague as this early code was in
reference to the psychologist/minor-client relationship,
it did imply that the minor client is incapable of
comprehending his/her position and is thus incompetent to
consent to treatment or have the same rights as an adult
in the psychotherapeutic relationship. It is not
surprising, then, that McGuire's (1974) study revealed a
general lack of awareness, at least among psychologists,
as to the content and applicability of existing APA
ethical codes to the child in psychotherapy.


129
Statistical differences beyond the .05 level revealed
that subjects who had no exposure to confidentiality
issues by the counselor scored lower on the
confidentiality questionnaire than subjects who had both
a verbal explanation and an opportunity for enactment of
case situations. Althouqh H0^--the hypothesis that no
relationship would exist between counselor explanation
about confidentiality and subjects' knowledge of
confidentialitywas supported, it is noteworthy that
total mean scores increased as the amount of exposure to
and involvement with the concept of confidentiality
increased. For subjects in this study, then, verbal
explanation appeared to increase knowledge but was
insufficient alone without the behavioral component of
role playing. This is not inconsistent with previous
research findings that verbal address of confidentiality
may change clients' understanding (Davis, 1980; Meyer &
Smith, 1977), yet real-life experiences may be even more
important to minor clients' conception of confidentiality
than verbalizations about it (Kobocow et al., 1983;
Messenger & McGuire, 1981).
Similar results were evident for Areas 2 and 4 of
the CCQ. Statistical differences beyond the .05 level
revealed that subjects who had no exposure to
confidentiality issues by the counselor scored lower than
children who both heard an explanation and role played
case situations. While the group receiving only a verbal


65
appropriate guidelines regarding
confidentiality, the distinction between public
and private information, and staff
consultation. (p. 7)
Such a code clearly indicates that school counselors
are becoming increasingly aware of the essential nature
of confidentiality in the counseling relationship and of
the dilemmas which they sometimes face. This increased
responsiveness by the ASCA organization is highlighted by
contrasting the current stipulates with the previous code
published more than a decade ago which was considerably
more vague in stating that the school counselor
Should respect at all times the confidences of
the counselee; should the counselee's condition
. . [endanger] . self or others, the
counselor is expected to report this fact to an
appropriate responsible person. (ASCA, 1972,
unpaged)
Throughout, however, ASCA has maintained a position
of student advocacy. In its 1976 position statement, the
organization stated that it was
committed to be actively involved in that
students be treated as citizens of the U.S.A.,
with all due rights, privileges, and
responsibilities. Counselors are serving as
advocates, activists, and catalysts for
assuring these rights. . ASCAs position
is that the counselor is the 'student
advocate'supporter, intercessor, pleader,
defenderthrough speaking, writing, and
actionl (pp. 281-282)
ASCA's position, then, appears to be a strong one
for the student, and the practices it promotes include
improvement of record-keeping, release of student
records' information/data in a law-abiding,
discriminating manner, and the recording of positive,


no exposure to confidentiality issues during their
session. Pretreatment assessment of students showed the
equivalence of their attitude toward other group members
and the counselor.
After particpating in group sessions, students
answered questionnaires assessing knowledge of
confidentiality (instrument based on professional ethical
standards) and perception of group trust (instrument
based on a scale of group environment). Results
indicated that mean scores for the
explanation/role-playing group were higher than the
explanation-only group and that mean scores for the
explanation-only group were higher than the control
group. However, statistical significance was only shown
between the explanation/role-playing group and the
control group. With trust perception, the
explanation-only group scored significantly lower than
either the explanation/role-playing group or the control
group. Overall, results suggest that an optimal method
to address confidentiality is combining explanation and
role play.
Students' sex and race were also investigated as
independent variables. As a main effect, neither was
identified as significantly related to overall initial
attitude, knowledge of confidentiality or perception of
trust. However, a number of two-way interactions for the
variables of sex and experimental condition were
x


93
Findings are inconclusive, however, and real-life
experiences with confidentiality may be more important to
minor clients than verbal discussion. Thus, while
counselors are ethically bound to address the topic of
confidentiality with their clients, it cannot be
concluded that verbalizations are adequate to change
clients' expectations and improve the counseling
relationship, specifically with respect to the component
of trust.
When considering future directions in the area of
counseling confidentiality with children, particularly in
a school setting, two directions appeared clear. First,
there was a need to determine whether direct instruction
about confidentiality (as opposed to verbal assurances)
would benefit students with either increased knowledge or
trust. Second, investigation of the significance of a
behavioral element, specifically enactment of case
situations by the clients, was needed. Such steps seemed
particularly helpful in bridging research and theory
regarding trust and confidentiality with actual practice
of counselors in the schools today.


