Is My Secret Safe with My Therapist? How Can I Be Sure?

Will a therapist give away my secret? I've got a big secret that I'm not going to tell here, but I need your advice coming from a therapist. I so want to talk about this, but I don't know if I can trust a therapist to keep my secret. If I tell the therapist, will he or she tell other people? Do therapists talk about their sessions with significant others or friends? Are therapists held to certain rules? When are those rules broken? This secret is eating away at me, and I need to get it off my chest. I can't tell my family. Please tell me the truth. Will a therapist keep my secret or not? —Burdened
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Dear Burdened,

This is a fantastic question that really strikes at the heart of one of psychotherapy’s cornerstones—confidentiality. You are not at all alone in feeling like you have something you desperately need to talk about. Many people crave the opportunity to confide in someone who is not part of their lives and who can guarantee complete and total privacy. This is exactly what therapy can provide. It is also one of the reasons therapy works. The promise of confidentiality allows people to say, feel, and explore things that they might not otherwise be able to.

Of course, there are some limits to confidentiality. For example, if you tell a therapist that you are going to commit suicide, your therapist is required to intervene in order to prevent the suicide. Under such circumstances, the intervention likely would be hospitalizing you. It would require acknowledging that you are a client in therapy, that you are planning to commit suicide, and any other relevant information the hospital might need to help you. Also, if you tell your therapist that you are going to hurt or kill someone else, your therapist is required to intervene not only to stop you, but to warn your potential target. Finally, if you reveal any ongoing child or elder abuse, your therapist must report this to appropriate authorities in order to protect the person, or people, being harmed. Under any of these circumstances, your therapist would be ethically and legally required to breach confidentiality. However, even when such situations occur, the therapist is obligated to reveal only what is necessary to address the crisis at hand.

Teaching and supervision constitute the only other contexts in which a therapist may ethically share information about your sessions. However, no identifying information about the client should ever be revealed in such cases. That is, your therapist might consult with a supervisor or colleague about how best to help a person in your situation, but he or she should never disclose anything that would reveal your identity. If your therapist is a supervisor or professor, he or she might also talk about your treatment (again, without revealing your identity) for training purposes.

Nonetheless, while therapists should not be sharing any information with anyone other than for the purposes of teaching and supervision, unfortunately some therapists do. I would venture to say, though, that when therapists let information about a session slip out when talking with friends or family (which, to be clear, they should not do), they still are not revealing any identifying information. It is very difficult for me to imagine a therapist getting all the way through graduate training and postgraduate licensing processes without a deep understanding and respect for the necessity of confidentiality. The vast majority of us go to great lengths to protect it.

I’ve shared a lot of information about the rules and limits of confidentiality and even a bit about what really happens, even if it isn’t supposed to. I’d like to leave you with a suggestion. Find a therapist and work on building a relationship with him or her. When you feel like you can trust your therapist, talk about your concerns about revealing this secret. If your therapist is someone who tends to let things slip here and there, knowing your concerns about revealing this secret should lead him or her to rigidly adhere to the strictest rules of confidentiality. This may also cue your therapist to get your permission before consulting with colleagues or supervisors, and before using your treatment as a training example. Therapy exists, in no small part, for people to unburden themselves of their deepest, darkest secrets. My hope for you is that you find a therapist you can trust, and that you experience the incredible relief that unburdening yourself can offer.

All my best,
Sarah

Sarah Noel
Sarah Noel, MS, LMHC is a licensed psychotherapist living and working in Brooklyn, New York. She specializes in working with people who are struggling through depression, anxiety, trauma, and major life transitions. She approaches her work from a person-centered perspective, always acknowledging the people she works with as experts on themselves. She is honored and humbled on a daily basis to be able to partner with people at such critical points in their unique journeys.
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  • cheyenne

    cheyenne

    December 28th, 2013 at 8:46 AM

    Aren’t there rules of confidentiality, like if it won’t hurt anyone else you can’t tell anyone?

