When Is A Therapist Allowed to Break Confidentiality?

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 board and mental health professional organizations.

 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
6 Comments  comments 

6 Responses

  1. My therapist who said she believed I was in danger of taking my own life called my emergency contact (my son) Being unable to get him on his cell she called his girlfriend who told my therapist they had broken up. My therapist then asked if she could get a message to my son. She then revealed to this person that she thought I was suicidal, that I had a planned I had rehearsed as well as other things I had discussed with her the week before. I think she violated Florida law and ethical codes to have revealed so mush to a vendictive x girlfriend who used the information to harm me and my family. What can I do?

    • Marina

      Hi Darlene,

      I am sorry I was unable to respond sooner. I was on vacation.

      I can’t say definitively whether your therapist broke the law or not firstly because I don’t know all the details of what went on in session, what specifically you told her that made her believe that you were in imminent danger of hurting yourself. Plus, I don’t know Florida’s legal requirements for breaching confidentiality as I reside in California. You need to call Florida’s licensing board to find out in what cases therapist is mandated or allowed to breach confidentiality. Therapists are trained to assess if the client is in imminent danger of committing suicide. There is no way for me to know if your therapist used those assessment tools or not. Call your state’s licensing board and tell them what happened. They are the best source for you to find out if your therapist broke any legal or ethical standards. Hope this helps.

  2. Marvin Thiem

    During a process group (more than one client present) a client discloses he committed a previous murder. Do I report to the police, remind the group of the conventionality of the group or discuss with the clinical supervisor?

    • Marina Tonkonogy

      I apologize for the delay in responding.

      This is the question you should bring to your clinical supervisor and possibly a lawyer from your professional organization or your licensing board. I do not give professional or legal advice on this website (see the disclaimer page).

  3. Hi my therapist said my mom shouldn’t give me info on her romantic
    Life I’m a very mature teenager and she then said she had to tell my mom now this wasn’t or isn’t bothering me about me and my moms relationship so did she break confidentiality and is it a councillors job to fix your life,I thought it’s just talking

    • Marina Tonkonogy

      Hi Belle,

      First off, I cannot comment on your particular case because I don’t know the specifics of it, as well as the specifics of your therapy process and what your therapist’s intentions are. Therapy with children and teenagers is much more complex than therapy with adults because of all the family issues involved, and so professional laws and ethics in those cases don’t work as straightforwardly as they do in other cases.

      Also, I can talk only about how professional laws and ethics work in my state. Every jurisdiction in the US has their own laws in regards to regulating mental health services, so if you want to be sure as to what your rights are as a client, the best thing to do is to contact your state’s licensing board about that.

      Now, in my state, minors, just like adult clients are entitled to confidentiality, which means that the therapist can’t just talk to the parents or anyone else about them without their permission. If the therapist believes that it is best to inform the parents about some issues, they should discuss it with their teenage client and obtain their consent first. It is a bad idea for a therapist to talk to the parents without making sure that the teenager is okay with that, because it destroys trust and makes therapy progress hard to achieve.

      However, there might be cases, when the therapist believes that their teenage client is acting self-destructively and has become a danger to themselves and/or to others. In such cases therapists are allowed to breach confidentiality and to talk to the parents’ without the minor’s permission. They are also allowed to do that if they believe that not doing so would be detrimental for the client’s well-being.

      Once again, the above information describes how psychotherapy with minors is generally conducted in my jurisdiction. If you want to know your rights as a therapy patient you need to contact your state’s licensing board or a psychotherapy malpractice attorney.

      You may want to tell your therapist that you are not okay with her talking to your mom and to explain why. If she is not receptive to what you are saying, then talk to your parents about changing therapists. I hope they won’t insist that you keep seeing the therapist you don’t trust.

Leave a Reply

Your email address will not be published. Required fields are marked *