Privacy and confidentiality are very important in psychotherapy. Mental health professionals understand the importance of speaking privately about personal information. Psychologists, clinical social workers, and other mental health professionals who provide psychotherapy, typically have confidentiality statements written in their professional code of ethics.
There are laws in place that protect one’s privacy. The Health Insurance Portability and Accountability Act (HIPPA) is a federal law that protects an individual’s medical records, personal health information, including the information that is shared during psychotherapy sessions. Some states have additional laws in place to protect your private health and mental health information.
There are specific circumstances in which a mental health professional can break confidentiality and share information without your permission. Those include instances when a client threatens imminent suicide or threatens to harm another person. In those circumstances, the therapist would alert the authorities or the individuals who are in harm’s way. What’s important to note here is that the therapist is required to report this information to the authorities when the threats are imminent (meaning about to happen) and those reports are typically to the authorities or person in harm’s way, not the parents of the client. The only time this information would be reported to one’s parents, is if the parents are the ones in imminent danger.
If someone is thinking about suicide, but they have no plans to act on it, this is not something that is reported. It certainly would not be reported to your parents unless you were very young. The fact that you are 18 would not prompt reporting to your parents.
Many people who attend therapy have discussed suicidal thoughts. It’s fairly common and it is not something that is reportable. There’s a major difference between thinking about suicide and having plans to act on those thoughts. Mental health professionals are mandated to report instances in which they believe that an individual is going to act on their thoughts.
Therapists may also break confidentiality if they learn of a client who was neglecting a child, an elderly person or an individual with disabilities. Most, if not all states, have laws that mandate reporting of abuse or neglect of a child. There is variability in the reporting laws regarding the reporting of abuse of an elderly person or an individual with disabilities.
One final instance in which the therapist may reveal information, without your permission, is in response to a court order. The court might mandate information about a client if they were involved in a legal proceeding and their mental health was in question.
Aside from those exceptions mentioned above, what you share with your therapist is private and confidential. Your privacy and confidentiality will likely be a main topic of discussion during your first session. Typically, the therapist will explain the rules about what can and cannot be shared and with whom.
There are times when an individual wishes to involve others in their therapy. In those instances, the client would sign a HIPPA waiver specifically indicating that a certain person is allowed to know certain information. Unless you sign that form, and outline specifically who can know, what and when, your information will be kept private.
If you’re receiving care under your parent’s insurance, they will likely receive paperwork in the mail explaining your health benefits. However, it will not include information about what you shared with your therapist nor will they be able to access your records.
Even if your parents tried to call your therapist and ask for information, it would not matter. Your therapist would have to refuse their request. Your therapist cannot legally share information with your parents.
I hope this answer helps you to feel more comfortable about seeking mental health treatment. You are doing the right thing by seeking help. Self-harm and suicidal thoughts are always concerning. The fact that you are open to treatment bodes well for your future progress. Sadly, too many people are unwilling to seek help and they unfortunately suffer unnecessarily with treatable problems. You, on the other hand, recognize the need for help and are willing to seek it. That greatly increases your chances of overcoming these issues and finding happiness. I wish you the best of luck with your efforts. Don’t hesitate to write again if you have additional questions. Please take care.
Dr. Kristina Randle