Does What We Talk About In Therapy Remain Confidential?

What Is Therapy Like?

Does What We Talk About In Therapy Remain Confidential?

Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called "Informed Consent". Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your physician, naturopath, attorney, etc). By law, your therapist cannot release this information without obtaining your written permission.

In general, the confidentiality of all communications between a patient and a psychologist or psychiatrist is protected by law, and we can only release information about you to others with your written permission. However, there are some exceptions to confidentiality. There are some situations in which providers are expected or legally required by California law to disclose patient information immediately, without patient consent, to relevant state or local agencies. We are legally required to take action to protect others from harm, even though that requires revealing some information about a patient’s treatment. For example,

  • If we believe that a child, an elderly person, or a disabled person is being abused, we must file a report with the appropriate state agency.
  • If we believe that a patient is threatening serious bodily harm to another, we are required to take protective actions, which may include notifying the potential victim, notifying the police, or seeking appropriate hospitalization.
  • If a patient threatens to harm him/herself, we may be required to seek hospitalization for the patient or to contact family members who can help provide protection.
These situations have rarely arisen in our practice. Should a situation occur, we will make every effort to fully discuss it with you first before taking any action.

Confidentiality, Insurance and Third Party Payors

In order to help you obtain reimbursement or authorization for services from insurance companies or similar agencies, we may be required to disclose certain personal and clinical information such as patient name, diagnosis, and dates and type of appointments to the insurance company. Some insurance companies also require more specific clinical reports such as symptoms and level of functioning. If you have questions about how your insurance company handles and stores this sensitive type of information, you should contact your insurance company directly.

Confidentiality and Consultation with other Professionals

We may occasionally find it helpful to consult about a case with other professionals. In these consultations, we make every effort to avoid revealing the identity of the patient. The consultant is, of course, also legally bound to keep information confidential. Unless you object, we will not tell you about these consultations unless we feel it is important to our work together.

Confidentiality and Legal Proceedings

In many judicial proceedings, you have the right to prevent us from providing information about your treatment. However, in some circumstances such as child custody proceedings or proceedings in which your emotional condition is an important element, a judge may require my testimony or treatment records if he or she determines that resolution of the issues before him or her demands it. Should a situation occur, we will make every effort to fully discuss it with you first before taking any action.

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What is therapy like?

Because each person has different issues and goals for therapy, therapy will be different depending on the individual. In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session. Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development. Either way, it is most common to schedule regular sessions with your therapist (usually weekly).
It is important to understand that you will get more results from therapy if you actively participate in the process. The ultimate purpose of therapy is to help you bring what you learn in session back into your life. Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.

What about medication vs. psychotherapy?

It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action.

How can therapy help me?

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that psychologists can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

  • Attaining a better understanding of yourself, your goals and values
  • Developing skills for improving your relationships
  • Finding resolution to the issues or concerns that led you to seek therapy
  • Learning new ways to cope with stress and anxiety
  • Managing anger, grief, depression, and other emotional pressures
  • Improving communications and listening skills
  • Changing old behavior patterns and developing new ones
  • Discovering new ways to solve problems in your family or marriage
  • Improving your self-esteem and boosting self-confidence

Do I really need therapy? I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to psychotherapy. Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well. Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks. Therapy can help provide some much needed encouragement and help with skills to get them through these periods. Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life. In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives.

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