How confidential is a therapist?!


Question:

How confidential is a therapist?

In situations where a child is involved (and there is no abuse to that child aside from hearing parents arguing) how confidential is treatment sought by a therapist? Also would it make a difference if the person seeking treatment has been abused? By that I mean not terribly abused but say, hit once or twice over a three years span?

Additional Details

2 weeks ago
Regarding the above what I mean is if an adult parent were to seek treatment--pardon me for not clearing that up as I should have. Also thanks for all of the answers and I hope they keep coming in because I am curious about your experiences or the experiences of someone you know. :)


Answers:

What an adult discloses in therapy sessions is completely confidential and can only be disclosed to another when the client signs a release of information with the following exceptions:
1) Information necessary to process insurance claims (the client usually signs a billing agreement when they provide their insurance information)
2) Evidence of child abuse, neglect, sexual abuse or neglect of children-all states have laws that require a therapist to report suspected abuse of children.
3) Threat of harm to oneself or another person-while therapists are not necessarily mandated to report threats to harm another person, most all follow a "duty to warn" procedure based on Tarasoff's Law (in the USA, anyway) and cannot be prosecuted for disclosing information in order to protect the client or another individual who is being harmed or threatened
4) If information is requested by subpoena, therapists comply with the court order or subpoena and disclose only what information is being specifically subpoena'ed

In your particular post you mention that you have been abused on a couple of occasions, so I wanted to clarify a case in point. If you are a victim of domestic violence, a therapist is not mandated to report the abuse nor would they except if it occured in the presence of a child. If your partner physically assaulted you in the presence of your child that would constitute neglect of the child because of the extremely damaging effects on child witnesses and the therapist would be required to report that to CPS unless you took immediate steps to protect the child from further likelihood of witnessing the violence. It can be a slightly gray area, however, in that a therapist would not likely report an incident if it was years ago and not repetitive, but if the incident was recent (and could indicate an escalating situation of violence) it is likely that the therapist would report it to Child Protection.
Hope this helps to clarify the limits of confidentiality-most therapists will advise you of this at the onset of therapy so that you are informed of your rights and the HIPAA statement that you receive explains it as well and defines what is PHI (protected health information) which encompasses all mental health records.




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