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When Does a Therapist Have to Break Confidentiality
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When Does a Therapist Have to Break Confidentiality
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When Does a Therapist Have to BreakConfidentiality
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Few things are more private than the therapist-client relationship, or any mental health counselor and
their patient. But when do you, as the confidant, need to break your silence? Counselors breaking
confidentiality comes down to the client’s personal safety and the safety of others. In this piece, we
will discuss:
Why patient confidentiality is important
How to maintain confidentiality
When to break client confidentiality
, Exceptions to confidentiality rules
How to permissibly break confidentiality for adults and children
Whether breaking confidentiality is grounds for malpractice
What Is Therapist-Client Confidentiality?
Client confidentiality is the legal and ethical requirement that mental health professionals protect their
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client’s privacy. Clearly, the act of spilling details from therapy sessions to friends is a confidentiality
violation. But less obvious examples can violate the ethics code too, such as leaving voicemails on a
public account, which could reveal that a person is in therapy — a violation unless the client provides
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written consent.
One of the most vital aspects of any successful mental health therapy relationship is creating a
connection around trust with a client. For this connection to happen, clients need to feel their
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thoughts, secrets, and traumas are safe in your hands. Setting confidentiality ground rules from the
start is crucial for building this trusting relationship (this includes signing confidentiality statements
and asking the client’s permission for certain disclosures — such as confirming an appointment over
voicemail).
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Other reasons, too, explain why therapist confidentiality is important. For example:
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Clients who trust that confidentiality is part of the therapy space more willingly seek care.
Clients are more likely to be honest when they trust that what they say is confidential (from
insurers and outsiders).
Clients will see that honest sharing positively impacts their mental health.
And then there’s HIPAA, which is a federal law that protects the client’s information, with an exception
that requires the therapist to intervene when necessary to protect the safety of the client or others.
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