Understanding Confidentiality in Therapy

Written by Tretbar Therapy

Updated 2 weeks ago

We are committed to creating a safe and confidential space where you can openly explore your thoughts, feelings, and experiences. This article explains our approach to confidentiality, how your information is protected, and the important legal and ethical limits to confidentiality.

Our Commitment to Your Privacy

As mental health professionals, we adhere to strict ethical codes (such as the AAMFT Code of Ethics) and legal requirements, including the Health Insurance Portability and Accountability Act (HIPAA), to protect your private health information (PHI).

What this means for you:

• Generally, everything you share with your therapist during sessions is kept confidential.
• Your therapist will not disclose information about your therapy to anyone without your explicit written consent, except in specific situations outlined below.
• We utilize secure systems for communication and record-keeping, such as our HIPAA-compliant office phone system and our SimplePractice Electronic Health Record (EHR) system, to safeguard your information.

Limits to Confidentiality: When Disclosure May Be Required or Permitted

While confidentiality is fundamental, there are specific, limited circumstances where therapists are legally and/or ethically mandated or permitted to disclose information without your consent. These exceptions are in place to protect you or others from harm, or as required by law. It's important you are aware of these limits:

1. Risk of Imminent Harm to Self: If your therapist believes you are in imminent danger of harming yourself (e.g., suicidal intent with a plan), they have a duty to take steps to ensure your safety. This may involve contacting family members, emergency services, or other necessary supports.
2. Risk of Imminent Harm to Others: If you communicate a serious threat of physical violence against a reasonably identifiable victim or victims, your therapist has a duty to protect those potential victims. This may involve warning the potential victim(s), notifying law enforcement, or taking other protective actions.
3. Suspected Child Abuse or Neglect: Therapists are mandated reporters. If we have reasonable suspicion that a child (under 18) is being abused or neglected, we are legally required to report this to the appropriate child protective services agency (e.g., the Kansas Department for Children and Families).
4. Suspected Abuse or Neglect of a Vulnerable Adult: Similarly, if we have reasonable suspicion that an elderly person or a dependent adult (who is unable to protect themselves due to a physical or mental impairment) is being abused, neglected, or exploited, we are legally required to report this to the appropriate adult protective services agency.
5. Court Order or Subpoena: In rare cases, a court of law may order a therapist to release client records or testify. We will take all reasonable legal steps to protect your confidentiality but must comply with a legitimate court order.
6. Professional Consultation/Supervision: Therapists may consult with other professionals or supervisors to enhance the quality of your care. In these cases, identifying information is kept to a minimum, and the consultant/supervisor is also bound by confidentiality.
7. Client-Requested Release: You can provide written authorization for us to share specific information with other individuals or entities (e.g., another healthcare provider, a school).
8. Public Health Emergencies (Rare): In certain public health situations, some information might be required by health authorities.
9. Legal Proceedings Involving the Client (where mental state is an issue): If you initiate legal action where your mental or emotional state is a key part of your claim, some information might become relevant.

Your therapist will discuss these limits with you, typically during your first session or as part of the informed consent process.

Confidentiality in Different Therapy Contexts

• Couples and Family Therapy: When working with couples or families, information shared in joint sessions is considered part of the "couple" or "family" therapy. Therapists often have a "no secrets" policy, meaning information shared by one member relevant to the couple/family work may be discussed with other participating members. Specific approaches to this will be discussed with you by your therapist.
• Therapy with Minors (Children and Adolescents): Minors generally have a right to confidential therapy. However, parents/legal guardians also have certain rights to be informed about their child's treatment, especially for younger children. The specifics of what is shared with parents will be discussed and agreed upon by the therapist, child (as appropriate for their age), and parents, balancing the child's need for privacy with the parents' right to be involved. Limits to confidentiality (like risk of harm or abuse) still apply.

What If I See My Therapist in Public?

To protect your privacy, your therapist will typically not acknowledge you first if you see them in a public place. This allows you to decide whether or not to initiate an interaction. If you choose to say hello, your therapist will respond politely but will not discuss any therapy-related matters to maintain your confidentiality.

Your Rights Regarding Your Information

You have rights regarding your health information under HIPAA, including the right to access, review, and request amendments to your records. Please discuss this with your therapist if you have questions.

We are committed to being transparent about our confidentiality policies. If you have any questions or concerns about confidentiality or how your information is protected, please feel free to discuss them with your therapist at any time.