Which of the following is a permitted exception to confidentiality in therapy?

The permitted exception to confidentiality in therapy occurs when a client is in a high-risk situation. This principle is rooted in the ethical obligation that therapists have to protect their clients, as well as others, from harm. When a therapist becomes aware that a client poses a serious risk to themselves or others—such as in cases of suicidal ideation, self-harm, potential violence, or abuse—they have a legal and ethical responsibility to breach confidentiality in order to intervene and ensure safety. This exception is crucial in maintaining a balance between a client's right to privacy and the responsibility of the therapist to act in the best interest of the client and the community.

The other options presented do not qualify as exceptions to confidentiality. Minor anxiety does not constitute a high-risk situation that would require a breach of confidentiality. A client's preference not to share personal information is their right and does not create a scenario where confidentiality may be bypassed. Finally, a client attending therapy voluntarily signifies that they are participating willingly, but it does not establish a basis for breaching confidentiality as no immediate risk is presented.