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The physical environment in which therapy happens can affect treatment effectiveness and personal well-being.

Therapists' duty of care extends to those who may inadvertently overhear client conversations.

Therapy rooms must accommodate what treatment is delivered and how, not determine it.

Providing appropriate facilities is an ethical and professional responsibility.

Picture yourself trying to discuss your deepest anxieties with your therapist while a conversation about last night’s TV can be heard outside the door. How about attempting a therapeutic exercise in a room barely large enough for two chairs?

A number of therapists have raised concerns to me about the spaces in which they are expected to work.

Some report being expected to conduct telephone or online sessions in settings where conversations could be overheard by colleagues or others nearby. Others describe working in noisy buildings, sharing spaces with services that have very different needs, or using communal waiting areas, which can unsettle clients and disrupt sessions.

Changes to room layout, size, availability and accessibility have also raised concerns. These situations can arise when therapy services face growing demand for appointments and staff must share limited facilities for face-to-face, telephone and online sessions.

The space in which therapy takes place really does matter.

Confidentiality is more than closing the door

Protecting a client’s confidentiality is a foundational principle of psychological therapy.

The ethical principles of acting in the client’s best interests, doing good, avoiding harm and acting fairly may all be compromised if private conversations can be overheard.

Telephone appointments carried out in call-center style settings can increase the good done for a larger number of........

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