One of the first things I learned in graduate school was the limits of confidentiality in therapy. What this basically means is what information am I required by law to keep between myself and my client and what must I not keep confidential.
The general rule of thumb is that everything that a client tells you in session must remain private unless one of these safety issues comes into play:
- The client poses a danger to themselves (suicidal thoughts or actions)
- The client poses a danger to someone else (threats of violence to another)
- The client is gravely disabled and unable to care for themselves
- The client reveals information about a child under the age of 18 who has or is being abused
- The client reveals information about an elderly or disabled person who is being abused
- The therapist is presented with a subpoena from the court to testify
Those are the only situations where client confidentiality can be legally breached without consent from the client. For every other situation a client must sign a release of information form for a therapist to speak to others about a client. Typically, these releases are used for a therapist to gather more information that might help the therapist. This includes, speaking to doctors, teachers and other family members.
Sometimes there are unusual requests to release information and this is where things can get a little murky. There are some therapeutic approaches that encourage bringing together like-minded clients. For instance, one client had came to therapy to process a divorce and worked through most of those issues. A second client has come to therapy for the same reason but is just starting to work on the issues. The therapist might encourage the two clients to meet and support each other. I have heard of this type of client pairing happening. The therapist intentions are good but it can be fraught with problems including potential breaches of confidentiality.
If you feel that you therapist has breached your confidentiality there are several things that you can do. First, you can talk to your therapist about your concerns and try to work it out with them. If you don’t feel satisfied with the results or the breach was so egregious that you never want to have contact again you can call your local licensing board and file and formal complaint. Typically these boards are listed by the type of license such as; psychologist, marriage and family therapist, licensed clinical social worker and licensed professional counselor.
Remember that a breach of confidentiality in therapy greatly affects the trust that you have with your therapist. If you can’t work it out then continuing in therapy with a therapist you don’t trust can be detrimental.