Can My Therapist Tell Other People About Our Sessions?

Woman with serene expression sitting in a clearing near some tall grassMany people interested in therapy may be hesitant to share private information or stories about themselves with a stranger. They may fear judgment from the therapist, or worse, that the therapist is going to share their details with others. For therapy to be effective, trust must be built between the individual seeking therapy and the therapist.

Is Therapy Confidential?

In almost every instance, therapy is absolutely confidential. You therapist is required to maintain confidentiality about everything said in sessions between the two of you, just like a doctor is required to keep your records private. While there are laws and regulations in place to protect your privacy, confidentiality is also a key part of psychology’s code of ethics. This means your therapist understands from the very beginning that in order for you to feel comfortable sharing openly with them, you need to know your information is safe.

Remember, you can always talk with your therapist if you have questions about the confidentiality agreement between the two of you during your sessions.

What Are the Limits of Confidentiality in Therapy?

For your own safety, there are some exceptions to the rule when it comes to confidentiality in therapy. Generally, these rules have to do with the well-being of the patient or people in the patient’s life.

For example, therapists are required to report if a patient is a threat to themselves or others. This may mean the patient has threatened suicide, is repeatedly harming themselves, or has threatened to harm another person. In this case, a therapist may recommend hospitalization so the patient can be monitored. Once the patient is deemed stable, the therapist may then work with close friends or family members to develop a support plan for the patient in order to maintain that sense of stability.

Additionally, therapists are also required to report cases of ongoing child abuse or neglect. In these cases, a variety of public servants may be brought into the fold, including law enforcement or child protective services. Again, this is a measure created to ensure the safety of a patient and it should not deter you from being open and honest about your situation with your therapist.

Finally, if a minor is seeking therapy and is engaging in risky behavior, their parents or guardian may be informed. Different states have different laws regarding minors in therapy, so it can be a good idea for the parent, therapist, and patient to sit down in an early session and establish ground rules.

HIPAA and Rules of Confidentiality in Therapy

The group of federal laws and regulations protecting the privacy of your health information is known as the Health Insurance Portability and Accountability Act, or HIPAA. They very clearly and thoroughly define when your therapist is allowed to talk about you or your treatment outside of your sessions. These instances may include but are not limited to:

  • When you are talking to your family. HIPAA allows your therapist to talk with your family about your mental health treatment in a variety of ways. If you are present and capable of making decisions and want your family to be involved in your treatment, HIPAA allows your therapist to share your information.
  • When you are at a mental health care appointment. If you are seeing a mental health care professional for prescription medication, HIPAA allows for some information to be shared with the family you may have present. For example, if there are warning signs your spouse needs to know in regard to your medication, then the provider is allowed to share that with them.
  • When you are incapacitated. If you are unable to make decisions for yourself, either because you are unconscious or deemed not of a sound mind, then your therapist may use their own reasonable judgment to share pertinent information with family or friends involved directly in your care. This usually means immediate family members or partners.

What Therapists Have to Say About Confidentiality

Here, several therapists discuss confidentiality of therapy sessions:

Therapist Ruth Wyatt
Ruth Wyatt, MA, LCSW
: Confidentiality is one of the cornerstones of therapy. Knowing that you can say anything to your therapist and it will remain in the room helps you feel safe and builds trust between you and the therapist. For this reason, all therapists are legally and ethically bound to keep their sessions confidential and not share with anyone else what was talked about. However, there are a few exceptions to this rule. For example, if your therapist has reason to believe that you are a danger to yourself or others, she or he must break that confidence in order to make sure that you and/or others are safe. There may also be times when you (or your therapist) would like your therapist to consult with someone else about your treatment, such as your doctor or psychiatrist, in order to coordinate care or clarify information. In cases such as these, your therapist should get your written permission to release information about you to the other party.

Therapist Erika MyersErika Myers, MS, MEd, LPC, NCC: What you share with your therapist is confidential; you have the right to expect confidentiality and respect for your privacy. There are some specific exceptions to the confidentiality expectation.

Therapists are required by law to disclose information to protect a client or a specific individual identified by the client from “serious and foreseeable harm.” That can include specific threats, disclosure of child abuse where a child is still in danger, or concerns about elder abuse.

There may be circumstances when your therapist could be subpoenaed by the courts to share information from a session. Also, you may ask your therapist to share specific information with specific people at any given time. Ideally, you should be informed about any situation in which confidentiality must be breached.

