Confidentiality is one of the most important components between a client and a psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist’s office. By law, what is discussed in therapy is privileged, namely it gives you, the client, the right to prevent the therapist from disclosing confidential information. You can expect that what you discuss in therapy sessions will not be shared with anyone unless you want me to share this information and you give your written permission to share it with specifically named individuals or organizations such as your spouse, your physician, your attorney, and other professionals. Such written permission may be revoked by you at any time. This information is what is referred to as “Informed Consent.”
There are, however, certain circumstances which would entitle me, by law, to reveal such confidential information without your consent or authorization. Such circumstances are limited to my having reason to believe that:
1. You are actually threatening physical violence against another person, or are an actual threat to the safety of another person, I am authorized by law to notify the police and inform the intended victim;
2. You are threatening immediate physical harm to yourself. If you intend to harm yourself, I will make every effort to enlist your cooperation in ensuring your safety. If you refuse to cooperate, I may take further action without your permission, as provided to me by law, to ensure your safety.
If I have reason to believe that a child under the age of eighteen (18) or an elderly, or a disabled person, or a dependent adult is being abused or neglected, I am obligated by law to notify the relevant state agency, such as social services. This is not a choice but an obligation.
You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I have to give them additional clinical information such as treatment plans or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. You can, of course, refuse to provide such information but, if you do so, your insurance company is unlikely to pay for your therapy sessions.
I am obligated by the ethics of my profession to keep appropriate records of the psychological services that I provide in which I note the date and time of our sessions, your reasons for seeking therapy, your progress, your diagnosis, topics we discuss, your medical, social and treatment history. I also keep in your file records I receive from other providers and copies of records or letters I send to others. Your file is at all times kept in a secure and locked location in my office.
Your records are protected under the Federal Confidentiality Regulations as well as the provision of HIPAA (Health Insurance Portability and Accountability Act of 1996) and cannot be disclosed without your written consent unless otherwise provided for in the regulations.