Confidentiality is a very important part of psychotherapy. You must feel confident that your therapist will not repeat what you say during a session to anyone, for any reason, unless s/he is mandated to report that information or unless you provide your written permission for the information to be shared.

Additionally, confidentiality means that your records—and anything with your name on it—are safeguarded. For this reason, address books, rolodexes and paper files may be locked in a secure cabinet and/or electronic files may be password protected. You should feel free to discuss the issue of confidentiality with your therapist and he or she should be able to provide you with detailed information about their practices.

There are, however, exclusions to confidentiality that are important to know about. Please scroll down the page for more information. If you are ever in doubt about what information is confidential, talk with your therapist.

Legal Exclusions

All licensed therapists are required by law to break confidentiality in the event that you disclose certain information. This information includes: (1) Statements that you intend to commit suicide (2) Statements that you intent to commit homicide (3) Statements that you intent to commit or have committed acts of child abuse and (4) Statements that you intend to commit or have committed acts of elder abuse.

Additionally, confidential information may be released without your consent in the event that the information could facilitate your own medical care in a life-threatening emergency.

Release of Information

A Release of Information is a document that provides your therapist with written permission to speak directly with or provide written information to another person or agency. Most therapists take this action quite seriously and even when permission is given to provide information, chatting about you or sharing information casually will not occur.

A Release of Information requires you to name the person to whom you want information given, provide his or her address and telephone number, and list any exclusion to the release that you want. Some information may require additional consent for release. It is important for you to understand why your therapist has requested a release of information and what information will be shared.

Most Releases of Information are time-limited and the period of validity should be expressly stated on the document. You may countermand any authorization of release at any time. This usually requires a statement from you in writing.

Utilization Review

If you are using insurance to pay for your course of psychotherapy, it is important to understand that your records may be reviewed by your insurance company and/or their utilization review department. If you have agreed to have your insurance company pay for your treatment, you have also agreed to a release of information to your insurance company. In many cases, progress records, diagnosis codes, and billing history become a part of your insurance record. If you have concerns about this, it is advisable for you to speak directly with your insurance company and ask about their Utilization Review process and what it entails.