In addition to the situations I discussed in the post Does everything I share with my therapist stay confidential?, there are cases when a therapist is allowed, but not required to disclose some information about a client to a third party. The most common situation when a therapist may do so is when a client presents a danger to themselves.
California law regarding suicidal clients/patients is rather vague. It states that a therapist has no legal duty to prevent suicide, however, they may “incur legal liability” if they “fall below the standards of care for the profession,” which means that they might be held liable if they fail to take “appropriate preventive measures” to avert harm to suicidal clients. Breaking confidentiality may be one of those “appropriate preventive measures”.
The way I read this law is that it is my professional obligation, as a therapist, to do what I can to prevent a client from harming themselves, and if I believe that breaking confidentiality might prevent suicide, then I would break it to fulfill my moral and professional obligation.
Therapists are also allowed, but not required to break confidentiality if they believe that a client could cause unintended harm to unknown victims. For example, the client came to a session intoxicated, and the therapist believes they are too much under the influence to drive safely. The therapist then should offer to arrange a transportation for the client. If the client refuses to be assisted with transportation and leaves the office, the therapist is legally allowed (but not required) to disclose the fact that the client is under the influence to police in order to prevent possible harm to the client and to unknown victims.
As I mentioned in my other post on confidentiality, keep in mind that therapists are not necessarily legally required to inform you about the limits of confidentiality (check the law in your state). They are encouraged to explain it in their Informed Consent Form and many of them do explain it in more or less detail.
The above rules and procedures are used in California. If you want to know what the law says in regards to confidentiality in psychotherapy in your state, contact your state’s licensing boards and mental health professional organizations.