Confidentiality in a Small Town

What Confidentiality Looks Like in a Small Town when you're in Therapy

One of the questions I’m asked most often as a counsellor in a small community is some version of: How does confidentiality actually work when everyone seems to know everyone?

The short answer is: carefully, intentionally, and with a lot of thought.

Confidentiality isn’t just a rule we follow behind closed doors, it shapes how we move through grocery stores, school gyms, hockey rinks, parking lots, and community events. It influences what we say, what we don’t say, and sometimes what we gently step away from altogether.

Confidentiality Is an Ethical Obligation — and a Daily Practice

As Registered Clinical Counsellors, we are bound by the BC Association of Clinical Counsellors (BCACC) Code of Ethics, which places confidentiality at the very core of ethical practice. You can read the full, current Code of Ethics on the BCACC website (bcacc.ca → Ethics → Code of Ethics). This includes protecting client identity, privacy, and personal information — not just in session, but in all contexts.

In a small town, that means confidentiality doesn’t stop when the session ends.

It often looks like:

• Not waving first in public, even when I’m genuinely happy to see you

• Never introducing someone as my client — not now, not ever

• Saying “through a friend” if someone asks how we know each other

• Keeping conversations light and neutral when paths cross

• Sitting a few rows apart at the rink or school gym, especially if I sense that’s what you’d prefer

• Choosing silence — or acting as though I don’t recognize a name, story, or connection — because it belongs to a client

These moments can feel awkward from the outside. They can even feel cold if you don’t know what’s happening underneath. But they are rooted in respect, care, and ethics.

When Confidentiality Means Letting Go

Sometimes, confidentiality looks like something harder.

It can look like ending work together because our worlds overlap too much.

In small communities, dual relationships are not uncommon but they must be approached with caution. The BCACC Code of Ethics asks counsellors to avoid relationships that could impair professional judgment or increase the risk of harm. When boundaries become too blurred, the most ethical choice may be to refer out or say goodbye, even when the therapeutic relationship itself felt meaningful and supportive.

Those decisions are never made lightly.

Why This Matters

Confidentiality is foundational to therapy. It’s what allows people to speak freely, take emotional risks, and trust the process. Without it, therapy simply doesn’t work.

In a small town, protecting confidentiality often requires more effort, not less. It means constantly checking our assumptions, monitoring boundaries, and prioritizing client safety over social comfort.

If you’ve ever noticed your counsellor seeming distant in public, avoiding eye contact, or keeping interactions brief, it’s not personal. It’s ethical.

And it’s one of the ways we care for you.

A Final Note

If you ever want to talk about how you’d prefer public encounters to be handled, that conversation is always welcome in session. Confidentiality is not one-size-fits-all, and your comfort matters.

In small towns especially, ethical counselling is a quiet practice, often invisible, sometimes misunderstood - but always intentional.

This post is informed by the BCACC Code of Ethics (available online through the BCACC website), which guides all clinical work at Talking Helps Heal.