For your protection, psychologists are bound by law as well as by professional ethical standards to keep your disclosures and even your participation in therapy confidential. Personal ethics also call for discretion and respect in dealing with the private and privileged information you communicate. Information that you share with your therapist will not be disclosed to anyone else, including spouses or other family members that are not present for the therapy, unless you expressly sign a release of information form for this purpose.
Therapists do sometimes wish to discuss your case with other providers for the purpose of making treatment as effective as possible. Therapists may wish to coordinate with your psychiatrist, other medical doctor, or previous therapist, and may ask you to sign a release of information form for this purpose. Your therapist may also wish to discuss your case with other colleagues in order to provide more effective treatment. In this situation, a therapist will share the general information about the case with other mental health professionals without a formal release of information form but will take reasonable precautions to ensure that your identity is not exposed.
There are rare exceptions in which the law does require psychologists to breach confidentiality and to share information from therapy with outside persons or agencies. This, too, is for the ultimate protection of clients or others that may be in harm’s way. Exceptions to confidentiality include:
1. When you tell your therapist or lead him/her to believe that you intend to harm yourself.
2. When you tell your therapist or lead him/her to believe that you intend to harm someone else.
3. When you tell your therapist of a situation in which a child, elderly person, or dependent adult may be being abused or neglected.
4. Rare cases in which your therapist receives a court order to release information contained in your record.
In these relatively unusual cases, therapists can, even without your consent, make an exception to confidentiality. They may be required to warn persons in danger, to release information to governing authorities (generally courts) that lawfully demand compliance, and/or to seek help from appropriate authorities (e.g., police, emergency psychiatric units, child protective services, and adult protective services).