A new client tells you that he is concerned about the amount of time he is watching pornography on his computer. He says that he sometimes spends whole weekends surfing the web for sites that might contain images or videos of interest to him, ignoring his spouse and children.

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His spouse is concerned and asked him to see you. You have some expertise in treating clients who chronically view pornography and agree to see him for therapy.

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One of your concerns is that some of the images he describes may be of minor children. Some of the sites he has visited are known by you to have programs that will download images even without the knowledge of the user. In addition to your other therapeutic concerns, you consider what to do about future web surfing by this man, and what images might be stored on his computer hard drive or any cloud servers that he uses.

You have informed the client of the limits of confidentiality as part of your initial session and again later as you gather more information.

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You know that possession of pornographic images of minor children is a state and federal crime which, if adjudicated, can result in a lengthy prison sentence and registration as a sex offender.

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What steps should you take to assist the client in what you consider is addictive behavior?

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If he were an alcoholic, you would encourage him to rid his house of any alcohol and enlist the aid of the family in that goal. Your experience and research inform you that eliminating part of the problem is at least one positive step toward sobriety. You consider if the same might be true in the case of addiction to viewing pornography.

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However, there is a difference between possessing alcohol and possessing pornography. Possessing alcohol for those of age is legal; not so for child pornography. Does eliminating the images from the computer constitute destruction of evidence? Is informing the client of what legal steps might occur if child pornography is found on his computer or a suggestion by you to eliminate the images, supporting the destruction of evidence or simply good therapy practice?

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Also, hitting the delete button on a computer does not make the file disappear. Deleting a file may simply send it to another part of a hard drive where it is stored until it is over-written. There are also internet histories, logs and cookies to consider since these leave a trail of activity by the user.

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There is a legal term called “spoliation of evidence,” defined among other acts, as the intentional altering or destroying of evidence relevant to a legal proceeding. You ask your client if he believes he is under investigation for his activities.

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He confirms that he has not interacted with anyone on any websites, such as

chatrooms, since you know that investigative agencies use bait sites to target

child pornography providers, viewers and child predators.

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He also confirms that at no time have police officers or investigators of any type come to his home to confiscate computers or question him about pornography use.

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As far as clinicians are concerned, broadly speaking, the ethical duties in conflict here are the duty to the client and the duty to society. More specifically, as psychologists, we have a legal and ethical duty to protect our clients’ confidentiality and to prevent them from harming themselves and others to the extent we can do so.

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The competing duties to society are to follow the law, including reporting child abuse. Failure of the therapist to report abuse may result in both criminal and civil liability, depending on local law. Our purpose in writing this piece is to clarify the conflict that a therapist faces when a patient reveals this type of information and not to provide an answer to the dilemma.

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The answer a therapist reaches may differ from one therapist to another based on the relative value given to fidelity to the patient's confidentiality versus allegiance to societal good.

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If instead of the spouse referring the client to you, suppose an attorney has referred the client and wants an evaluation as part of defense preparation. You find that the client may have computer files with illegal images, which were not revealed to the attorney and not thus far discovered by any investigative authority.

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Is there a difference between telling or suggesting that a client deletes files versus simply describing what consequences may occur if one possesses such files on a computer?

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Should a therapist be charged with conspiracy to obstruct justice by colluding in eliminating illicit images on a computer? A defense to the tampering with evidence charge might be “abandonment,” in that you could argue that evidence was not “destroyed,” but rather discarded because it was no longer wanted by the accused, which was part of a therapeutic plan designed to change the addictive behavior of the client – much like helping an alcoholic rid the home of alcohol.

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As with any true ethical dilemma, different clinicians may reach different decisions about what to do. As long as you are informed and thoughtful about the suggestions you make, any problems resulting from your actions are at least defensible. Decisions that are thoughtful and not simply reactive are much better for the clinician and the client.