It's not really an issue for me, even though my T writes down everything I say, because of confidentiality laws. My T absolutely can not discuss me, other than in very general terms unless I sign a release. The only exceptions to this is if she believes I'm an immediate danger to self or others or if she was ever suppoenned to testify in court in a case involving me (extremely unlikely). Same thing with all medical Dr's. They can't disclose anything without written consent. When my pdoc wanted to talk to my addictions Dr, this past summer, I had to fill out a ton of forms.

The only exception to this is if you're IP or have a team treating you as an outpatient. Then the care providers can talk between themselves and share notes about your care, but they can't disclose to anyone outside the institution.