On 2015 May 31, Robert Withers commented:

It is indeed difficult to tread the fine line between the need to insure client confidentiality and the need to present accurate clinical material. This is why I have restricted myself to describing and reflecting on a real critical incident,without disclosing any information that could identify 'John'.

On 2015 May 23, Andrew Kewley commented:

In the manuscript, the author states: "While Chris has kindly granted me permission to use his material in this article, I am not in a position to request similar permission from John. So I will create a composite case, within which to frame a real ‘critical incident’ to which I wish to give particular attention. In doing this, I will aim to remain as true as I can to the dynamics of the original case without compromising client confidentiality."

I'm not convinced that this is ethical. Basically, it means that either privacy/confidentially is violated, or that the case is basically fictional and thus has no place being published.

On 2015 May 23, Andrew Kewley commented:

In the manuscript, the author states: "While Chris has kindly granted me permission to use his material in this article, I am not in a position to request similar permission from John. So I will create a composite case, within which to frame a real ‘critical incident’ to which I wish to give particular attention. In doing this, I will aim to remain as true as I can to the dynamics of the original case without compromising client confidentiality."

I'm not convinced that this is ethical. Basically, it means that either privacy/confidentially is violated, or that the case is basically fictional and thus has no place being published.