72
they should maintain complete confidentiality of
information received during counseling.
Hart and Price (1970) compared principals'
expectations of counselor dimensions with ideal counselor
roles as seen by counselor educators. Confidentiality
was one area in which principals and counselor educators
differed? indeed all principals "differed markedly" from
the ideal role as viewed by counselor educators.
Within the college or university setting, the
psychotherapist often has conflicting roles. Blaine
(1964) pointed out that, although maintaining the
private, confidential nature in therapy is a primary
responsibility of the therapist, various situations may
arise wherein communicating student information to
administrators is necessary. Szasz (1967) examined the
role of the college psychotherapist, describing him as a
double agent with divided loyalties between students
(including minor students) and the institution. He
contended that college-employed therapists are so willing
to break confidences of their patients whenever they
personally consider it in the best interest of the
patient, the institution or the community, that "any
reference to 'confidentiality' is absurd" (p. 18).
Besides the allegiance to the institution of the
school lies the question of parental rights. While
diverse opinions are present in the literature regarding
minor clients in general, within the school setting,


62
The issue thus becomes whether the minor-client is
in fact capable of comprehending his/her position and is
thereby competent to undergo psychotherapeutic treatment
with the assurance of confidentiality afforded an adult.
The traditional concern of society with the protection
and welfare of minors is based on the notion that the
minor must be protected against his own innocence and
lack of experience. If the therapist can establish the
child-client's intellectual ability to contribute to and
participate in the psychotherapeutic process, this
concern would be unfounded. Moreover, there may exist
the possibility that the minor in psychotherapy may need
to be protected more against the divulgence of his
private communications than his own innocence.
Thus, divergent opinions appear in the literature as
to the status of the child in psychotherapy, and ethical
standards and legal statutes are vague on the issue.
Studies which have examined the attitudes and behaviors
of psychologists and counselors have found that
practicioners tend to respect the confidential
communications of their child-clients. The capacity of
the minor to comprehend the nature and consequences of
treatment appears crucial in determining the confidential
nature of the psychotherapeutic relationship.


139
confidential information being released only with the
client's express permission and the limitation of
breaching confidentiality in the case of clear, imminent
danger. In contrast, children appear to best internalize
the concept of confidentiality when the exposure includes
both a verbal and behavioral component; that is, role
playing appears to reinforce the counselors' verbal
explanation to enhance cognitive awareness.
Group trust appears to be a more sensitive area for
students than knowledge of confidentiality. It is
speculated that discussing counseling confidentiality,
particularly its limitations, may increase awareness but
simultaneously may increase concern about the impact of
disclosing personal information. Thus, verbal discussion
alone seems to raise defensiveness where students would
have otherwise implicitly trusted the group and
participated in a self-exploration process. The
behavioral component, however, is a significant counter
to this effect. Real-life experiences appear to be very
important to childrenmore important than simply talking
about an issue. Even simulated experiences appear to
make a greater impact than abstract discussion alone.
Thus, the opportunity to enact case situations faced by
the counselor allows students to understand potential
dilemmas from a counselor's perspective. While awareness
alone may raise defensiveness, role playing allows better
integration of the complexities of counseling


7
investigation attempted to determine whether the
independent variables of (1) counselors' instructions
about confidentiality (specifically, ethical
responsibility and limitations) and group members' role
playing situations to reinforce this explanation, (2)
subjects' sex and (3) subjects' race would have an effect
upon the dependent variables of (1) sixth-grade students'
knowledge of confidentiality in a counseling relationship
and (2) their perception of group trust.
Rationale for the Study
This study utilized the field experiment format
described by Kerlinger (1973) because its identified
advantages included ability to test broad hypotheses,
strength of the involved variables, and appropriateness
for studying complex social processes. Moreover,
Campbell and Stanley (1963) pointed out that the true
experimental method is recommended in the methodological
literature because sources of internal invalidity are
more tightly controlled.
Additional advantages involved the normal school
conditions under which this study was carried out. The
treatment conditions were "conducted by regular staff of
the schools concerned" (Campbell & Stanley, 1963, p. 21),
and the research was designed to appear to participating
students as an extension of structured classroom guidance
units in which they have already participated. The