  • Peter

    Peter

    December 29th, 2013 at 2:06 AM

    I think that once you find someone whom you can trust in this therapeutic setting you are going to feel so much better. It will probably be kind of scary letting someone else in on this secret but I think that if you are asking about it then that means that you are getting close to being ready to start sharing. It is a crazy burden to have to carry around something like this and have no one to talk to about it, and having a great therapist to share with can be a huge relief. Even if it isn’t for advice, just to have someone to who you can talk and share your thoughts and feelings with can feel good.

  • Samuel

    Samuel

    December 29th, 2013 at 7:22 AM

    I don’t think that there is a therapist alive who would go into the field with the sole inyent of finding out your secrets and then running off to talk about them with other people. With that being said I do think that if they hadve your best interests at heart and they think that you could case harm to yourself or to someone else they should intervene and try to get you some necessary help and sometimes that may mean sharing with others what could be going on and getting outside help. You have to know going in that this could be a possibility but know that they would be doing what they thought was right and what could ultimately save lives.

  • Jared

    Jared

    January 27th, 2017 at 2:59 PM

    I was in a lot of therapy when I was younger and the thing is everything I told the therapist would go straight to my parents and now I have been hearing that it was illegal to give out my private information is that true ?

  • GMC

    GMC

    July 23rd, 2018 at 1:57 PM

    On the one hand, while it does seem a bit far fetched that therapists go into the profession in order to steal and tell tour secrets, still of course there are going to be therapists who do this anyway. It’s naive to think otherwise. But , getting onto the other hand, there are examples here in these comments as bad or worse than therapists who actually enter the profession to tell your secrets to others. One commenter mentioned a cult. Some cults do tend to think of control of a therapist as a high prize, whom they might be able then to use. Separately there are people in all walks of life who go into their professions for the power it brings them, no profession escapes this characteristic of some people. There is power in being a therapist where you are dealing with a sensitive person and their secrets. Some therapists’ modus operandi is to convince a subject of the need for social conformity, maybe expressing their power that way. Yes, the occasional therapist will indeed want to show you they have the ability to achieve your trust but also express power by not sticking to that trust. The person who asked the question is absolutely right to. You have to make a judgement on trust, and you can never really be sure, I suppose.

  • tate

    tate

    December 30th, 2013 at 10:22 AM

    Guess there’s always that chance, but it’s a chance that you have to be willing to take if this is a step that you are ready to take to make some changes in your life.
    Honestly though, unless this is something criminal I think that you are safe. A therapist is going to be looking out for you, not looking to be working against you.

  • Aiden

    Aiden

    January 25th, 2014 at 9:19 AM

    If you aren’t ready to share it all then that’s your choice but don’t think that you will ever have complete healing without opening up and sharing it all either.

    It is obvious that you realize that holding back information like this could be detrimental to your healing and I know that it has to be difficult letting a virtual stranger in when this feels so scary to you.. But there are times when you have to trust your instincts and let others help you even when you have kind of lost hope. How are you ever going to be able to break free from that hurt if you don’t share it with someone else and let them help you?

  • GMC

    GMC

    July 23rd, 2018 at 2:02 PM

    It is up to the person. You make your own decisions.
    It’s also important to be aware that just the act of disclosing information of your experiences or knowledge is not necessarily going to heal you. It may and it may not. Even going through longer processes after can guarantee anything. The “how are you going to heal if you don’t” angle can be very misleading. Also, a good therapist will be sensitive both to your questions of trust and to issues which you just can’t seem to express, whether trust is relevant or not. The therapist may advise you that you can kind of use yourself as a therapist for such issues, suggesting methods. This has worked for people in the past. Then, that might help you open up further if you want, or maybe it’s the help you need if you don’t want to or can’t go further.