Unless it is one of the specific circumstances in which exceptions to confidentiality exists, you will be asked to sign a release of information form before any information is shared. This may include sharing diagnoses with your insurance company to cover the cost of services, sharing results of testing with schools or educational services, or sharing information with other practitioners, like physicians, in order to help provide you with the best possible care.

Your therapist should have all of their guidelines and policies, including issues of confidentiality, explained in a written document called a Professional Disclosure Statement or an Informed Consent document. You and your therapist can review the limitations and expectations of confidentiality before you begin your work together.

Therapist Lisa VallejosLisa M. Vallejos, MA, LPC, NCC: Therapy is confidential and therapists are bound by both laws and ethics to maintain client confidentiality to the best of their ability. There are exceptions that I will cover in detail.

The major exceptions for confidentiality are when a person in therapy is either an imminent risk to himself or others, or in cases of child abuse and neglect. That means, if a person comes to therapy and shares with his or her therapist that they are feeling suicidal, and if after assessing them the therapist feels they are a danger to themselves, the therapist is obligated to contact the proper authorities. Also, if a person in therapy is at risk of harming someone else, the therapist is required to notify the proper authorities and take measures to ensure the safety of those who are at risk. Finally, if the individual in therapy discloses situations of child abuse or neglect, the therapist is obligated to report that information to the proper child protection agency in the area.

The last exception is the therapist being subpoenaed or compelled by a judge to testify. Those circumstances are rare and therapists can usually claim “privileged communication.”  By and large, your therapist should never reveal your identity or any information that makes you identifiable to others. There may be times when your therapist discusses your situation with other therapists or their supervisor, which is known as consultation, but even in those situations, the therapist is obligated to keep your identity and privacy as much as possible.

Ethical therapists NEVER share information about people in therapy casually with friends, family or co-workers.

When in Doubt, Ask Your Therapist

It’s crucial for the therapist-patient relationship that you feel at ease sharing personal information during therapy sessions. Your therapist understands this and is happy to answer any questions you may have about your privacy or well-being during treatment.

If you haven’t started therapy yet, remember as you begin to find a therapist that any mental health professional is held to HIPAA laws and reporting protocols. No one wants you to feel uncomfortable as you begin the journey to improved mental health—especially not your therapist.

References:

  1. Larson, S., & Londoño-McConnell, A. (2019). Protecting your privacy: Understanding confidentiality. The American Psychological Association. Retrieved from https://www.apa.org/helpcenter/confidentiality
  2. U.S. Department of Health and Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved from https://www.hhs.gov/sites/default/files/hipaa-privacy-rule-and-sharing-info-related-to-mental-health.pdf

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  • 21 comments
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  • Christine

    Christine

    May 7th, 2015 at 11:08 PM

    I brought my daughter to counseling at the urging of my ex husband in WA state.
    I spoke to her in confidence about myself as well as my daughter. said counselor has been seeing my daughter for just weeks at that time.
    I spoke in confidence. Counselor said she thought I was on Methamphetamine and reported her suspicion to both police and local CPS then told me she did and then said my daughter is “scared” and wanted to go home with her dad. She made me think I had no choice so to avoid drama, I let her go home with him. He won’t take my calls, respond to text messages requesting to speak to my daughter in two weeks straight, then got an emergency hearing to file a restraining order so I can’t even see, call or speak to her. This is a violation of our parenting plan.
    I am lived because the counselor then called and emailed my exes wife, not my ex husband and broke my trust when shared private info. What should I do? Does this violate my rights to confidentiality?
    Please help!!!!!!!

  • lyssa

    lyssa

    November 13th, 2015 at 10:01 AM

    Who can you talk to about reporting a therapist? I found out my therapist is treating my ex husband whom I have retraining order against, even after she stated that she would not treat him. My ex was well aware that we were seeing this therapist as we had mentioned it in a custody hearing. I had no idea that the therapist was treating him and blew up when I found out about, which they both used against me in court. The therapist told the court that my outburst of anger did not fit with the situation, I wasn’t suppose to be pissed off that she was telling my ex when my family sessions where as in dates and times, I had no idea that he had been given that information as again I have a restraining order that the ex has already been arrested for breaking before, and the therapist was aware of the criminal charges against him for domestic abuse of me and my family. My family had gone to see her regarding domestic violence issues having to do with my ex. The therapist after 8 sessions of mainly speaking to my very young children and maybe an hour with me, has now told my ex without my permission and the courts without my permission that I have a borderline personality disorder. Funny, when she was talking to me, the therapist had stated she wanted to treat me for PTSD from all the abuse I had suffered at the hands of my ex.

