Privacy Policy

Confidentiality

Confidentiality is one of the most important elements of the sanctity of the relationship between psychotherapist and client. Successful therapy requires a high degree of trust with highly sensitive subject matter that, for many clients, is often not something they discuss anywhere but the therapist's office.

California law protects the relationship between a client and a psychotherapist, and information revealed by a client cannot be disclosed without written permission. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent." Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (physician, psychiatrist), your attorney, or other person in your life, but by law your therapist cannot release this information without obtaining your written permission.

However, state law and professional ethics require therapists to supersede confidentiality in the following situations, in the name of protecting life and the physical safety of the client or threatened others. These two kinds of described circumstances are the only exceptions to absolute confidentiality. It is very important that all clients understand these exceptions prior to beginning therapy, and at the outset of the first session, you will be asked to sign a statement verifying that you are aware of these exceptions:

1. if the therapist has reason to suspect past or present abuse or neglect of children (under 18), dependent adults, or elders (over 65), which means abuse by the client or by another caregiver as reported by the client.

It is not a therapist's obligation to investigate such suspicions but rather to report immediately to the appropriate authorities, including Child Protection/DCFS and law enforcement, based on information provided by the client or collateral sources. Preferably the client will be involved in making the report with the therapist so as to understand the process. Those authorities then make a preliminary investigation to determine whether there is an actionable concern. Note that therapists, by law, do not report suspected abuse such as domestic violence if it involves only independent (non-handicapped) adults between the ages of 18 to 65. Such domestic violence reports are under the mandate of medical personnel such as ER doctors attending to injured parties.

2. if the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threatened to harm another person. In such cases, the therapist's role is first to clarify the client's intent and degree of seriousness and second to take actions to minimize risk of harm to human life.

When the client her/himself is in danger (i.e., suicidality), the therapist will make every effort to enlist the client's cooperation in ensuring their safety, including consideration of such measures as voluntary hospitalization. But if, for example, a suicidal client is in imminent danger and refuses voluntary care, the therapist will initiate involuntary hospitalization. In this case, confidentiality may have to be broken in order to inform someone in the client's life of the need for emergency action, in the interest of protecting life and safety.

When the client threatens physical harm to another known person (e.g., homicide), the therapist is required by law to alert authorities (the police) as well as the intended victim. The goal is to maximize the safety of all concerned. In this case, if intent to harm affirms a threat of imminent danger, the client's confidentiality must be violated, again in the interest of protecting life and safety.

Thus, if a client is not threatening imminent future physical harm to him/herself or someone else and is not suspected of past or present abuse of children, elders, or dependent adults, then confidentiality in the therapy room will be completely maintained, and nothing the client says will be divulged to anyone unless s/he gives written authorization to the therapist to release information to a specific other named person for a limited time and scope that the client determines.

Couples and Family Therapy Considerations

Generally speaking, all couples and family therapy sessions (meaning two or more clients in the room) are conducted with the understanding that information will be shared among clients without reservation, and clients themselves will commit to honoring the confidentiality of what their fellow clients reveal in session. With rare exception, therapists will not be obliged to keep secret information revealed by one client from a fellow client. The most important aspect of such situations, which may arise in therapy, is that the therapist will endeavor to assist clients to learn whether, when, and how to share difficult information with others in their lives, especially their fellow clients, and a key role of the therapist will be to facilitate such communication in session.