97
The Orange County Public School system serves 88,485
students in grades kindergarten through twelve, with
6,458 students counted within the sixth grade (OCPS,
1984). Most recent data about this grade indicate the
following demographic breakdown: male 50.70% (3274),
female 49.30% (3184; and white, non-Hispanic 69.74%
(45.04), ethnic minorityincluding Black, Hispanic,
Asian/Pacific Islander, American Indian30.26% (1954).
While a demographic breakdown of sixth-grade students in
the identified 38 schools is not available, these
percentages by sex and race encompassing all sixth-grade
students in the 67 elementary schools were judged by the
researcher to be adequate approximations of the 38
schools in the researched population.
Sampling Procedure
The sample of students was drawn from the 38
elementary schools in which counselors had led the
classroom students. All 38 counselors were offered the
opportunity to participate in follow-up sessions to the
classroom units. This offer was made at the beginning of
a mandatory staff-development session for all elementary
counselors in the county, set up by the Coordinator of
Guidance. For counselors not in attendance, a letter of
explanation, an outline of procedures, and a response
form were sent out. Incentives offered to the counselors
included county staff development credits for


30
as well as level of disclosure among females. The
behavioral responses observed included shifting of
position, hand movements, nervous laughter and clearing
of the throat. Woods suggested that the high anxiety
tended to go with less self-disclosure. Graves (1982)
found that clients disclosed to a greater degree when the
interview situation was recorded manually by the
interviewer as opposed to having the session
video-recorded with clients knowledge. These findings
suggest that fear of disclosure to the public can be
harmful to the development of trust and its part in the
therapeutic process.
The literature, then, indicates that trust appears
to be essential within a counseling relationship;
indeed, without it, undesirable outcomes may be
anticipated. Some variables (e.g., sex, age, ethnicity,
technology) may significantly impact the establishment
and development of counseling trust, although research is
still inconclusive. Intricately tied to the aspect of
trust is the counselor's responsibility to protect client
self-disclosures and maintain confidentiality of
communications.
Confidentiality
Ford and Urban (1963), in citing general
characteristics of psychotherapy, focused on
confidentiality. In their description, "the [counseling]


43
importance of confidentiality for the group processes.
Gazda (1978) wrote that many group leaders believe
confidentiality to be an essential component in the
entire group process, particularly in regard to the
development of trust among group members. Rogers (1970)
perceived an atmosphere of acceptance and trust (wherein
members could reveal aspects of themselves they typically
conceal) to be essential to group movement. Moreover, he
expressed an intense trust in the ability of group
members to develop their own potential. One such aspect
specifically focused on the group moving from lacking
trust and being closed and fearful with others to
becoming increasingly open and expressive in
interpersonal relationships.
The level of trust in a group seemingly depends on
two interrelated factors: "the willingness of the members
to share themselves and the quality of the response they
receive once they do share themselves" (Egan, 1975, p.
156). Trust is an issue that surfaces early as a new
group gets underway.
Members will often question their ability
to trust the group leaders, the other
members, and even themselves. ... It is
clear that, if members are to drop their
defenses and reveal themselves--as indeed
they must if the group is to be
effective--they need assurance that the
group is a safe place to do this. (Corey,
1981, pp. 356-357)
The imporance of confidentiality is implied through the
members' need to believe the group is a "safe place" to


109
On the day of the study, the counselor was given the
list of students assigned to each group by the
researcher. After introducing the researcher to the
students in the participating class as "a friend of mine
who works at another school," the counselor exited. The
researcher then followed standardized instructions (see
Appendix J) to build enthusiasm, explain in general terms
the purpose of the research, and instruct in the method
of completing the questionnaire. The researcher then
administered to the class the GEQ pretest. Anonymity of
participants was retained by having the subjects remove
their name stickers from the questionnaires while the
code numbers remained printed on them. To control for
variations in reading level, each item was read aloud by
the researcher before students responded. After the
completed questionnaires were collected, students were
instructed to remain at their desks doing individual seat
work (as prearranged with the teacher) except for those
times they were called out for their group session.
The counselor reentered, announced the students'
names for the first group, and led them to a separate
counseling room. After the session, the counselor
returned the students to the classroom, called for the
next group, and continued the cycle. Students were
requested not to talk until the project was over, and the
researcher remained in the classroom while the counselor
led the sessions with each group.


