Confidentiality: What Does it Mean and How Does it Work?

How does confidentiality work?

Confidentiality: What Does it Mean and How Does it Work?

As promised in a previous blog, we are covering the topic of confidentiality. The term confidentiality is used often throughout professional settings. Yet what does confidentiality actually mean when you’re in therapy? Are your secrets actually safe?

The answer is yes...mostly.


Confidentiality means that everything you say to your therapist, stays with your therapist. Legally, they are not allowed to disclose any details of your session to anyone without your permission. What this means is that you can rest easily, knowing that your information is safe with your therapist. You do not have to worry about them gossiping to others about your sessions or about other people finding out what you say.

The Limits

However, there are times when confidentiality has to be broken.

Here are the Main Limits to Confidentiality:

1. You tell your therapist you are going to seriously hurt yourself.

As mandated reporters, it is your therapist’s job to save lives when someone is in danger. If you tell your therapist that you are in imminent risk of hurting, or killing, yourself, it is their job to report that information. This is in order to ensure your safety, which is your therapist’s first priority. As far as your information--they will only share details that are directly related to their concern.

2. You tell your therapist you are going to seriously hurt someone else.

Again, as mandated reporters, therapists must also report if you say you are going to seriously hurt, or kill, someone else. This wouldn’t be a case of you casually saying, “I’m going to kill my brother, he drives me crazy,” but a case of serious intent to inflict harm. Again, therapist have the intent of saving lives. As part of their job, they have to ensure that everyone is kept safe to the best of their abilities.

3. You tell your therapist that someone is hurting you.

This primarily applies for children, as therapists must report any and all concerns regarding the potential of child abuse occurring. If a therapist is ever told by a child, or about a child, that abuse or neglect is occurring, they must report the information immediately.

Other Exceptions

Other exceptions to breaking the limits of confidentiality include cases such as court mandated situations or having to communicate with your healthcare providers, job, or other services. This would be done with your permission and your therapist would only disclose the minimum amount of information necessary for the situation.

Your Consent

You have the discretion of providing consent to your therapist to share information with other parties. As stated before, this could include contact with your healthcare provider, job, and other agencies and services. This is dependent on your needs and can be discussed with your therapist.

In All

When starting therapy, the rules and limits of confidentiality are usually explicitly explained. If you have any questions or concerns at all, just ask and your therapist would be happy to talk with you about it! The goal is for you to feel comfortable talking, while also having a full understanding of your therapist’s role as a mandated reporter. Having the conversation and ensuring a full understanding of confidentiality should help make sure you are both on the same page and that no misunderstandings arise in the future.

Therapy in White Plains