Christian Changes Counseling & Recovery Center

Licensed Professional Counseling from a Christian Perspective

What You Should Know about Confidentiality in Therapy

I, as your therapist, will treat what you tell me with great care.  My professional ethics (that is, my profession’s rules about values and moral matters) and the laws of this state prevent me from telling anyone else what you tell me unless you give me written permission.  These rules and laws are the ways our society recognizes and supports the privacy of what we talk about – in other words, the “confidentiality” of therapy.  However, I cannot promise that everything you tell me will never be revealed to someone else.  There are some times when the law requires me to tell things to others.  There are also other limits to confidentiality.  Because I want you to understand clearly what I can and cannot keep confidential, your review of these limits is very important.  You need to know about these rules now, so that you don’t tell me something as a “secret” that I cannot keep secret.  Please read these pages carefully and sign below acknowledging your understanding of the limits of confidentiality. At our next meeting, or at any time, we may discuss any questions you might have.

  1. When you or other persons are in physical danger, the law requires me to tell others about it.  Specifically:
  1. If I come to believe that you are threatening serious harm to another person, I am required to try to protect that person.  I may have to tell the person and the police, or perhaps arrange for you a medical evaluation.
  2. If you seriously threaten or act in a way that is very likely to harm yourself, I may have to seek a hospital for you or to call on your family members or others who can help protect you.  If such a situation does arise, I will fully discuss the situation with you before I do anything, unless there is a very strong reason not to.
  3. In an emergency where your life or health is in danger, and I cannot get your consent, I may give another professional some information to protect your life.  I will try to get your permission first, and I will discuss this with you as soon as possible afterwards.
  4. If I believe or suspect that you are abusing a child, an elderly person, or a disabled person I must file a report with a state agency such as the Department of Human Services or a law enforcement agency.  To “abuse” means to neglect, hurt, or sexually molest another person.  I do not have any legal power to investigate the situation to find out all the facts.  The state agency will investigate.  If this might be your situation, we should discuss the legal aspects in detail before you tell me anything about these topics.  You may also want to talk to your lawyer.


In any of these situations, I would reveal only the information that is needed to protect you or the other person.  I would not tell everything you have told me.


  1. In general, if you become involved in a court case or proceeding, you may prevent me from testifying in court about what you have told me.  This is called “privilege” and it is your choice to prevent me from testifying or to allow me to do so.  However, there are some situations where a judge or court may require me to testify:


  1. In child custody or adoption proceedings, where your fitness as a parent is questioned or in doubt.
  2. In cases where your emotional or mental condition is important information for a court’s decision.
  3. During a malpractice case or an investigation of me or another therapist by a professional group.
  4. In a civil commitment hearing to decide if you will be admitted to or continued in a psychiatric hospital.
  5. When you are seeing me for court-ordered evaluations or treatment.  In this case we need to discuss confidentiality fully, because you don’t have to tell me what you don’t want the court to find out through my report.
  6. If you were sent to me for an evaluation by worker’s compensation or Social Security disability, I will be sending my report to a representative of that agency and it may contain anything/everything that you tell me.
  7. In a court proceeding or deposition when a subpoena or court order has been issued.


  1. There are a few others things you must know about confidentiality and your treatment:


  1. I may sometimes consult (talk) with another professional about your treatment, or a supervised counseling intern may be present as an observer in our sessions ( allowing interns to observe is strictly voluntary, interns will only be present with your verbal consent ).  This other person is also required by professional ethics to keep your information confidential.  Likewise, when I am out of town or unavailable, another therapist will be available to help my clients.  I must give him or her some information about my clients.
  2. I am required to keep records of your treatment, such as the notes I take when we meet.  You have a right to review these records with me.  If something in the record might seriously upset you, I may leave it out, but I will fully explain my reasons to you. Client requests to review treatment records must be in writing and may take up to 15 business days to fulfill.


  1. Here is what you need to know about confidentiality in regard to insurance and money matters:
  1. If you use health insurance to pay part of our fees, the insurance company, the managed care organization, or perhaps your employer’s benefit office may require us to provide information about your functioning in many areas of your life, your social and psychological history, and your current symptoms.  I may also be required to provide possible diagnosis, a treatment plan for your problems, and information on how you are doing in therapy.
  2. In most cases, our office will file a claim on your behalf to your insurance carrier for your benefits and reimbursement.  It is against the law for insurers to release information about our office visits to anyone without your written permission.  Although I believe the insurance company will act morally and legally, I cannot control who sees this information after it leaves our office.
  3. If you have been sent to me by your employer’s employee assistance program (EAP), the program’s case managers may require some additional clinical information.  Again, I believe that they will act morally and legally, but I cannot control who sees this information at their offices.  If this is your situation, let us fully discuss my agreement with your employer or the EAP before we talk further.
  4. If your account with me is unpaid and you have not arranged an approved payment plan, I can use legal means to get paid.  The only information I will give to the court, a collection agency, or a lawyer will be your name and address, the dates we met for professional services, and the amount due to me.


  1. Children and families create some special confidentiality questions.
  1. When I treat children under the age of 12, I must tell their parents or guardians whatever they ask me.  As children grow more able to understand and choose, they assume legal rights.  For those between 12 and 18, most of the details in things they tell me will be treated as confidential.  However, parents or guardians do have the right to general information, including how therapy is going.  They need to be able to make well-informed decisions about therapy.  I may also have to tell parents or guardians some information about other family members that I am told, especially if these others’ actions put them or others in any danger.
  2. In cases where I treat several members of a family (parents and children or other relatives), the confidentiality situation can become very complicated.  I may have different duties toward different family members.  At the start of our treatment, we must all have a clear understanding of our purposes and my role.  Then we can be clear about any limits on confidentiality that may exist.
  3. If you tell me something your spouse does not know, and not knowing this could harm him or her , I cannot promise to keep that information confidential.  I will work with you to decide on the best way to handle situations like this.
  4. If you and your spouse have a custody dispute I will need to know about it.  My professional ethics prevent me from doing both therapy and custody evaluations.
  5. If you are seeing me for marriage counseling, you must agree at the start of treatment that if you eventually decide to divorce, you will not request my testimony for either side.  The court, however, may order me to testify.
  6. At the start of family treatment, we must also specify which members of the family must sign a release form for the common record. (See point 7b, below.)


  1. Confidentiality in group therapy is also a special situation.  In group therapy, the other members of the group are not therapists.  They do not have the same ethics and laws that I have to work under.  You cannot be certain that they will always keep what you say in the group confidential.  Neither myself as therapist, nor this facility, may be held liable for the actions of group participants whether in or outside group sessions.


  1. Finally, here are a few other points:


  1. I will not record our therapy sessions on audiotape or videotape without your written permission.
  2. If you want me to send information about our therapy to someone else, you must sign a “Release of Information Form”.  We will retain copies for your review, so you will know what is involved.
  3. Any information that you tell me and also share outside of therapy, willingly and publicly, will not be considered protected or confidential by a court.


The laws and rules on confidentiality are complicated.  Please bear in mind that I am not able to give you legal advice.  If you have special or unusual concerns, and so need special advice, I strongly suggest that you talk to a lawyer to protect your interests legally and to act in your best interests.