114
where a significant interaction effect was noted, the
SPSS program "Breakdown" was utilized so that means,
counts and standard deviations could be obtained (Nie et
al., 1975) and two-way t-tests (£ < .10) could be
calculated for subgroups.
As far as the other posttest, each subject had a
total group trust questionnaire score in the range of 0
to 18, with subscale scores (Expressiveness and
Self-Discovery) ranging from 0 to 9. Using both total
and subscale scores from the GTQ as dependent variables,
analysis of variance was performed to find significant
differences among groups for the independent variables of
experimental condition, sex and race. Main effects,
two-way interactions, and three-way interactions were
investigated, with a confidence of p < .05 being
considered significant. The Scheffe test (alpha = .10)
was used for further analysis, where a significant
difference of group mean effects was evidence, and the
"Breakdown" procedure was used with supplemental t-tests
(p < .10) for further analysis where significant
interactions were identified.
Methodological Limitations
This study has several limiting factors. The
measures of child-clients' knowledge of confidentiality
and perception of group trust are not perfect. The CCQ
assesses the child's conception of confidentiality


11
Privacy means freedom of the individual to choose
for him/herself the time, circumstances, and especially
the extent to which personal beliefs, opinion, and
behaviors will be shared with, or withheld from, others
(Reubenhausen & Brim, 1966).
Privileged communication is a legal terms referring
to the client's right which exists by statute (if at all)
not to have confidences revealed publicly from the
witness stand during legal proceedings without the
client's permission; it is narrower in scope than
confidentiality (Shah, 1969a). The privilege itself is
basically an extension of the Fifth Amendment privilege,
and hence it is not the professionals' but the clients',
and they may waive it at any time (Boyd & Heisen, 1971).
Organization of the Study
The remainder of this study has been organized into
four chapters. In Chapter II, the professional
literature in regard to trust and confidentiality is
explored in relation to these major aspects:
expressiveness and self-discovery, other variables,
ethical standards, privileged communication, and case
records. Additionally, the areas of group settings,
minor clients, school counseling, and clients'
expectations/counselors' explanations are closely
examined. The research methodology, data collection, and
data analysis procedures are described in Chapter III.



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63
School Counseling
Within the school setting, the counselor's
responsibilities focus on growth process through which
individual students or groups of students are assisted in
(1) defining goals; (2) planning and implementing
decisions; and (3) solving problems related to
educational, career, and personal-social development
(California State Department of Education, 1982). Some
typical issues which may be worked through in counseling
with adolescents are related to curriculum planning,
vocational choices, family conflict, peer group pressure,
or sexual confusion (Lewis, 1970). At the elementary
level, there had been a lack of effort directed toward
work with young children by counselors up until 10 to 15
years ago; however, one of the purposes of counseling
remains to help the child make adjustments to life's
demands that are acceptable to both self and society
(Muro & Dinkmeyer, 1977).
Because the school is a public institution, the
issues regarding confidentiality and self-disclosure
become increasingly complex. While the previous
discussion of minor clients remains pertinent, the public
school setting is unique in that counselors are public
employees working with other professionals in the area of
education. Guildroy (1979) noted that as the school
counselor deals with student, parents, teachers,
administrators and colleges, the legal and ethical


42
student to deal honestly with himself is
alarming, (p. 59)
Nonetheless, Boyd, Tennyson and Erickson (1973) have
found that, in practice, complete confidentiality of
records is rarely, if ever, extended to school-age
clients. A study by these authors reveals that while
counselors were more prone to deny requests for personal
interview data than general education-vocational
information, there was considerable individual
variability in the extent of release of student records.
Moreover, "school personnel receive more exact data about
individual students than do parents or the students
themselves" (p. 285).
The issue of confidentiality between client and
counselor has been explored by a number of authors with
respect to trust, professional ethics, privileged
communication, and school records. These considerations
provide a basis with which to examine clients' behaviors
and perceptions of confidentiality and trust within a
unique counseling relationship: the group. The efficacy
of the group therapeutic encounter appears highly related
to the degree of disclosure of private information,
including feelings and attitudes, the client shares with
the counselor and other members.
Group Settings
As in the case of the one-to-one counseling
relationship, various authors have indicated the