  • JB

    JB

    June 20th, 2014 at 1:23 PM

    I had a therpaist at a methadone treatment facility tell others about a legal issue I was having and I lost my take homes. I have been clean for 14 months and never miss any type of appt. The clinic wouldn’t have even known if I didn’t say anything. Is this a violation?

  • Ella

    Ella

    August 22nd, 2015 at 5:30 AM

    I’m watching an episode of suits where a therapist testified against her client about some corporate legal stuff. Are there any legal ramifications that require a therapist to reveal secrets,apart from a life-threatening stuff?

  • ishe

    ishe

    May 26th, 2016 at 4:24 AM

    i honestl;y think talking to someone is a great step as it is very helpful to talk about your secret with someone who has nothing to do with your life lest you will lower your self esteem and think there is o point in living …….I really want to be a psychol0ogist but I already have a career I am working towards which is medicine but I want to do something in life to help the hopeless

  • GIovanna

    GIovanna

    October 2nd, 2016 at 8:48 PM

    My parents say i worry to much, and took me to the doctor and told them about me stressing. I do think i stress a lot. But many things have impacted me like my sisters death, my other sister car crash,moving away and leaving everything behind, everything has gave me a different perspective. I cant sleep at night, im always hungry or worrying. I am in ASB and in Basketball and im thinking of quitting both because i have a lot of homework, and my parents are always yelling at me for sleeping “late” from doing homework. I get so frusturated when my older sister wears short shorts at home, i dont know why, its like her butt is halfway out, and might as well call it an underwear. I hate wearing certain clothes because of perverts, and i hate it when my sister does something because then people will a some that i do that as well or have that as well since im related to her. I get so worried sometimes my head hurts, or i lock myself in the restroom and cry to let it out but i really want to scream. At school my friends always ask me why am so worried about rushing to get to the next class. When i watch something sad or not i cry, i am very emotional, and wasnt as much before, like ill see someone talk about their fight loosing weight and ill cry. I have thought of committing suicide but i worry about committing suicide, and this just leads me to wonder how much am i really stressing? No i have never cut or anything for i believe it causes more pain and if you really have pain you will just end it by killing yourself not cutting. One day i thought to myself would my family miss me if i left, so i came up with a plan to started to run away and hide in a parks restroom so i ran away from home at night, and then i worried about getting rapped or something so i came back, but they didn’t notice except my dad who i came clean to and confessed what i was trying to do. I am sort of learning to control myself and suicide thoughts, for i am a child of god, but i worry about my own suicide. Like who is going to help my parents cook, and clean, what if they separate and everything in family just falls apart, or one of my siblings commits suicide as well, or the money my parents have to pay for my funeral, or what if people think i committed suicide because of my parents or something. I just want to say i don’t think if suicide anymore as much but please can someone tell me if i should see a therapist, or what i can do, or how bad i am from a 1-10. Please.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    October 3rd, 2016 at 8:06 AM

    Hi Glovanna,
    Thank you so much for reaching out. If you are in immediate danger of hurting yourself, it is very important you seek help immediately. You can call 911 or your local law enforcement, or visit your nearest hospital emergency room. If or when you experience suicidal thoughts, you can call to talk to someone immediately at the National Suicide Prevention Lifeline at 1-800-273-8255 (TTY: 1-800-799-4TTY). You can also search for a therapist in your area on the GoodTherapy.org directory by visitinghttps://www.goodtherapy.org/find-therapist.html.

    Please know there is hope, and help is available. We are thinking of you and wishing you the very best!
    Kind regards,
    The GoodTherapy.org Team

  • Edward

    Edward

    October 7th, 2016 at 9:25 PM

    Another replier mentioned “as long as it’s not something illegal”, with regard to discretion. What if the patient is a criminal such as a drug dealer and it needs to be mentioned because it’s such a pervasive part of their life that omitting it may affect their treatment plan? I understand the imminent harm thing but what about the common criminal? And if the therapist works in conjunction with a psychiatrist, are they obliged to tell him that?

