When Confidentiality Collides with Collaboration: Supporting Psychologists to Work Effectively in the MDT

Multidisciplinary team (MDT) working is essential in litigation and rehabilitation cases — especially when complexity, risk, and long-term recovery are involved. But tensions can arise when professionals approach boundaries differently. A common challenge for case managers is when a psychologist’s well-intended stance on confidentiality limits their participation in the MDT and impacts the wider team’s ability to plan and respond effectively.

1. Where It Starts: Ethical Grounding

Psychologists are bound by strict codes of ethics, and maintaining confidentiality is central to building safety and trust in therapy — especially in litigation contexts where clients may already feel exposed and scrutinised.

But these ethical duties can sometimes be interpreted too narrowly, leading to:

• Limited sharing of insights that could help the team understand barriers or risks

• Avoidance of MDT meetings out of concern for breaching confidentiality

• Tension between therapeutic goals and rehabilitation planning

2. Why This Becomes a Challenge

While the intent is to protect the client, the outcome can be:

• Fragmented care — other professionals are working in the dark

• Misaligned goals — therapy is moving in one direction, the MDT in another

• Frustration or conflict — case managers are left to hold complexity without the full picture

• Delays in recovery — because emotional or psychological issues aren’t factored into planning

3. How to Support Productive Collaboration (Without Breaching Confidentiality)

Confidentiality doesn’t mean isolation. There are effective ways to maintain ethical practice while contributing meaningfully to the team. At Healthy You, we support our psychologists to:

3.1. Set the Frame Early

Help the client understand what information may be shared with the MDT — with their consent — and why. Shared goals can be discussed in broad terms without disclosing session content.

3.2. Share Themes, Not Details

Instead of relaying what’s been said in therapy, psychologists can share helpful clinical observations.
For example:
“There are psychological barriers affecting engagement with rehab; we’re working on emotional regulation and confidence-building.”

3.3. Attend MDTs with Intention

Psychologists don’t have to be in every meeting — but joining key ones, especially when progress is stuck or input is needed, can foster cohesion and help avoid duplication or missteps.

3.4. Use Healthy You Supervision

If a psychologist is unsure how to navigate their role in the MDT or is feeling conflicted about what to share, they can raise it in supervision. Our senior clinical team supports psychologists to uphold ethics and enable effective MDT working.

4. What You Can Do as a Case Manager

If you’re finding a psychologist’s involvement limited or unclear:

• Check in early — a quick conversation to clarify expectations can go a long way.

• Name what’s missing — respectfully flag if the team is lacking input that affects planning.

Loop in Healthy You — if you’re concerned about disconnect or barriers, speak to the lead psychologist or supervision lead - contact our Practice Manager to arrange. We’re here to help bridge the gap.

Final Thoughts

Confidentiality is critical — but so is collaboration. When we strike the right balance, everyone benefits, most importantly the client. At Healthy You, we support our team of psychologists to hold their ethical responsibilities and work productively within the MDT. It’s not either/or — it’s both/and.

At Healthy You, we work with case managers across the UK to support sustainable, emotionally intelligent practice. Whether through training, supervision, or peer forums, we’re here to help you stay well—while continuing to make a difference for the clients who need you most. If you’re curious about this subject, need support or just want to listen to your Peers discuss their cases and gain insight, please join us for our free Case Manager Confidential sessions – a safe space to support Case Managers. For more information contact sarahsawyer@healthyyoultd.co.uk.