Privacy is an essential precondition for psychotherapy. You have to feel secure in the knowledge that whatever you say will remain confidential. If you don’t, you won’t feel free to talk about the things that are bothering you the most.
It also helps if the setting is comfortable and quiet, and you have a sense that the therapist is paying attention and cares about you and what you are saying.
You are free to talk to anyone about your therapy. Your life belongs to you. But a therapist must be very careful to protect you.
* My session notes are kept confidential and locked away.
* My records are also kept locked away.
* I can’t tell anyone about you without your permission.
Other people don’t even get to know that you are coming to see me, unless you want me to tell them. If I want to speak to anyone about you, I will have to get your permission first.
There are exceptions to confidentiality. In order to make use of your insurance to pay for sessions, a therapist has to let the insurance company know that you are coming and justify the treatment. This can include reporting…
* Dates of sessions
* A description of the kind of treatment offered and reasons for it.
* A justification of the need for psychotherapy, including a diagnosis and symptoms that support the diagnosis. Some insurance companies also want written treatment plans and reports of progress made. You will be included in this process.
In addition, a therapist is morally and legally mandated to…
* Report suspected cases of child abuse, elder abuse, and abuse of handicapped people.
* Do whatever it takes to try to prevent a patient from harming him/herself or others. This can include warning the intended victim, calling family or friends, or reporting the threat to the police.
* Provide information to a court in response to a legal order to do so
In recent years, the government has made a requirement of the very conditions that are so essential to the work. The HIPAA rules are formal and enforceable statements of your rights to privacy, similar to the rights I listed above.