Here we record some of the themes that have come up in our supervision groups that are useful to all of us and help us to create standards for our practice.
Please feel free to add your perspectives, bearing in mind client and peer confidentiality.
‘Confidentiality in the Community’
22nd November 2012
We recently had a discussion about how to approach enquiries from neighbours and members of a community when they know someone is dying. In a small town where people know each other, it is natural for people to be concerned or want to be informed or be able to support.
The question we looked at was: to what extent should we maintain confidentiality and should we lie about the fact that we are working with a family?
We agreed that Doulas are embedded in their community and this is fundamental to our ethos. We agreed that neighbours are likely to see us coming and going and that it would be pointless to lie. We agreed that the boundaries are not the same as in psychotherapeutic settings, where a therapist would not divulge their relationship with a client.
We agreed on two possible approaches:
- One might be, we could ask the family for their view eg: “If I am asked by friends or neighbours how things are going, how would you like me to respond.” The family may like you to have a prepared ‘statement’ so that you can act as a spokesperson for them.
- Secondly, acknowledge that you are working with the client or family, but say that you never talk about your clients. We felt this would also give people some confidence in the role, that you are respecting the families privacy.
Any thoughts or comments?
‘Confidentiality within our own family’
We also discussed whether it is appropriate to divulge to our partner or family members that we are working with a client. We agreed that the Doula role is different from a psychotherapeutic relationship and that it is unrealistic to withhold this information, especially as we are in the same community and are ‘lone workers’. It is important that people know where we are going for our own safety. We agreed the boundary of confidentiality is withhold private details of the clients condition, process or family circumstances, but to be open about who we are working with and when we are going to visit.