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Confidentiality

“37% of Americans would be reluctant to seek treatment because of confidentiality concerns.”

         -Opinion Research Corporation, 2004

All information disclosed within your sessions and the written records pertaining to those sessions are confidential and may not be revealed to anyone without the client’s written permission, but there are some exceptions where disclosure may occur or is even required to occur by law without your consent (Florida Statute  490.0147  Confidentiality and Privileged Communications).

For a complete listing of the issues surrounding confidentiality and the Health Insurance Portability and Accountability Act in Florida, please download and read this leaflet (HIPAA  Leaflet- Florida Notice Form).

Here are the instances when your mental health practitioner may disclose your private information to others without your consent.

When Disclosure Is Required By Law: Some of the circumstances where disclosure is required by the law are: where there is a reasonable cause to suspect abuse or neglect to a child or vulnerable adult; and where the client presents as a danger to self and/or others. 

Basically, this means that if you tell your therapist that you are going to hurt yourself or someone else or that you are hurting or have hurt a protected individual (i.e., child, vulnerable adult, such as a disabled person or elderly individual) then your provider is mandated by law to take action that will include informing others. 

In the event of abuse or neglect of a protected individual, the therapist is mandated by law to report your actions to The Florida Department of Children and Families (DCF) (See also Mandated Reporters).

In the event that you made it known that you intended to harm yourself or someone else, your therapist may need to take action to inform others to insure your safety and the safety of others.  This might include initiating an involuntary hospitalization (“Baker Act“) or enacting a duty to warn.

When Disclosure May Be Required: Disclosure may be required pursuant to a legal proceeding.  If you place your mental status at issue in litigation initiated by you, the defendant may have the right to obtain the psychotherapy records and/or testimony from your provider. In couple/family therapy, or when different family members are seen individually, confidentiality may not apply. Your provider should use his or her clinical judgment to support the disclosure of such information.  Your provider should not release records to any outside party unless he or she is authorized to do so by all adult family members who were part of the treatment.

Emergencies:  If there is an emergency where your mental health practitioner becomes concerned about your personal safety, he or she will do whatever can be done within the limits of the law, to prevent you from injuring yourself and to ensure that you receive proper medical and mental health care. For this purpose, your practitioner may contact the emergency person whose name you have provided at the beginning of your treatment.

Health Insurance & Confidentiality of Records: Disclosure of confidential information may be required by your health insurance carrier/HMO/EAP in order to process the claims.  Only the minimum necessary information will be communicated to the carrier. You must be aware that submitting an invoice for reimbursement can entail some risk to confidentiality, privacy, or future eligibility to obtain health or life insurance.  Mental health information is entered into insurance companies’ computers and soon will be reported to the congress-approved National Medical Data Bank. Computers are vulnerable to break-ins and unauthorized access; therefore, you could be in a vulnerable position. 

Confidentiality of E-mail, Cell Phone and Faxes Communication: It is very important to be aware that e-mail and cell phone communication can be accessed by unauthorized people; hence, the privacy and confidentiality of such communication can be compromised.  E-mails, in particular, are vulnerable to unauthorized access.  Faxes can easily be sent erroneously to the wrong address.  If you communicate with your provider using one of these means, you should be aware of this.

Consultation: providers typically consult regularly with other professionals regarding their clients; however, names or other identifying information should never be mentioned.  If your provider is consulting with other professional regarding your care, your provider should make every effort to keep your identity completely anonymous so that confidentiality is fully maintained.

For more information about the role of HIPAA in the provision of psychological services, the reader is invited to download this HIPAA booklet.