Ethics of Therapy in Film: Examining the Boundaries of Confidentiality and Dual Relationships

The vast majority of us don’t fully realize the impact that film has on our lives. Not only does it provide a significant portion of many people’s weekly entertainment, but it also profoundly influences our unconscious biases and belief systems. Some of the most thoroughly ingrained things that we believe may come from how we’ve seen them represented in films for our entire lives. 

This undoubtedly places a huge burden on the film industry to adequately represent real human experiences, especially when they are centered around sensitive issues. An example of this is in seeking mental health treatment. How films portray the types of characters that seek mental health treatment, the treatments they receive, and the reactions of any supporting characters can have a profound impact on viewers’ perceptions of mental health treatment in the real world. 

A Therapist Burden

In many films, therapists get somewhat of a bad rap. They are often portrayed as just another burden that the main character must overcome to be successful in the film’s plot. Therapists are frequently characterized as dismissive of their patients’ problems, bored of the patients they see on a regular basis, or downright abusive towards them. Even in some of the best portrayals of therapists in film, such as Robin Williams in “Good Will Hunting,” ethical lines are crossed. No real-life therapist would ever get away with putting a patient in a chokehold. 

Unfortunately, this creates feelings of mistrust and worthlessness not only in the patient seeking treatment in the film, but in society’s feelings towards therapists in general. Today, nearly 47% of Americans see going to therapy as a sign of weakness or a lack of strong character. Although films certainly aren’t the only cause of this lingering stigma against therapy, the ones that portray therapists as unhelpful burdens are certainly not helping the situation. 


In reality, going to therapy to help manage a mental health concern is a sign of resourcefulness. It is an indication of someone who recognizes a problem and actively takes steps to address it in their lives. Although it might take a couple of tries to find a therapist that you feel comfortable talking to and opening up with, a good, positive relationship with a therapist is out there. 

Technology and Relationships

Oftentimes in films, therapists who are actively engaged in treating their patients tend to cross professional lines. These therapists might give out personal information like home phone numbers or addresses. It is common for film therapists to say or do things that many of us would consider unprofessional. Worst of all, there are more than a couple of films or TV series where therapists develop relationships with their clients — see Mr. Jones, 50/50, or You

In the real world, things like technology truly are blurring the lines for many healthcare providers. Although many therapists have very firm rules about giving out personal information to patients, the rise of mobile work phones can make it more feasible for patients to reach their therapists at any time. Likewise, therapists can learn a lot about their patients from how they choose to interact with their smartphones during a therapy session. 

A number of films may actually do pretty well with handling how modern technology has changed the patient-therapist relationship. For instance, the film Live Health captures some of the rise of telehealth and how it can give rise to many benefits and risks. A benefit is that many patients can see professionals without having to leave their homes, while a risk is that many therapists may slowly get sucked into being overworked and blurring the lines between home life and work life. 

Managing Patient Confidentiality 

When it comes to patient confidentiality, once again, more than a few films create a bad image for therapists. Films regularly portray therapists as willing to talk to friends and family members about a certain patient’s treatment. Or they’re willing to accept bribes to divulge traumas that a patient has revealed during a session. The film “Swallow” does just that

Fortunately, there are very strict rules regarding a patient-therapist relationship when it comes to patient confidentiality in the real world. For instance, the handling and proper disposal of all medical records is something regulated by the federal government. Even as medical records move online, the rules and regulations surrounding them are stringent. Breaching these rules could not only cost a therapist a job, but potentially time in jail.  

Patients’ conversations with their therapists are highly confidential. In fact, many courts have ruled that there is certain information that patients may tell their therapists during the course of their mental health treatment that cannot be divulged in court. There are very few, very serious instances where a therapist would have to report the nature of patient conversations with any outside entity.  

The portrayal of therapists in films has undoubtedly been misguided over the years and could impact the way many people still feel about going to a therapist for a mental health concern. Combating these stigmas starts with educating people about how real therapist relationships are supposed to look. Mental health concerns are real and any efforts to help address them are positive steps in the right direction.  

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