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Are Your Conversations With Your Psychotherapist Protected By Doctor-patient Confidentiality?

Are Your Conversations With Your Psychotherapist Protected By Doctor-patient Confidentiality?

The laws regarding patient-therapist confidentiality are not as clear cut as some might imagine

. Confidentiality in psychotherapy ensures that the person seeking help and the professional providing it can establish complete trust. Since family counseling frequently involves baring one's soul and purging it of the deepest, darkest and most damaging secrets, this level of trust is instrumental in any form of mental health treatment. While it is a well-known fact that physicians are bound - legally and morally - by complete confidentiality, those in the mental health field actually operate under slightly different requirements. Granted, private conversations are still legally required to remain confidential, but under a few specific circumstances, the therapist may be required to break the bonds of confidence.

For example, if during the course of therapy the psychologist learns that a person is entertaining a suicidal or homicidal thought, the psychologist has the duty to protect (in the case of suicide) or warn (in the case of homicide). A professional psychologist may choose to request an observational hold of the patient at a mental health facility, which is commonly referred to as a suicide watch. They may also contact local law enforcement to warn a person who may be the target of homicidal ideations.

Child and elder abuse are strictly regulated by both federal and state laws. While the laws differ slightly from state to state, there are no states in the U.S., and actually few countries around the world, that see child or elder abuse as anything but a criminal action. Whether it is the patient who is guilty of the crime or a third party they name, psychologists are mandatory reporters who need to alert authorities whenever these types of abuse are suspected.

Most confidential conversations with a therapist are indeed confidential. In fact, the patient's written permission is required to allow the therapist to disclose any information. However, there are times when discussions from family counseling sessions may be made public. Psychotherapy notes and records may be subpoenaed in a case where a person claims that a mental disorder lessened their personal responsibility for a crime or infraction. This also holds true in cases where someone pursues legal action due to "emotional suffering."Are Your Conversations With Your Psychotherapist Protected By Doctor-patient Confidentiality?


With the rising popularity of HMOs (gatekeeper types of insurance policies), insurance companies often forced therapists to turn over confidential records before paying any claims. This has resulted in increasing numbers of therapists not accepting insurance or responsibility for filing insurance claims on behalf of their clients.

There are now many circumstances which require mental health professionals to reveal the contents of private conversations to authorities, insurance companies or courts. As a result, some psychologists now keep less-than-complete notes on therapy sessions in an effort to protect patients' trust in their confidentiality. The notes may contain no more than the date of the visit, the mood of the patient and the diagnosis. While insurance companies, court systems and law authorities push for the rights to have confidential records, mental health professionals are fighting to defend patients' rights. In most cases, unless a person has criminal or suicidal tendencies to hide, their patient-therapist confidentiality is protected.

by: Stephen Daniels
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Are Your Conversations With Your Psychotherapist Protected By Doctor-patient Confidentiality?