The Sacredness of Confidentiality in Therapy: Insights From A Seattle Therapist

One of the first things you’ll hear me say in your initial therapy session is “Everything we discuss is confidential. The only exceptions are…..”  On the surface, confidentiality isn’t a very exciting topic. However, I would argue it’s a pretty amazing topic. Hear me out.

Image from Unsplash by Mitch Njup

Let’s first get some clear definitions. (I am NOT a lawyer, this is a brief overview of concepts, not legal definitions).

Confidential: Private Or Restricted Information.

Often confidential information is highly personal and intimate. It’s generally not information you want the whole world to know. There’s a legal concept known as privilege which is different than confidentiality but for purposes of this discussion we aren’t going to get into it.

Most people know that therapy is confidential, but don’t really understand it’s role, its importance, or stop to think about the impact of its presence. It’s one of the first things you learn about as a therapist in training and is top of mind for practicing clinicians everywhere.

The Role Confidentiality Holds in Therapy

In my opinion, the therapy space, whether that’s online or in an office, that space is sacred. I don’t mean that in a religious way but in the way that it is a dedicated space, a space deserving respect and reverence. I believe that because over the last 13 years of practice, I’ve seen incredible transformations happen in that space. A huge tenant of what maintains the sacredness of the therapy space is the role that confidentiality plays in our practice.

There are very few places or people in the world who are ethically and legally obligated to keep not only what you say private, but also basic information about who you are. A few examples include lawyers, doctors, and clergy. But other than that, few professionals or personal contacts have that ethical and legal obligation to keep what you express private. Unfortunately, just like in any profession, there are people who break these rules, but most therapists consider it a huge honor to be able to create a confidential, safe, and non-judgmental space for you to land and grow.

Maintaining Confidentiality: What It Means For Your Therapy

Due to strict ethical and legal requirements, you can come to therapy rest assured that your information is safe. We have strict rules when it comes to discussing or sharing your information. Even if someone called and asked if you were a client, all I could say was “I can neither confirm nor deny that.” A release of information is required for your provider to discuss you and your treatment with anyone. Now, there are a few exceptions, but fortunately they don’t occur too often.

Exceptions to Confidentiality in Therapy

If I suspect abuse or neglect of a child or vulnerable adult, I am a mandated reporter. This means if I reasonably believe there may be abuse or neglect, I have to contact the authorities, being Child Protective Services or Adult Protective Services. This is to ensure safety of vulnerable populations.

I can also break confidentiality when it comes to your safety or if you’re a danger to others. Most of the time this comes up is in relationship to suicidal intents or plans. Bringing up suicidal ideation to me won’t cause me to freak out and call the cops. This can be a big misconception. Suicide is a serious topic that needs serious intervention, however, there’s a wide spectrum between thoughts and actions. A big part of my job is to make sure that you and the people around you are safe.

Upholding your confidentiality and privacy is important to us professionals. Unfortunately, in recent years, more tech companies and big business have gotten into the therapy world with detrimental effects. Between exploiting employees and selling protected health information (your data), the main goal is to make money, not service clients. To read more about that, read the article below.

https://www.zynnyme.com/blog/online-mental-health-tech-companies-what-every-therapist-should-know-before-you-sign-the-contract

Image from Pexels by Design Ecologist

How Confidentiality Builds Trust in Therapy

Everything from engaging in office processes, using client software, technology, sound machines, to using paper records, therapist are consistently working to keep the therapy space confidential. How cool is that? One of the reasons I prefer private pay rather than working with insurance companies is that they get to keep their nose out of your records, unless you consciously decide to provide them with that information. In my mind, upholding confidentiality relates to upholding a consistently safe, reliable place for you to come be you without judgement. This could not happen if the ethical and legal protections weren’t in place. The consistent container must be present for the magic to happen within it.

You are worth creating a safe, reliable, confidential space.

How cool is therapy!?

Do you have more questions about confidentiality or therapy in general? If you’ve been thinking about therapy but don’t know where to start, reach out and schedule a free consultation today! I’d love to speak to you about your journey and goals.

About the Author: Seattle Therapist Chelsea Kramer LMFT

Chelsea Kramer is a Seattle Therapist who works with individual and families facing grief, anxiety and trauma, with special focus on medical challenges, reproductive health, and life transitions.

Learn more about Chelsea’s specialties: grief, anxiety, infertility, pregnancy loss, chronic illness, menopause, medical trauma

Learn more about Chelsea

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