Privacy and confidentiality
This section is not meant to constitute legal advice. If you have specific questions about confidentiality, please consult an attorney. The therapist/client relationship is a legally protected relationship governed by the Healthcare Insurance Portability and Accountability Act (HIPAA) and a variety of state laws and statutes that are state specific. Information disclosed during a session as well as any clinical notes generally cannot be shared without expressed written permission from the client. The following situations are exceptions/limits to confidentiality where mental health professionals may be required to report or share information:
- If a therapist suspects abuse of a vulnerable adult (elderly or disabled) or child, they are required to report the abuse to child or adult protective services.
- If a client is threatening serious bodily harm to another person, the therapist is required to report that threat to the police.
- If a client demonstrates intent and a plan to hurt or kill themselves, the therapist is required to report this threat.
- If the client is involved in a legal battle such as a divorce or custody, a judge can request that mental health and medical records be released to the court. If the judge orders the records via a subpoena and signed written order, the therapist may be required to release records and testify in court proceedings.
- Insurance companies have some rights to review treatment records to verify treatment goals and progress and the appropriateness of services.
A client can protect their privacy by taking the following steps: they can limit who knows about their treatment and pay out-of-pocket for services. In that case, fewer people will know about their treatment and have access to their records.