Psychologists, psychiatrists, social workers and other counseling professionals are bound by rules that mandate confidentiality. The promise of confidentiality is part of what gives a patient the confidence to honestly discuss their circumstances in a professional setting.
However, there are occasionally circumstances that may justify or even necessitate a breach of that confidentiality. When would it not be a license-threatening violation for a therapist, counselor or other mental health professional to inform others of what a patient has said during a session?
Credible threats are the primary exception to the rule
Sometimes, those experiencing mental health disturbances may become a threat to themselves or others. Scenarios involving someone talking about harming another person or themselves may warrant a therapist taking action to notify authorities, reach out to intended targets or warn family members of someone’s intention to harm themselves. In extreme cases, such threats may even warrant an involuntary hold at a psychiatric facility for evaluation purposes.
Unfortunately, the steps that a mental health professional takes out of a sense of obligation to their clients could end up harming their professional future. If circumstances do not meet the relatively high standard for breaching the confidentiality rule, then the professional could be at risk of legal action initiated by the patient and also the loss of their license.
For example, if a patient with a history of intrusive thoughts talked about a sudden idea they had to commit an act of violence, that likely wouldn’t constitute a credible reason for concern unless they indicated that they had continued perseverating on the idea and had started to develop a workable plan to carry it out.
People may also discuss thoughts of self-harm or suicide without having true suicidal ideation, and it can be a challenge for mental health professionals to know when they must speak up and when they should respect their patient’s confidentiality. Seeking legal guidance to learn more about the exceptions to confidentiality rules can help people feel more confident about acting to protect a patient or other people when mental health challenges may warrant the choice to speak up.