The relationship between a therapist and his clients is considered a privileged relationship. Even so, there are exceptions to confidentiality.  As a client of any therapist, it is your right to know under what circumstances your confidentiality may be compromised.

As noted on the portion of this web site that discusses my rates, if you choose to see a therapist that is billing your insurance company, your therapy records may be a part of a larger medical record. If that is the case all of your therapy notes may be available to any health provider treating you for any purpose. This is true in the government domain, as well. If you are a government employee or if you are working for a government contractor, and you see a mental health professional within that system all of your therapy notes may be available to any other health provider within that system, treating you for any purpose.  This is also true if you are seeing someone within the Veterans Health Administration of the United States (the V.A.) or using the benefits of the V.A. to see a contracted provider.

Additionally, as electronic medical records are becoming the norm, it is reasonable to reduce your expectation of confidentiality within institutions such as insurance companies, HMO’s, PPO’s, and even government agencies, as “Incidental Use and Disclosure”* becomes ever more likely. I do not, and will not, under any circumstances, transmit medical records electronically.

I do not accept payments from insurance companies. With few exceptions the only people that will ever know about our professional relationship is you and I.   I have a number of clients that have elected to place their concern for security, confidentiality and quality treatment ahead of convenience and finances.  If this applies to you, please call me. 

Other circumstances in which your confidentiality may be compromised;

• If a therapist has a good reason to suspect that a client is abusing a child, an elder, or a dependant adult, the therapist is required to report this to the appropriate authorities immediately.
• If a client is threatening serious bodily harm to another person, the therapist is required to notify the police.
• If a client intends to harm him or herself, I will make every effort to work with the individual to ensure their safety. However, if an individual does not cooperate, additional measures may need to be taken.
• What about the courts?  A court may compel a therapist to provide the court with notes on clients and even compel him/her to testify.  This rarely occurs and is usually avoidable.

*The OCR Summary of HIPAA Privacy Rule can be accessed through the HSS.Govwebsite;http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/smallbusiness.html

*(4) Incidental Use and Disclosure.  The Privacy Rule does not require that every risk of an incidental use or disclosure of protected health information be eliminated. A use or disclosure of this information that occurs as a result of, or as “incident to,” an otherwise permitted use or disclosure is permitted as long as the covered entity has adopted reasonable safeguards as required by the Privacy Rule, and the information being shared was limited to the “minimum necessary,” as required by the Privacy Act