Confidentiality: Its effect on interviewee behavior.

It is generally assumed that the promise of confidentiality is an essential ingredient in inducing people to reveal important and intimate matters to a therapist. The present study investigated this question by means of an interview analog. 30 male and 30 female undergraduates were administered a standardized interview composed of items requiring various levels of intimate responding under conditions that promised confidentiality, nonconfidentiality, or no expectation of confidentiality. Ss receiving the promise of confidentiality were more open in their disclosures than those given nonconfidential instructions. Results also show that the possible release of confidential information was less negatively viewed by males than by females. The effects of fully disclosing the limits of confidentiality with a client are discussed. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help is where you find it: Four informal helping groups.

Investigated the nature of help-giving provided by 90 hairdressers, 62 family-practice attorneys, 97 industrial supervisors, and 76 bartenders. It was found that moderate to serious personal problems were raised with all groups, but particularly with hairdressers and lawyers. Although those problems in the aggregate were similar to those brought to mental health professionals, somewhat different problems came up with different groups. Ss used a variety of handling strategies, some of which were similar to those used by mental health professionals. The special ecologies of the several situations related both to the number of personal problems raised and to how they were handled. Most Ss felt good about providing interpersonal help and believed that they did so moderately well. It is concluded that more precise knowledge of society's de facto help-giving mechanisms is an essential precondition for rational future planning by mental health professionals. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What do people want to know about psychotherapy?

Assessed information people want about psychotherapy, and the effect of prior exposure to a written consent form on preferences for information. 108 adults, half of whom had received a written informed consent form, answered an open-ended question about their preferences for information. Ss most frequently asked for information about the therapist, especially personal characteristics. Least frequently cited were items concerning appointments, alternatives, and confidentiality. Ss exposed to the written consent form were more likely to ask about confidentiality and financial arrangements and, if they had not had previous therapy experience, were less likely to ask about personal characteristics of the therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of feedback of physiological information on responses to innocent associations and guilty knowledge.

Investigated the effects of providing Ss with feedback concerning their physiological responding while they were questioned about (a) innocent associations varying in degree of personal involvement and (b) innocent associations vs guilty knowledge. In Exp I, 48 undergraduates were divided into 3 groups—electrodermal, heart-rate, or no feedback. Ss were then questioned separately about a list of geometric figures, containing one that they had chosen beforehand, and about a list of Social Security numbers, which included their own. Results, based on the relative amplitude of electrodermal responses, indicate that feedback significantly augmented responses to the relevant item as did personal involvement. In Exp II, 26 undergraduates were provided with guilty knowledge about a mock crime while another 26 Ss received innocent associations. Half of each group received electrodermal feedback and half no feedback. Results show significant differences in the responding of guilty and innocent Ss. Feedback increased responding to relevant items in both groups. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public versus private expectancy of success: Confidence booster or performance pressure?

In Exp I, private expectancies of success were manipulated by having 38 male and 26 female undergraduates complete a confidential preliminary test that was rigged to cause either success or failure. Ss furnished confidential self-reports of expectancies and were informed that their audience expected them to succeed in an anagram-solving task. Results show that Ss' private expectancies of success improved performance, while audience's expectations of success lowered performance. Findings were strongest for Ss low in trait self-consciousness and for males. In Exp II, 30 undergraduates completed a personality questionnaire and were told they had an integration score of 75. Ss were (1) told they were expected to do well on the basis of past research findings, (2) told they were expected to do well on the basis of the experimenter's theory, or (3) given no information about expectations. Results show that Condition 1 raised performance while Condition 2 lowered performance. Findings fit a model holding that audience expectations of success constitute performance pressure that harms performance except when substantial private confidence is created. (24 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social judgeability: The impact of meta-informational cues on the use of stereotypes.

According to a social judgeability analysis, a crucial determinant of impression formation is the extent to which people feel entitled to judge a target person. Two experiments, with a total of 113 undergraduates, tested the impact of the subjective availability of individuating information on a social judgment independent of its actual presence. In Exp 1, Ss made a stereotypical judgment when they believed individuating information was present even if no information was in fact given. In Exp 2, Ss who thought they received individuating information made more extreme and confident judgments than Ss who thought they received category information. This indicates that Ss' judgments were not simply a function of implicit demand: The illusion of receiving individuating information led Ss to believe they possessed the necessary evidence for legitimate decision making. This result supports the existence of rules in the social inference process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive constraints on ordering operations: The case of geometric analogies.

