What is Confidentiality in Therapy? – With Exceptions

Before you read any further, we must emphasize that client confidentiality in therapy is an integral part of a therapist’s code of ethics. Every therapist must maintain privacy of the contents of therapy. Clients should feel safe and comfortable sharing what they would like to, without the fear of the information leaving the room.

In fact, confidentiality in therapy includes not just the contents of therapy, but also the fact that a client is in therapy. For example, a therapist may not acknowledge a client, if the therapist runs into the client outside of therapy, to protect client privacy.

Some other ways of protecting confidentiality in therapy include:

• Not leaving revealing information on the client’s voicemail
• Not acknowledging that a client has an appointment, to anyone other than the client
• Not discussing the contents of treatment with another person, without the permission of the client

All therapists at ICHARS respect and maintain confidentiality in therapy.

However, sometimes there can be exceptions to confidentiality in therapy.

Exceptions to confidentiality in therapy

1. Licensed mental health professionals may need to break confidentiality in some situations. The most common ones include situations when a client is a threat to himself/herself or others, in which case a therapist must notify the person in danger or notify someone who can keep the client safe. Therapists may be forced to testify against their clients, depending upon the laws of the country where the therapist and the client are. Usually it is much more difficult to force a therapist to testify than to force a non-licensed mental health professional. This is because laws governing therapists are much stricter about confidentiality.
2. Therapists may have to reveal information about treatment to insurance companies in order for their clients’ treatment to be covered, but usually the information revealed is limited to the diagnosis and medications required.
3. Confidentiality in case of children is a widely debated issue. Since minors cannot consent to treatment, they may not have the strong confidentiality rights that adults have. However, this can interfere with the treatment process, so many therapists seek the permission of their minor clients’ parents to keep the treatment confidential. Even when parents do not agree to confidentiality, therapists may only reveal information about broad treatment goals and progress, rather than revealing the discussions in therapy.