  • Audrey

    Audrey

    February 8th, 2018 at 9:54 AM

    You can report a therapist to their licensing board. For example, I am a LPC (licensed professional counselor) in the State of Ohio. If there is a complaint against my practices, it can be directed there. I am hoping your counselor provided you with a professional disclosure statement and/or informed consent that gives this information. The guidelines on a complaint included in mine include: 1. expressing concerns with therapist directly if possible. 2. seek advice from counselor’s supervisor in a setting where he/she receives supervision (specific licenses mean a counselor is under supervision–as a LPC, I am under supervision until I am licensed independently, which is hopefully in the next 2 months!) 3. terminate the counselor if unresolved and 4. contact the licensing board (mine has contact information; hopefully your counselor’s does as well) if you believe the counselor’s conduct to be unethical. If you feel the dual relationship of counseling both of you is an ethical concern, a state board will help to determine its appropriateness and take action accordingly. Hope this was helpful!

  • Alice W.

    Alice W.

    December 10th, 2015 at 4:30 PM

    I know that in some cases the psychologist is allowed to break the confidentiality. Like I tried kill myself twice this year and I understand completely my therapist tell my parents but she went in my college and did talk with some professors and a coordinator and found out something that I was avoiding to talk about in sessions. It’s killing me because I can’t trust her anymore and now that she knows what happend I’m completely lost. I was not ready to talk about that. Is she wrong? What can I do? Please help me! How can I revert this situation?

  • sammy

    sammy

    February 18th, 2016 at 4:06 PM

    well four days ago i went to the therapist and they told my mom i was at high risk due to the hospitalization does that mean i cant leave the state and is it just like suicide watch

  • Sam

    Sam

    April 11th, 2016 at 12:30 PM

    I was seeing a drug counselor for my SubooneDr. I took my four year old daughter with me I never thought nothing of it I’m usually in and out. That day we were there I was there for over two hours my daughter was tired and hungry by thay time. She was being mean in the waiting room throwi g her toys and stuff. My counselor came out to the waiting room when we usually go into her off office we didn’t that time. She stood there read my results to my drug screen. I was so so aggravated I had taken my daughter to car to correct her twice over what she’d been doimg. So I did call my daughter a idiot not really meaning it in another way I don’t know why I did it I do aggravated and agitated that day and so was my daughter cause we had been there so long and she was acting out so bad and here she was reading my results in front of people and kicking me out of the program she said my test results was one way n me knowing the other. I was allowed to see the results. I went back the next day cause I felt so bad bout calling my daughter that and I also apologized a thousand times to my daughter.
    The next day they told me that if I drove 96 miles to Prestonburg KY every week to Parenting classes for five months they’d let me stay in the program. I agreed cause I thought maybe I needed them classes but I asked to let me go somewhere closer where they do them would be better cause my tires on my car were very bad car and they had that like three 3iles from my house.
    Come to find out at least 4 people came back and told me my councler had told them about my situation.

  • Crm

    Crm

    April 12th, 2016 at 6:09 PM

    I went to a new therapist today which I thought would be a great new beginning in my life, but the entire session was spent with her comparing me to other clients and telling me their personal business. Is there anyway to report their breech of trust? She also told me that should I miss an appointment she would bill me despite the fact that she technically can’t because I have medi-cal.

  • Ashleyy

    Ashleyy

    May 14th, 2016 at 9:16 AM

    Is a therapist in a treatment center allowed to tell a client a conversation they had with a significant other ? The significant other is not a client of said therepist but is a client in the same treatment center

  • Kody L

    Kody L

    June 22nd, 2016 at 8:49 AM

    Thank you very much for the information. I have a brother who really wants to got to a therapist, but he is nervous about the information being shared or talked about with other. I think he will find it comforting to know that the information will not be shared. I know that if he is a danger to himself the therapist may tell medical professionals. That seems like a safe way to go anyway.