Examined the order of performing mental transformations in the solution of geometric analogies in 4 experiments with a total of 237 undergraduates. In Exps I and II, Ss solved geometric analogies requiring 2 or 3 transformations and indicated the order in which they performed the transformations. There was close agreement on nearly the same order for both types of analogies. In Exp II, Ss were directed to perform pairs of transformations in the preferred or unpreferred order. Both speed and accuracy were greater for the preferred orders. In Exp IV, Ss were asked to indicate the order in which they would need specific types of information in order to draw a simple picture. This drawing order paralleled the order of performing mental transformations during analogy solution. Results suggest that in solving geometric analogies, Ss tap into procedures and constraints common to the domains of imagery, drawing, and object identification. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client anticipations and preferences for confidentiality of records.

116 new clients requesting services during one semester at a medium-sized university counseling center participated in a survey of preferences and anticipations about confidentiality of their client records. The survey asked Ss to rate the amount of information that they preferred and anticipated would be released by the psychotherapist under 13 request scenarios. Generally, Ss preferred less information to be released than they anticipated would be, but differences existed by scenario and recipient. Homogeneous clusters of Ss were identified who expressed unique anticipations and preferences about confidentiality. Some clusters of Ss preferred absolute confidentiality, but other clusters preferred broad release of their information. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Informing clients about the limits to confidentiality, risks, and their rights: Is self-disclosure inhibited?

Investigated the effects of providing varying amounts of detail regarding the limits to confidentiality in a psychotherapy analog. 24 mildly depressed undergraduates (as determined on the Beck Depression Inventory) were offered an interview to explore their depression and were told it would be much like single-session therapy. Before the interview, Ss were randomly assigned to read and sign 1 of 3 consent forms. Little evidence emerged of significant inhibition of disclosure when detailed information was provided; straightforward encouragement for disclosure eliminated the small inhibitory effect. A 2nd study, with 40 Ss, demonstrated the concurrent validity and sensitivity to change of the major dependent variable. The results of the 2 studies are encouraging not only to psychologists concerned about the moral rights of their clients but also to psychologists who have avoided informing clients about the limits to confidentiality, risks of therapy, and clients' rights because they feared it would necessarily discourage disclosure. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of mental health and reactance-reducing information on offenders' compliance with court-mandated psychiatric evaluations.

Using psychological reactance theory, we examined the effects of 3 educational interventions on the appointment-related behaviors of offenders who were mandated by court to participate in psychiatric evaluations. A posttest-only control group design was used to determine the effects of type of information received on 120 probationers' preappointment requests for additional information, appropriate cancellation of appointments, and compliance with referrals. Ss were provided minimal information, basic mental health information, reactance-reducing information, or a combination of basic mental health and reactance-reducing information. Results indicate that type of information received affected Ss' compliance. The theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decisions about confidentiality in medical student mental health settings.

Investigated orientations toward confidentiality of 59 mental health practitioners in US medical schools who were requested to respond to 10 case vignettes representing a range of students' problems by indicating the action they would take. Results suggest that Ss were generally unwilling to break confidentiality in response to cluster of presenting problems that involved suicidal tendencies, sexual coercion/seduction, nonviolent social transgressions, and falsifying data. This was most pronounced when risk of suicide was evident. Only a bomb threat scenario clearly elicited responses suggesting a likely breach of confidence. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Service use and mental impairment among the elderly: Arguments for consultation and education.

Compared the service use patterns of older adults with varying levels of mental impairment, and assessed the effects of services received on their mental health status over a 1-yr period. Data were obtained from a US General Accounting Office (1977, 1979) study of 531 elderly persons (mean age 76.1 yrs), which included administration of a modified version of the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Ss were interviewed twice, 1 yr apart. 174 Ss were classified as having a mild psychiatric impairment, and 118 Ss had a severe psychiatric impairment. The existence of mental impairment was related to marital status, race, and level of education. Usage of mental health services was low, although mentally impaired Ss were more likely than unimpaired Ss to use social and medical services. Results also suggest that such services can have an important effect on the mental health of older persons. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge and beliefs about confidentiality in psychotherapy.

Surveyed 200 high school students, 308 undergraduate psychology students, 34 former clients from a community mental health center, and 40 former clients from a university counseling center regarding their knowledge of and attitudes toward confidentiality in therapy. Overall results show that the vast majority of Ss viewed confidentiality as an all-encompassing, superordinate mandate for the psychology profession and that most Ss wanted to be told of the limitations to confidentiality but would have limited therapeutic communications when told. It is concluded that the general population, including those who have been in therapy, does not have an accurate perception of current ethical limitations regarding confidentiality in psychotherapy. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of confidentiality conditions on self-disclosure of early adolescents.

A self-disclosure questionnaire was administered to 45 male and 45 female 7th–8th graders under 1 of 3 conditions: confidentiality explicitly assured, no instructions regarding confidentiality, and confidentiality explicitly not assured. A self-disclosure score was derived by summing the number of "true" responses to a 74-item questionnaire. Results do not support the hypothesis that Ss would more frequently disclose personal and possibly stigmatizing information when confidentiality was assured. Across conditions, males disclosed significantly more frequently than females, suggesting that females were more cautious and had a higher level of self-protective needs. Responses to a posttest questionnaire revealed significant overreporting of confidentiality instructions among males and females. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned taste aversions over long delays in rats: The role of learned safety.

