What Does Confidentiality Mean in Therapy?

The goal of therapy is to have a safe space to explore and process our experiences while learning techniques to manage the difficult emotions. In order to make sure all clients have access to this safety, therapists are required by law to maintain confidentiality. What you share in therapy is kept safe between you and your therapist. 

What does confidentiality look like in therapy? 

Here are a few real world examples of what confidentiality looks like:

  • Talking with a teen or child client before a parent meeting and planning what will be disclosed to parents.

  • Crimes committed in the past cannot be reported (unless the crime is classified as child, dependent adult or elder abuse).

  • You run into your therapist in a public setting - therapists generally don’t acknowledge client’s in public first. This is to maintain your right to privacy in any situation where you could be identified as a possible client. 

  • Therapists cannot talk to other providers without the client’s consent. 

    • If we need to talk to your doctor or psychiatrist, we get a release of information before we can even acknowledge we know you! 

  • Not looking up or following a client on social media. 

Confidentiality is fundamental for the trust required for therapy to be successful. Just as confidentiality is mandated for therapists, for all clients there are three situations where therapists are required by law to break confidentiality for the client’s safety.

When does confidentiality not apply in therapy?

  1. You want to seriously hurt yourself

If a client expresses a significant and realistic self-harm plan or the therapist feels the client is an immediate risk to themselves, confidentiality is broken to keep the client safe. If a minor is talking about self-harm thoughts or behaviors that are not a risk to their life, it is up to the therapist’s discretion to break confidentiality. 

2. You want to hurt someone else

If a client shares a plan to harm an identifiable person, the therapist is required to make a police report immediately. It is also encouraged that the therapist warns the individual at risk when possible.

3. Someone is hurting you 

If a client is under 18 years of age, a therapist is required to make a report if there is knowledge or reasonable suspicion of physical or sexual abuse. This includes situations of past abuse. Emotional abuse is reportable based on the therapist’s discretion. 

If a client is 18 years or older, abuse can only be reported if the client is a dependent adult or age 60 or older.  Elder abuse and dependent adult abuse can include financial abuse, abandonment, isolation or neglect, among other issues. 

Every client deserves to fully understand confidentiality and the therapist's legal obligation to make a report when necessary. If you have questions and are currently in therapy, please revisit the informed consent you signed at the beginning of therapy. You are welcome to ask your therapist any questions regarding confidentiality at any time in sessions. 

If you are not working with a therapist but are ready to get started, please schedule your free 15 minute consultation to get started with therapy in Dublin, CA with me today. 

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