The obstacle that limitations of confidentiality pose in student counselling, and overcoming it

Abby Cleaver discusses her experience with the Student Counselling Services at Trinity, and how it was much different than first imagined

Content warning: this article contains mention of sexual assault, self-harm, and suicidal thoughts.

Limitations of confidentiality were not an obstacle I had expected to face when I started using Trinity College’s Student Counselling Services (SCS). Of course, you can find that the information is available online when you search for it specifically. Regardless, it was something I was completely unaware of until my first in-person counselling session. While I was surprised by the confidentiality limitations, I am relieved looking back that I didn’t know about this beforehand. While I greatly benefited from my sessions, I doubt I would have taken that important first step by reaching out had I known my experience would be completely different from what I had originally anticipated.

It was only in my first consultation session that limitations of confidentiality were brought to my attention

The process of applying for the SCS involves emailing them to express interest, followed up by a questionnaire that helps them to narrow down the kinds of support you may need. They will then either recommend that you check out a student support group they facilitate or suggest an in-person or online consultation session during which you can discuss available support routes further. From the questionnaire submission they will also be made aware of your mental health history, including instances of abuse, assault, self-harm, and suicidal thoughts. It was only in my first consultation session that limitations of confidentiality were brought to my attention, as depending on the answers you provide in the questionnaire they have to inform you that there are certain things that you cannot talk about explicitly without the information leaving the room. This comes down to the idea that, if what you say suggests that you or others may be at risk, it has to be reported in some way. Even if it was a sexual assault that took place years ago, if the incident was never reported to the Gardaí then your counsellor is obligated to do so themselves, for the potential harm that could be done to others just as it was done to you.

When I first heard of this I immediately felt a mixture of disappointment and anger. While I understand that these measures are in place to prevent further harm, the kind of traumatic events that fall under this rule are ones that people feel they cannot report for different reasons, either for lack of physical evidence that would be necessary for anything to come out of the report legally, social complications for them within different circles, or avoiding the ordeal of reporting such a crime as a self-protective measure for their own mental health. Traumatic events being so important not to bottle up, I was extremely frustrated with the system for preventing those affected from having a safe, professional space to talk about and work through issues without having to worry about whether an official report will be filed. These are also deeply personal things that can be extremely hard to talk about, and the challenging process of getting to the point of being ready to talk and be open to support, only to find out that you cannot talk freely, is crushingly disheartening. 

Taking a different approach, we began avoiding stories like this, and even talking things out at length in general.

Despite this frustrating barrier, we came up with potential solutions to work around it. These involved indirectly speaking of the events using hypotheticals or implying rather than explicitly stating — even talking about “your friend” in your place isn’t possible as this would still need to be reported for implying someone is at risk. This was something that was quite awkward and stressful for me. Speaking in hypotheticals, or even just putting so much thought into what I was saying, felt unnatural and quite frustrating, and ended up not being a viable route for me at all. Taking a different approach, we began avoiding stories like this, and even talking things out at length in general. Instead, we would focus on developing and practising positive coping mechanisms and thought patterns that would help deal with not only dealing with past or current issues but put good habits in place for future ones too. Getting my head around this took time, but was helpful.

Shifting the focus in this way was an interesting process for me that wasn’t met with an immediately smooth transition. It was not what I had expected of counselling, but it worked. I’m not sure how exactly I thought talking things out at length would help, I just knew that counselling was something that was supposed to, and figured that it would be part of a healing process. I guess it probably can be, but not being able to do that to the full extent did not end my experience.

The counsellor I was assigned to was genuinely helpful. As we were nearing the end of the year I found a distinct difference in how I dealt with certain events and thought patterns. Though the time that the SCS is able to provide is not very long compared to private paid counselling (the SCS can facilitate about 10 sessions) we decided to put time between each session to set them over a longer period — one session every two or three weeks. This way I found I was able to work on the last session and prepare for the next with enough time to actively notice the progress I was making. Though my experience was partially shaped by the limitations of confidentiality in place and this was initially hard to swallow, it turned out to be a helpful approach for me. I was now more comfortable sitting with my own thoughts, both good and not-so-good, and was able to think through them. I found I had less trouble solving the big and the small issues in my day-to-day life. Recognising and rationalising unhealthy thought patterns as they came up started to become easier over time.

While I understand that this is not everyone’s experience, it was a surprising turn in mine. Limitations of confidentiality may bring up obstacles for both you and your counsellor when navigating certain conversations, but it doesn’t have to ruin or end the experience. Fortunately for me, it did not result in a lost cause, and I’m glad that it was not a deterrent from counselling as a whole before I even got to try it.

Abby Cleaver

Abby Cleaver is the current life editor at Trinity News, having previously served as comment editor, and is a final year English literature and philosophy student.