Are Therapy Sessions Confidential?

Therapists need to practice under a set of ethics. Different therapy license boards have different ethics, however, all therapists must maintain confidentiality for their patients.  There is no Gray area when it comes to confidentiality, a therapy session between a therapist and a patient must be kept confidential.

Like all great things, there are times when confidentiality must be broken. The therapist will let the patient know what is stated in their ethics about when and how confidentiality can be broken in the first session, and the guidelines can usually be found in the therapist’s informed consent. There are general guidelines about when confidentiality must be broken. Therapists are mandated reporters, so any mention of child abuse or elder abuse will Elicit a call to Child Protective Services or Adult Protective Services. This is to ensure that these vulnerable populations are safe and in a caring environment.

Another area where confidentiality can be broken is if there are homicidal ideations or an intent to harm others. Therapists are required to notify authorities of an intent to harm others to keep the other person or persons safe from impending or threatened harm. In some cases, suicidal ideations must be reported and the patient may be admitted to a hospital for care and safety.

Sometimes court cases will require records from a therapist, and if a judge orders them, they must be turned over. This does not happen frequently, but it does happen and the judge can subpoena a partial or full record to be used in the court case. Generally, a patient will have an idea if there will be an active court case, so breaking confidentiality, in this case, may not come as a surprise.

The most common reason for breaking confidentiality is when it is requested by the patient for various reasons. If a patient would like the therapist to coordinate care with another provider, speak with a family member or friend about treatment, or a patient would like to transfer care to a different provider, the patient would sign a release of information, note who the records will be transferred to, and the therapist will release the information.