Psychotherapy is most effective when you can be open and honest. If you’ve never sought care from a psychologist before, you may have some questions about privacy.
Will the things I discuss in therapy be kept private?
Psychologists take your privacy very seriously, and confidentiality is a central part of psychology’s code of ethics. Psychologists understand that for people to feel comfortable talking about private and revealing information, they need to see the therapist’s office as a place where they can talk about anything they’d like, without fear of that information leaving the room.
Laws are also in place to protect your privacy. The Health Insurance Portability and Accountability Act (HIPAA), for example, is a federal law that sets national standards for the protection of individuals’ medical records and personal health information, including information about psychotherapy and mental health. Some states have even stricter laws in place to protect your personal health information.
At your first visit, your psychologist should give you written information, explaining your privacy rights and his or her policies regarding how your personal information will be handled. This information will explain that, in some cases, there are exceptions to legal and ethical privacy protections, as described below.
When can a psychologist share my private information without my permission?
In some specific situations, psychologists can share information without your permission. Common exceptions to confidentiality are:
- To protect you or the public from serious harm. For example, if you threaten to attempt suicide or seriously harm another person, the psychologist may alert people who can reasonably prevent the threat, including, for example, law enforcement or the other person.
- To report abuse or neglect of children, the elderly or people with disabilities. Psychologists are typically required under state law to report this type of abuse or neglect. The specific circumstances that trigger the duty to report vary from state to state. Some states, for example, require psychologists to report abuse that an adult patient suffered as a child, while other states do not. If you are an adult who suffered abuse as a child, you should ask your psychologist about reporting requirements so that you can talk about your experience without triggering the mandatory reporting.
- To respond to an order from a court. This might happen if you’re involved in a legal proceeding and your mental health comes into play.
Will insurance companies see my records?
Psychologists may have to share certain information about your diagnosis and treatment with the health insurance company or government program (like Medicare or Medicaid) that is paying for your treatment. Payers will ask for this information to verify that services were provided or to decide whether to continue paying for treatment. These companies and programs, though, are also bound by HIPAA and must keep your information confidential.
In addition, if you pay out-of-pocket, in full, for a particular therapy session, and you request that your psychologist not submit a bill to your insurance company for that session, then your psychologist must not do so.
Will my employer know I saw a psychotherapist if I use my company’s insurance?
Employers don’t receive information about the health services an employee receives, even if he or she uses company insurance.
Some companies offer employee assistance programs (EAPs), which provide mental health services to employees. Usually, the company simply provides the EAP and doesn’t receive information about how each employee uses it. If you have any questions about privacy and your organization’s EAP, talk to a human resources representative for more details.
I’m under 18. Will the psychologist tell my parents what we talk about?
Many states permit young people to seek mental health care without requiring that parents be notified. States that permit this typically require that the minor be above a certain minimum age. (You can check with your state’s board of psychology about the law in your state.) In most cases, though, a parent is involved when a minor receives psychotherapy services.
Psychologists want you to feel comfortable sharing your feelings and are careful to respect your privacy. Often, at the first psychotherapy visit, the psychologist will sit down with you and your parent(s) to discuss ground rules for privacy. That way both you and your parent(s) know exactly what types of information the psychologist might share, and what he or she will keep private. For example, it is common for parents to agree to be informed only if their minor child is engaged in risky activities. Remember, the goal is to keep you safe and healthy.
I’m older than 18, but still use my parents’ insurance. What do I need to know about privacy?
When a person receives services using health insurance, the insurance company sends a statement called an Explanation of Benefits (EOB) that explains which services were used and paid for. If you use your parents’ insurance for psychotherapy services, your parents may receive an EOB that outlines the services you used. However, they will not be able to access your records or find out what you discussed during your sessions with a psychologist.
If you are in college, note that many college counseling centers don’t require insurance. If you go to the counseling center, you should be able to receive mental health services without your parents’ knowledge.
What information can I share about my psychotherapy treatment?
Privacy is your right as a patient. If you choose to tell your friends or family that you’re seeing a psychologist, you are free to do so. How much information you decide to share is up to you. Psychologists are ethically and legally bound to protect your privacy regardless of what information you choose to share with others. For example, psychologists typically won’t connect with patients on social media sites, even if the patient initiated the request.
Can a psychologist talk to others about me?
Sometimes, psychologists find it helpful to discuss your concerns or behaviors with other people in your life. A psychologist may want to interview your spouse to better understand what’s going on in your home, for example. And if a child is having trouble at school, the psychologist may want to interview the child’s teachers. Similarly, your psychologist may ask for your consent to share information, or discuss your care, with your other health care professionals to coordinate your care. But whether you allow others to be involved in your care is completely up to you. Psychologists generally can’t contact anyone else without your permission.
If you have specific concerns about confidentiality or what information a psychologist is legally permitted or required to disclose, discuss it with your psychologist. He or she will be happy to help you understand your rights.
Code of Ethics:
Additional Info:
When Does a Therapist Have to Break Confidentiality?
Mandatory Reporting Laws for the State of Arizona:
https://www.azleg.gov/ars/13/03620.htm
http://www.ncsl.org/research/health/mental-health-professionals-duty-to-warn.aspx
HIPPA
HIPAA: Acronym that stands for the Health Insurance Portability and Accountability Act, a US law designed to provide privacy standards to protect patients’ medical records and other health information provided to health plans, doctors, hospitals and other health care providers.