  • jessica

    jessica

    April 21st, 2017 at 6:27 PM

    i have a question what does it mean when a therapist calls me mentally unstable an that i need to stay with her

  • Cathy

    Cathy

    August 10th, 2017 at 6:24 AM

    No, your secrets are never safe with these “healers” “therapists” “respectable professionals.” I was betrayed by two of them. The people who go into “mental health” are far worse then the patients. These people are slime. They are imposters. Therapy is not just self indulgent quackery, it can do you real harm. It is nothing but an insurance scam dressed up as medicine by caring geniuses. If you are considering therapy, I can’t warn you enough that many of these therapists are terrible at what they do. Many have “problems” themselves, bad moral character. A duped society gives them a lot of power, which makes them dangerous.

  • GMC

    GMC

    July 23rd, 2018 at 2:17 PM

    Thanks a lot for sharing that.
    People do need to be realistic. Therapy doesn’t wash away the world which hurt you. The world doesn’t change after therapy, it will be as bad or worse, while hopefully the subject would be in a better position. But it needs to be pointed out that the ‘world of therapy’ is also in the real world, it’s not in some removed heaven. There’s nowhere else it can be but in the real world, and that means all real world problems can exist within the ‘world of therapy’. It’s also just staffed by human beings. Human beings can be everything on the spectrum from the most bad to the most good, and there is no magic spell which means all therapists are on the good part of the scale. It’s much better to be aware and realistic. It may be telling that the (very good) answer to the question in the blog post actually advises you, with any therapist, to try to kind of win and want your therapist into keeping your case confidential; by you actually treating them specially; by you letting them know they are in a special place if they learn your secrets so they’re more likely to respect them. Every therapist is just another human being. None of these are perfect! Some therapists are pretty perfect at their jobs by standards, but then there are others,

  • Lynn

    Lynn

    June 16th, 2018 at 10:20 PM

    I agree. I was betrayed. A psychologist was connected to a cult and worked to do me harm. She hypnotized me to go online and meet a specific man who was feeding back my personal info discussed in my sessions. I was also hypnotized to remove my clothes when I was with one specific man on this dating site. I have been terrified. I’ve had difficulty sleeping and when I do I have nightmares. She also told several cult members who In 2005 I went to a psycholo to treat depression. She asked me if I wanted to participate in a healing experience. The first 10-15 minutes of each session was devoted to this purpose. This, which involved placing me under hypnosis (though I did not feel like it at the time) and reading paragraphs of info, was done over several sessions. I was also instructed to attend a Qigong event which would contribute to the “healing”. I did so. I was told the healing would occur in ten years. There were times when I thought of leaving the state to work elsewhere, to which she would reply “Oh no, don’t do that. That would ruin the healing experience”.Ten years later I got interested in Islam and joined dating website. I met a man I fell in love with instantly, but then things got scary. His name sounded familiar and I remembered a “psychic” giving me his name (first and last) 23 years ago and telling me he was my soulmate. This man began repeating things read from the paragraphs read to me while under hypnosis in the psychologist’s office and also started to feed back info from my psych sessions. I was also hypnotized to remove my clothes online. I have had nightmare and anxiety. They have shown up at my work giving me very clear signs that they have my personal info as well. I feel like I’ve been raped and I am scared.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    June 18th, 2018 at 7:26 AM

    Dear Lynn,

    I’m so sorry to hear about what you’ve gone through. If you would like to consult with a mental health professional, please feel free to return to our homepage, http://www.goodtherapy.org/, and enter your zip code into the search field to find therapists in your area.

    Once you enter your information, you’ll be directed to a list of therapists and counselors who meet your criteria. From this list you can click to view our members’ full profiles and contact the therapists themselves for more information. You are also welcome to call us for assistance finding a therapist. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Pacific Time; our phone number is 888-563-2112 ext. 1.

    Kind regards,

    The GoodTherapy.org Team

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