59
obligation and accountability of the parent, not the
parent's right to dominate the child because of his
immaturity.
Practice and Trends
Despite the numerous, and often heated, exhortations
on both sides of the issue, few actual studies have been
conducted in the area of child-client confidentiality.
Those studies available show that counselors and
psychologists tend to respect the confidentiality of the
minor's communications. As Trachtman (1972) stated
There seems to be some sympathy for the
psychologist having discretionary power to
withhold confidential verbal communication
from parents, even by those who would grant
parents complete access to the written
record. (p. 41)
McGuire (1974) surveyed forty-five mental health
professionals concerning their attitudes and behaviors
with regard to practical situations involving
confidentiality with children in therapy. These
professionals varied in age, years of experience and
degree. It was found that the mental health workers in
this sample tended to favor a position wherein
child-clients are extended the same rights and privileges
regarding confidentiality as adult clients. McGuire
wrote that this position appears to be basically
inconsistent with a strict interpretation of the APA Code
of Ethics.


170
Procedures:
I.
Introduction: Same as El.
II.
Discussion: Same as El, except limit student
discussion. Instead of each student sharing an
example or two, have only one or two members
talk. Then state: "Now try to remember these
rules while we pretend that certain things
happen." Read situations from index cards and
ask for volunteers to play the varous roles of
counselor, teacher, parent, principal. For each
case, go back to the stipulates for
confidentiality listed as "rules" and have
students tell what the counselor should dokeep
or break the confidentiality? Have students use
the list to give a rationale for counselor
behavior.
III.
Closure: Same as El.
Control
Group
Purpose:
: To review previous six sessions related to study
habits and facilitate self-exploration of what
students might do differently as a result of
participation in the sessions.
Materials: Chalkboard and chalk or large pad with
markers.
Approximate Time: 30 minutes.


169
Add to the list, with appropriate explanation
and discussion:
4. It is my job to let you know if something
that is said in counseling cannot be kept
secret for any reason. [Area 5]
5. I will break a secret if there is real
danger, or an emergency, or I think someone
will get hurt. [Area 2]
Facilitate discussion of a time students might
have broken a secret because they were helping
someone or maybe kept a secret but it ended up
being the wrong thing to do.
III. Closure. Review the term and five "rules" and
answer any questions. Request students not to
discuss the group with anyone else back in the
classroom.
Experimental Group 2
Purpose: To instruct students about the meaning and
limitations of confidentiality in a counseling
relationship; and to facilitate role playing of
case situations to reinforce this concept.
Materials: Chalkboard and chalk or large pad and
markers; index cards with case situations
written on them (Appendix I).
Approximate Time: 30-35 Minutes.


130
explanation did not score significantly different from
either of these two groups, again total mean scores did
increase as the amount of exposure to and involvement
with the concept increased. Closer examination of these
specific areas indicates that they directly relate to the
ethical obligation of obtaining clients' express
permission before revealing information disclosed to the
counselor to others and to the limitation of counselors'
responsibility to reveal confidentiality in cases of
clear, imminent danger. This finding, regarding the
restriction of gaining client permission and limitation
on the amount of confidentiality that can be afforded,
complements previous findings that, without
clarification, clients may misinterpret some of the basic
stipulates of counseling confidentiality (Edelman &
Snead, 1972; Jagim et al., 1978; Meyer & Smith, 1977;
Plaut, 1974; Woods, 1977).
This study did generate support for HO^the
hypothesis that no relationship would exist between
subjects' sex and their knowledge of confidentiality as
measured by CCQ scores. No significant differences were
revealed between scores of males and females for the
total confidentiality mean score or for any of the
subarea mean scores. Most research regarding subjects'
sex as a significant variable relate it to perception of
trust and/or behavior of self-disclosure; very little is
available in terms of studies of male and females


