Each independent counseling association has a standard of conduct that specifies expectations regarding confidentiality restrictions. Most associations recommend therapists retain patient anonymity unless they are mandated to disclose or feel strongly motivated to do so based on professional opinion. However, it is not as simple as simply adhering to your organization’s rules. Most states have legislation that either allows or compels mental health providers to share client information in specific circumstances. In addition, the Health Insurance Portability and Accountability Act (HIPAA) provides instructions from the federal government.<\/p>\n\n\n\n

Confidentiality is a contentious issue because clients may withhold information if they fear their therapist will not maintain confidentiality. To maintain patient confidentiality, therapists should get acquainted with local legal requirements and the guidelines of their professional association.<\/p>\n\n\n\n

The American Psychological Association\u2019s (APA) Ethical Principles of Psychologists Code of Conduct says, \u201cPsychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to provide needed professional services; obtain appropriate professional consultations; protect the client\/patient, psychologist, or others from harm; or obtain payment for services from a client\/patient, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose.\u201d<\/p>\n\n\n\n

The National Association of Social Workers (NASW) Code of Ethics says, \u201cSocial workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep the information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed.\u201d<\/p>\n\n\n\n

With a few exceptions, the federal Health Insurance Portability and Accountability Act treats mental health information in the same way as it does other types of health information. Clients may sue those who violate confidentiality in particular situations, and they may face disciplinary action from state licensing bodies as a result.<\/p>\n\n\n\n

HIPAA also allows a therapist to obtain a client’s consent to communicate pertinent information with an insurance provider to be compensated for claims. This normally contains simply the diagnosis and any prescriptions prescribed. It expressly specifies that the therapist should not disclose more than is necessary to ensure coverage. If a client refuses to consent, insurance cannot be utilized to pay.<\/p>\n\n\n\n

Most states have legislation governing confidentiality releases. It is critical that therapists grasp the norms and regulations applicable to their location. The National Conference of State Legislatures advises all states on confidentiality regulations. Only a few states have no obligation to disclose if there is a threat of violence. The majority of states have either a statutory or permissive but non-obligatory responsibility to warn or report. Therapists need to understand the laws they must uphold in their region because of the disparities between states.<\/p>\n\n\n\n

Therapists are held to extremely strict ethical standards by their regulating state board. Violations can result in a loss of licensure, costly fines, and even jail time. However, there are several instances in which mental health providers are legally required to disclose something a patient says or does during a therapy session.<\/p>\n\n\n\n

Here are some examples of when a therapist may be required by law to violate a patient\/client confidentiality agreement and report on what they’ve heard during a session.<\/p>\n\n\n\n