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Confidentiality in Psychotherapy

The Building Block of Healing

Psychotherapy is a marvelous tool for healing. This is especially true when you are facing a major mental health disorder. But how can one be sure that the stranger they are spilling your guts to will not tell the world what you have said?

In this article, we shall explore confidentiality and the laws that govern it.

What is Confidentiality in the Therapeutic Relationship?

Confidentiality is the cornerstone of psychotherapy and one of the most important terms of which clients sometimes have little understanding. It is important for clients to know their rights and how confidentiality works to protect them.

Confidentiality reassures one that their therapist will honor their privacy.

It is only with confidentiality that a client can feel free to tell their Therapist the secrets that bind them from being able to move on with their lives. Without this privacy, healing would not be possible.

The APA and Confidentiality

When it comes to confidentiality in psychotherapy, therapists are required to follow a code of conduct. This code of conduct is laid out for therapists and any mental health professional by the American Psychological Association.

Basically, the code states that the confidentiality of anything said in therapy shall remain between the client and the therapist. So strict is this code of conduct that it even controls what therapist does in public. If the client and therapist see one another in public, the therapist is prohibited from acknowledging or greeting unless the client does it first.    


An important rule many clients do not understand is the Health Insurance Portability and Accountability Act of 1996 (HIPPA). This rule protects most “individually identifiable health information” held or transmitted by a covered provider or their business associates.

This information may be in any form, electronic, paper, or oral. This act was passed into law in the United States by congress to protect the privacy of health information. With this important law, a client’s information, whether it be something written down, posted to a website or verbal, cannot be given, or transmitted without express permission of the client.

Even in the case of an insurance companies billing for services, only information that is necessary, such as a diagnosis code, may be shared. In other words, anything said or done in the confidence of a Therapists presence is protected by law. This gives the client a lot of assurance and opens the door for meaningful and healing dialogue.

Jaffee Versus Redmond

In 1991, a police officer was forced to kill a person who was chasing another man with a butcher knife in hand. She ordered him to drop the knife, but he would not. Finally, when it appeared to the officer that the man with the knife was going to stab his victim, she shot him dead.

Later, witnesses stated that the man with the knife had been unarmed and his family decided to sue. Officer Redmond asked for the perpetrator’s notes from his therapist to prove in court she was innocent. The therapist refused the request and a court battle for the notes began. Finally, the matter came before the Supreme Court.

In 1996, the Supreme Court of the United States ruled the following:

“Effective psychotherapy, by contrast, depends upon an atmosphere of confidence and trust in which the patient is willing to make a frank and complete disclosure of facts, emotions, memories, and fears.

Because of the sensitive nature of the problems for which individuals consult psychotherapists, disclosure of confidential communications made during counseling sessions may cause embarrassment or disgrace. For this reason, the mere possibility of disclosure may impede development of the confidential relationship necessary for successful treatment.”

Thus, began the laws and protections that govern confidentiality.

Myths About Confidentiality

There are myths about confidentiality that are perpetuated by television programs and movies that simply are not true. One of the most prevalent is that everyone who offers psychotherapy services are bound by rules protecting confidentiality.

This is incorrect.

Some service providers, such as life coaches, are not regulated enough and are therefore not bound by the rules that have been set up to protect client’s privacy.

Another myth is that a licensed professional can never tell anyone information shared during a therapeutic session.

This also is incorrect.

Under certain circumstances, a Therapist may indeed share information they have learned in their office from a client, but only if the life of that client or someone else is endangered. They may also have to share information as a mandated reporter if a child, the elderly, or a disabled person is suspected of being abused.

If subpoenaed by a court of law, therapists may have to testify about what they have learned during sessions with a client, but it takes unusual circumstances for them to have do so.

In Closing

As can be seen, client’s rights are strictly regulated. If a person believes their rights have been violated, they have the privilege and the right to report such abuses to the licensing service of their Therapist.

They may also have grounds for a lawsuit.

Confidentiality leaves clients and therapists capable of open and honest discussions so that the client can successfully heal.

“In almost every profession – whether it’s law or journalism, finance or medicine or academia or running a small business – people rely on confidential communications to do their jobs. We count on the space of trust that confidentiality provides. When someone breaches that trust, we are all worse off for it.” ~ Hillary Clinton

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