Is what I say confidential?

Confidentiality is at the core of therapy and is vital to developing a good therapeutic relationship between the client and therapist. Nevertheless, there are limits to confidentiality in therapy that the therapist is aware of and in turn should communicate clearly to the client. These limits aim to protect the client, the therapist and others. 

Some common limits of confidentiality are outlined below. 

Duty to report: Therapists are required by law to report specific behaviours or occurrences to the appropriate authorities, such as harm to oneself or others and suspected abuse or neglect of vulnerable individuals.  The therapist may also have to consult the client’s GP or another service involved in their care in the interest of the client’s safety and wellbeing and in planning an effective care plan. In such cases the client’s consent is obtained unless it is an emergency and the client may be at immediate risk. 

Insurance: Insurance companies may require therapists to provide information about treatment, such as outcome measures, rationale for treatment or treatment plan, in order to authorize payment for services and or to audit effectiveness of treatment. 

Consultation: Therapists may consult other mental health professionals for advice or support. This may be in the context of supervision in which only essential information for feedback is provided and no identifying information is shared

Court order: Therapists may be required to produce a report for court related to work with a client or may be required to appear in court and present notes on the work with their client.

Client disclosure: Clients may wish to talk about their therapy with others such as friends and family members, although this is not an essential part of therapy and all decisions around this are left up to the patient to decide.