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Privacy, Confidentiality, and Consent

In the sphere of mental health therapy, client confidentiality is paramount. It mandates that mental health professionals such as therapists, psychiatrists, psychologists, among others, uphold the privacy of their clients by not disclosing details of therapy sessions.

 

Confidentiality goes beyond just the content of the therapy sessions, extending to the very fact that a client is receiving therapy. To illustrate, therapists may not acknowledge their clients in public settings to maintain their client's confidentiality.

 

Protecting confidentiality involves:

  • Avoiding revealing information through voicemail or text.

  • Except for situations that require official documentation, such as absence notes for work or school, avoiding confirming to third parties that a client has an appointment.

  • Not discussing the therapy's details with a third party without the explicit permission of the client.

 

Confidentiality is safeguarded by state laws and the Health Insurance Portability and Accountability Act (HIPAA). Breaches of confidentiality can lead to consequences for therapists, such as disciplinary action by state licensing boards and potential lawsuits.

 

Exceptions to Confidentiality

In certain circumstances, mental health professionals are allowed, or even required, to breach confidentiality. For instance, if a client presents a clear and immediate danger to themselves or others, the therapist is obligated to take steps to ensure safety, often resulting in hospitalization. However, it's important to clarify that simply expressing suicidal thoughts doesn't automatically lead to a breach of confidentiality or hospitalization; the client needs to demonstrate intent and a specific plan for this consideration.

 

Mandatory reporting laws may also necessitate a breach of confidentiality if the therapist has reasonable suspicion of abuse towards a child or a disabled person. 

 

In rare instances, therapists may be legally obligated to testify against their clients via a subpoena. However, it's far more challenging to compel testimony from licensed mental health professionals due to the strict laws safeguarding confidentiality.

 

Patient Rights

When participating in psychotherapy, every client has the following rights:

 

  • The right to receive an explanation of services according to the treatment plan.

  • The right to voluntarily participate in and consent to treatment.

  • The right to object to, or terminate, treatment.

  • The right to access one's records.

  • The right to receive clinically appropriate care and treatment that respects their dignity and personal integrity.

  • The right to be treated ethically, free from abuse, discrimination, mistreatment, and exploitation.

  • The right to be treated by culturally sensitive staff.

  • The right to privacy during therapy sessions.

  • The right to voice concerns or complaints directly to the therapist.

  • The right to be informed of the expected results of prescribed therapies, including potential adverse effects.

  • The right to request a change in therapy approach.

  • The right to seek a second opinion from a professional of their choosing.

  • The right to have records protected by confidentiality, not to be disclosed without written authorization.

 

There are some circumstances where confidentiality might, or even must be breached, varying according to federal, state, and local laws:

 

  • Knowledge of child or elder abuse.

  • Knowledge of the client’s intent to harm themselves or others.

  • Receipt of a court order.

  • In case the client initiates litigation against the therapist.

  • If the client is a minor, aspects of their care might be discussed with their parents or legal guardians.

 

Office Policies

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