  • Luz d

    Luz d

    July 14th, 2016 at 12:28 PM

    My stepdaughter left my home because I wouldin’t allow her to use drugs and she had to attend therapy she is bipolar and has depression and has had delusions.where she herself put herself in the hospital. She was and still mutilating ! My daughter called me in December asking for money I met up with her to but her clothes and food. I did not hear from her until last week she left a message that she was in the hospital picked up from the street passed out. She told the hospital she tried to commit suicide. I did not want to speak to my daughter I have hodgekins lymphoma she is calling me not for help and when she left she manipulated so many people with lies about me ! So I called the social worker at the hospital and left a message that my daughter is homeless on drugs living from house to house and on trains and if they don’t help her she will die . I guess my daughter found out that I was concerned about her living in the streets that she left. Message on my phone that she did have a home and was fine! I told the social worker to please let me give her papers about how sick my child is but she won’t call me. Why is that? My daughter is known that her manipulative ways are part of her illness

  • Greg

    Greg

    October 2nd, 2017 at 3:49 PM

    My 14 year old grandchildren (we have legal guardianship) are seeing individual therapists. Court has ordered family therapy between mother and children (after 6 year absence by mother after childrens abuse allegations of her and her present husband) but therapists state they cannot talk to the family therapist. The court wants family therapist to speak with mothers and childrens individual therapist before sessions start and the childrens therapist are siting privilage. What can we do?

  • vivienne

    vivienne

    November 4th, 2017 at 1:15 PM

    I’d like to know can my therapist who has his own therapist tell his therapist about my problems?

  • Marianne

    Marianne

    December 16th, 2017 at 4:59 PM

    I would presume that the therapist your therapist is seeing could be considered as acting in a supervisory capacity. Information sharing in this relationship is also covered by confidentiality rights. This means that personal information is de-identified and discussions are focused on the best interests of the client. Information sharing in consultation with another therapist may provide another perspective on how to best help you and help your therapist focus clearly on your needs.

  • claire

    claire

    August 1st, 2018 at 6:28 PM

    What about if you give them permission? My boyfriend is angry, and says he will only speak to me through a therapist, but not in couples counseling. He told me to find a therapist who will let me sign a waiver to discuss things over the phone, in order for him to feel safe.

  • Marianne

    Marianne

    August 2nd, 2018 at 7:43 PM

    You can give written consent for your counsellor/therapist to discuss issues with your boyfriend. If your boyfriend also has an agreement (i.e., as a client) with the same counsellortherapist, then he would also have to give written consent for information sharing. I am curious as to why there is a safety issue for your boyfriend when he is the one experiencing anger.

  • farrell

    farrell

    August 17th, 2018 at 10:41 PM

    I spent 6 years trying to figure out the point of therapy. For me it was a waste. The one I hired did not listen, did not understand, and would not explain. I never figured out what was supposed to be happening or how it was supposed to help me.

  • Vic

    Vic

    December 15th, 2018 at 1:54 PM

    Many therapist are not necessarily good or competent or properly educated; some are even dangerous. I know therapists who have taken advantage of their patients, sexually. Chances are your therapist was one of those ones. I have seen both bad and good ones. Bad ones can damage a lot. The best scenario would be delaying your healing. The worst scenarios can be nightmarish. I am still haunted by a psychiatrist who badly injured me 20 years ago! But good ones can help a LOT.

  • Vic

    Vic

    December 15th, 2018 at 1:50 PM

    Can therapists / psychiatrists share the therapeutic sessions with their colleagues or friends, WITHOUT the knowledge and consent of the patients, but also without mentioning any personal identifiers?
    As a patient, I would not even allow a therapist to talk about me outside the room, even without telling my name. But I see many psychiatrists or therapists who tell tales of their patients (without their consent or even knowledge), in a poetic glorious way. Their justification is that they are not exposing the patient identity (therefore, they are not breaching confidentiality). Is that ethically correct? If not, could you please give me a reference so that I can show those therapists?

  • jacquelyn

    jacquelyn

    October 28th, 2019 at 6:19 PM

    i went to the same clinic for 25 years for mental disability. 24 years later they became hostile after i signed a release notice for a therapist to talked to them. i do not know what she said but i told her my entire life of abuse stories. i then found another therapist and i think she is doing the same. i am not violent! i was also tricked into going to a private hospital who sent me to another clinic who i hav found out is not charging my insurance. the second therapist is having me send her emails. i feel i am being set up for something and they will not tell me what it is. what do i do?

  • Lloyd

    Lloyd

    October 29th, 2019 at 8:38 AM

    I’m grateful that your article mentions how therapists prioritize confidentiality in regards to sessions. My family and I are considering going to therapy. We’ll be sure to find a therapist whose clinic instills these beliefs.

  • Jo

    Jo

    November 4th, 2019 at 4:01 PM

    I am dating someone who’s a therapist. We are just dating, I am not seeing them for therapy, but I disclosed to them that I’m currently in therapy with someone else. Can the dating partner, being a therapist themselves, contact my current therapist if they’re worried about me, and would my current therapist be able to disclose or discuss anything with the dating partner?

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