Tested the proposal that learned safety accounts for the delay gradient in learned taste aversions in 4 experiments. In Exp I and II, 132 female Sprague-Dawley rats drank a small quantity of a nontoxic solution toward which they had a mild aversion. It was found, in support of the learned safety concept, that the intake in a 2nd test was a function of the delay time between tests. Exp III with 72 Ss demonstrated that no additional curve of learned safety would occur when Ss had previously received extensive experience with the solution. Exp IV with 81 Ss found, however, that learned safety was not a sufficient explanation for the delay gradient in learned taste aversions by showing that the gradient still persisted even when the experimental procedure minimized the effects of learned safety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Episodic spatial memory in adulthood.

Two experiments examined age-related differences in memory for spatial location information in a museum exhibit (Exp 1) and in a secretarial office (Exp 2). In Exp 1, Ss were the visitors to the exhibit (N?=?302, 15–74 yrs of age), and memory was assessed using a map test. In Exp 2, Ss were 64 young adults (M?=?21.2 yrs) and 32 older adults (M?=?71.2 yrs), and memory was assessed using both a map test and a relocation test. The relocation test required Ss to replace the to-be-remembered targets where they appeared at study. Exp 1 showed an age-related decline in spatial memory performance, and it placed the onset of this decline in the 6th decade of life. Exp 2 showed an age-related decline on both tests, but age effects were smaller on the relocation test than on the map test, and when Ss knew that spatial memory would be tested than when they were not informed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health needs of the chronically mentally ill elderly.

The treatment histories and current social, financial, and clinical status of 111 chronically mentally ill (CMI) persons over the age of 60 were examined. Information was obtained from Ss, family, mental health records, and mental health professionals familiar with Ss. Psychiatric symptoms were observed in 74% of Ss. Many Ss experienced long periods without acute episodes of illness. Recurring episodes eventually appeared in most Ss, however, and ongoing deficits in daily functioning and social contacts were prototypical. Two thirds of the Ss were living in the community, relying heavily on family contacts; the rest lived primarily in nursing homes (23.4%) or psychiatric hospitals (7.2%). Social support was the best predictor of level of functioning. Findings suggest that failure of CMI elderly to use mental health services is not due to lack of need. Mental health services currently do not appear to be meeting the needs of this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's recognition of rights violations in counseling.

Evaluated the capacity of children and adolescents to comprehend and protect their rights in a mental health setting in 60 male Ss. 20 Ss at each of 3 age levels (8.2–9.7 yrs, 15.2–16.0 yrs, and 20.4–23.1 yrs) were explained 6 rights—refusal of treatment, knowing the reason for refusal, withholding information from counselors, refusal to allow videotaping of a treatment session, confidentiality, and the right of access to records—and then asked to view videotapes in which these rights were violated. Results show that, for 9-yr-old Ss, the experimental effect of providing information about rights was minimal; both experimental Ss and noninformed controls demonstrated low scores on measures of recognition of rights violation and protection of rights. At ages 15 and 21, experimental Ss demonstrated significantly higher scores on both measures than did control Ss. There was no significant difference in the experimental effect between the 15- and 21-yr-old Ss, which suggests that by age 15, the average adolescent is fully capable of comprehending and exercising his or her rights. Guidelines are proposed regarding the provision of information about rights to minors who receive mental health services. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency judgments by depressed college students: Sadder but not always wiser.

Three experiments with 296 undergraduates examined depressed and nondepressed (Beck Depression Inventory) Ss' perceptions of control over outcomes in a task similar to the one introduced by L. B. Alloy and L. Y. Abramson (see record 1981-02686-001). In Exp I, when Ss completed a contingency learning task with no one else present, nondepressed Ss perceived themselves to have more control over frequently occurring response-independent outcomes than did depressed Ss, which replicated Alloy and Abramson's finding. When Ss completed the task in the presence of an observer, depressed students perceived themselves to have more control than did nondepressed Ss. In Exp II, the observer effects found in Exp I were replicated; the present authors also showed that, when response-independent outcomes occurred relatively infrequently, depressed and nondepressed Ss who completed the task in the presence of an observer did not reliably differ in their estimates of personal control. In Exp III, the pattern of results found in Exps I and II was replicated under conditions in which observers were present while Ss received frequently occurring outcomes. Overall findings demonstrate that the consistently accurate personal control estimates of depressed Ss that have been found across a variety of situations break down when Ss complete a contingency learning task in the presence of an observer, and outcomes occur independently of response at a high frequency. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)