APPENDIX E
GROUP TRUST QUESTIONNAIRE
Code Number
1. When members disagree with each other, they
usually say so.
TRUE
FALSE
2.
Personal problems are openly talked about.
TRUE
FALSE
3.
It's hard to tell how members of this group
are feeling.
TRUE
FALSE
4.
Members are expected to keep their personal
hang-ups out of the group.
TRUE
FALSE
5.
Members often say the first thing that comes
into their minds.
TRUE
FALSE
6.
Members sometimes tell others about their
feelings of self-doubt.
TRUE
FALSE
7.
Members show a good deal of caution and
self-control in the group.
TRUE
FALSE
8.
Members sometimes talk about their dreams
and ambitions.
TRUE
FALSE
9.
Members tend to hide their feelings from
one another.
TRUE
FALSE
10.
Members hardly ever discuss really private
things.
TRUE
FALSE
11.
It's OK to say what ever you want to in
this group.
TRUE
FALSE
12.
Members' religious beliefs are never
discussed in this group.
TRUE
FALSE
13.
There is a lot of spontaneous (open)
discussion in this group.
TRUE
FALSE
14.
Members can discuss family problems in
the group.
TRUE
FALSE
15.
Members are careful about what they say.
TRUE
FALSE
16.
In this group, you can find out what other
people think of you.
TRUE
FALSE
162


155
(2) 37. If he/she really think he/she is YES NO
helping you stay out of trouble, is
it OK for your counselor to tell your
parents what you said in counseling?
(D) 38. If you are really having trouble YES NO
with a test, is it OK to ask the
teacher for help?
(4) 39. If your parents ask your counselor YES NO
what you talked about, should he/she
tell them if you don't want him/her to?
(B) 40. If you asked a friend to help you YES NO
with your homework, would your teacher
think that was OK?


110
The guidance units were designed by the researcher
with a general sequence of introduction, activity, and
closure. The independent variables of counselors'
instructions about confidentiality for El and the
combination of counselors' instructions and members' role
playing for E2 varied. Appendix H describes the guidance
unit for each experimental condition in detail, and
Appendix I shows the case situations for E2.
Upon completion of all guidance sessions, the
researcher administered the two posttests according to
the standard instructions (see Appendix J). As with the
pretest, student code numbers rather than names were
utilized, and individual items were read aloud before
students responded. Administration of these two
instruments to the students as a classroom unit was
considered to be most time efficient and most realistic
(simulating the experience of test taking). Motivation
was maintained throughout by the use of small concrete
reinforcers (cartoon stickers or coupons from a fast food
restaurant); these were revealed prior to the posttest,
reemphasized between questionnaires, and given out upon
completion. To conclude, students in the class were
debriefed about the study by the researcher and any
student questions were answered openly and honestly.


17
Expressiveness and Self-Discovery
For heuristic purposes, Truax and Carkhuff (1967)
have specified self-exploration as a necessary antecedent
for constructive personality change. Clinical
observations suggest that clients involved in successful
therapy do indeed become involved in a process of
self-disclosure and self-exploration (Corey, 1982). This
is a process of coming to know one's beliefs, motives,
values, fears, perceptions of others, relationships, and
life choices.
An early study by Steele (1948) reported data
showing that more successful patients increasingly
explored their problems as therapy proceeded, while less
successful patients explored their problems less as
therapy progressed. Braaten (1958) found, from a
comparison of early and later interviews with successful
and unsuccessful clients, that the more successful cases
revealed a higher amount of self-references, especially
revelations of the private self. Similar supporting data
were reported by Blau (1953), Seeman (1949), and Wolfson
(1949). In both traditional psychotherapy and
contemporary counseling, the role of the therapist has
been geared toward efforts to faciliate this
self-exploration process.
Without personal revelations by the client, the
therapist (and client) will lack the necessary insight to
formulate intervention strategies. Jourard (1959)


Page
REFERENCES 176
BIOGRAPHICAL SKETCH 191
viii


98
recertification, a letter of recognition to the school
principal, and the opportunities to further develop
counseling and research competencies and to contribute to
increased knowledge about the student/counselor
relationship. Of the 12 counselors who indicated a
positive interest, eight were randomly chosen to
participate in this study. It was judged that random
selection of classrooms from volunteering counselors was
appropriate to allow the researched student to be
representative of the population. The demographic data
about the sample, depicted in Table 3-2, reflect a close
approximation to the statistics of the identified
population.
After random selection of the eight classes (one
from each school) was completed, the participating
counselors provided the researcher a list of the students
in the class (see Appendix A) identifying for each
subject the following: First name (and last initial if
necessary), Sex (male/female), and Race (white/ethnic
minority). Using this information, each class was
divided into thirds, with students randomly assigned to
one of two treatment groups or a control group. An
attempt was made to equalize the groups by sex and race
as much as possible, as some, though inconclusive,
research has suggested that levels of self-disclosure may
significantly differ based on these variables. Although