All communications made by you in the context of a therapeutic session are held in the strictest of confidence. Members of groups will be informed that they must be in agreement to participate. In order for information to be released to outside parties, you must sign a release of information. However, there are exceptions to confidentiality.
Exceptions to Confidentiality:
1. Danger to Self or others
When information is communicated to a therapist that an individual intends to harm him/herself or intends to harm another person(s), California law mandates that action must be taken to prevent harm. In the case of harm to self, such actions may include notifying family, the police, and/or psychiatric emergency teams from the country or psychiatric hospitals. In the case of harm to others, an attempt must be made to notify the intended victim and the police.
2. Child Abuse/Elder Abuse/Abuse of Handicapped
California law mandates that when a therapist (or other mandated reporter) receives information which creates a reasonable suspicion of:
a) Child abuse or neglect (under 18 years of age)
b) Elder abuse (over 65 years of age)
c) Abuse of physically or mentally handicapped adults
Information about the suspected abuse must be turned over to the appropriate governmental agency (i.e. child protective services, adult protective services).
Examples of child abuse can include, but are not limited to: slapping the child in the face, hitting in such a manner as to leave a mark on the child's body, punishment which results in physical injury or which psychologically traumatizes the child. Abuse also includes reasonable suspicion of sexual molestation. Neglect includes acts or absence of acts which could be reasonably construed as dangerous to the child's safety and well being.
Please note: State law requires that the therapist report such abusive situations even when the abuse was in the past, if there is reasonable suspicion that the child, elder, or handicapped individual is still in the
situation where the abuse occurred, or if the abuser has direct access to their children, elders, or handicapped individuals. For example: If an adult states that he/she was abused as a child by a parent, and if that parent still has charge over the children, the situation must be reported.
3. Escaping Prosecution. When a client attempts to use therapy as a means of escaping prosecution for the commission of a crime.
4. Insanity Plea. When a client make an "insanity plea" as a defense in criminal proceedings.
5. Court Order. When a court orders a psychological evaluation as part of a legal proceeding, or your medical record is subpoenaed by the court, all information provided is accessible to the court.
6. Minors. While it is useful for minors to have confidentiality during therapy, except in cases specified by law, the parents have a right to information provided by the minor in the course of therapy.
Other circumstances when confidentiality may be broken:
1. Client's choice. If the client chooses to have a therapist release information to another individual(s) (i.e. medical doctor, new therapist, family member, clergy, etc.) he/she may do so by signing consent form which lists the person(s) or agency to receive the information, the type of information which will be released, and the duration for which the consent is valid.
2. Insurance. Confidentiality may be broken in order to provide the necessary information for processing insurance claims for reimbursement of clinical services. The client must consent to this release of information. The client's refusal to allow the release of such information to an insurance carrier places the client at full financial responsibility for the consequences which may result.
This information is provided so that the client of psychotherapy can understand the legal and voluntary limits of confidentiality. It is not intended to discourage someone from disclosing a problem where a problem exists. If a problem, such as outlined above exists, it is best to acknowledge it and seek help from the appropriate agency.