Guides
Is therapy confidential?
What you say in session stays between us. Here’s what that means in practice, and the few exceptions the law requires.
The practical side
Being able to speak freely is the foundation of therapy, so it makes sense to want to know exactly where the edges of privacy are before you start. Confidentiality can feel like a vague promise until someone spells it out. Here’s how it works in my practice, in plain language.
What confidentiality means here
What you say in session stays between us. I don’t share information about you—including whether you’re a client at all—without your written permission. That holds whoever is asking, whether it’s a family member, a partner or an employer.
If there’s ever someone you’d like me to speak with, such as another professional involved in your care, we’d talk it through first, and I’d only do it with your written consent.
The exceptions the law requires
There are a few situations where I’m required to act, and I’d rather you hear about them now than be surprised later. I must act if there is:
- A serious risk of harm to you or to someone else
- Suspected abuse or neglect of a child, an older adult, or a dependent adult
- A court order requiring disclosure
If one of those situations comes up
Where I can, I’ll tell you first and involve you in what happens next—I’d much rather we face something like that together than have you find out after the fact. And if you’re ever unsure whether something you want to share falls into one of these categories, you can ask me how it would be handled before you say it.
Records
I keep brief clinical records, stored securely, as the law and professional standards require. You’re entitled to request a copy—and if you do, we can go through it together so it makes sense to you, rather than reading like a stack of paperwork.
Email, messages and the contact form
Email and my website’s contact form are for scheduling and practical matters only. Neither is a secure or confidential channel, so please keep clinical details out of them and bring those to session instead. A short note like “Can we move Thursday?” is perfect.
This website and my inbox are not for emergencies. Call or text 988 for the Suicide and Crisis Lifeline, available twenty four hours a day. Call 911, or go to your nearest emergency department, if you or someone else is in immediate danger.
Insurance and your privacy
Because I’m out of network, nothing goes to an insurer unless you choose to submit a superbill. If you do, it includes a mental health diagnosis, which then becomes part of your insurance record. You may decide that trade-off is worth it, or you may prefer to pay privately and keep your therapy entirely between us. My guide to out-of-network benefits and my rates page explain more.
On your side of the screen, privacy matters too. A closed door or a pair of headphones can make it much easier to speak freely.
If you have questions about privacy before starting, ask me on a free 15-minute consultation. My practice policies cover all of this in more detail, and we go over them together before your first session.
A few common questions
Will my family or employer find out I’m in therapy?
Not from me. I don’t share anything about you, including whether you’re a client, without your written permission. If you submit a superbill, your insurer will have a record of it, which is one reason some people choose to pay privately.
Is video therapy confidential?
Yes. Sessions happen by secure video, and the same confidentiality applies. The main difference is that privacy on your end depends on where you are, so it’s worth finding a spot where you can’t be overheard.
What if I want to talk about something I’m ashamed of?
That’s exactly what therapy is for, and it stays confidential. The only exceptions are the specific situations listed above. If you’re unsure, you can always ask me how something would be handled before you share it.