Confidentiality and Informed Consent
Is the information discussed in therapy kept private? Psychotherapy and counseling sessions are private and confidential and your therapist is not allowed by law to discuss information a client shares during their therapy sessions with anyone else. It is important for a client to know and trust they can share openly during their session. It is important for meaningful therapy to create a safe therapeutic environment where sessions are private and you can speak freely and confidentially.
However, there are some limitations to confidentiality in therapy. The legal system acknowledges that there are times when the client, society or both can benefit from release of information. Certain professionals are required by law (mandated reporters) to report and break confidence under certain circumstances.
The most common circumstances in which confidentiality can be breached as defined by State and Federal case law include:
Danger to self or others- All states allow a therapist to reveal the name of a client who is deemed a real and present danger to self (e.g., suicide) or others. Some states even require that the therapist warn or attempt to protect the person against whom the threats are being made.
Abuse of children, elderly, or mentally or physically handicapped-Mandated reporters are required to report suspected child abuse or maltreatment – or cause a report to be made – when, in their professional roles, they are presented with reasonable cause to suspect abuse or maltreatment. In most states a therapist is required to report credible knowledge of current or past abuse. This applies to situations in which the client is the one who was abused as well as to situations in which the client is the abuse.
Third-party reimbursement- If your insurance coverage pays for any of the costs of your therapy treatment, you are giving your consent for information such as your treatment diagnosis and dates of sessions to be put on claim forms to be shared with your insurance company.
Debt Collection- If you do not pay the account balance for your therapy sessions, your name and the amount you owe can be made known to a collection agency.
Defense of malpractice or professional complaint- If you were to allege that your therapist engaged in malpractice or some other unethical act, the therapist has the right to disclose information from your sessions in their defense of your charges.