[sarah5147]

Can someone explain how confidentiality works in therapy. When can they break it and tell someone something? Can they send me to a hospital without my consent? If so when? Does it vary by state or something? I thought if it was only if you are going to kill yourself or hurt someone else, not true?

All the sudden confused and frightened. Can anyone help shed some light? R tell me where to find out?

[growlycat]

From what I understand, confidentiality ends if you are going to hurt yourself, a child or vulnerable adult. Feeling like hurting yourself vs actively planning on hurting yourself although two separate things can be misinterpreted by therapists.
Therapists generally don't like committing people against their will.

[atisketatasket]

What growly said. Also, I think a therapist does not have the power to hospitalize you (a psychiatrist might), though they can call the police on you, which could lead to hospitalization.

[sarah5147]

Originally Posted by growlycat

From what I understand, confidentiality ends if you are going to hurt yourself, a child or vulnerable adult. Feeling like hurting yourself vs actively planning on hurting yourself although two separate things can be misinterpreted by therapists.
Therapists generally don't like committing people against their will.

Thanks! Is there any better definition of "hurting yourself", i,e. if your not trying to kill yourself but are cutting for instance. That is hurting, but your not in danger really. Is that a reason?

[growlycat]

Some therapists understand that cutting does not usually mean an attempt at suicide but a way of managing emotional pain. I've read on PC about less experienced T's freaking out and hospitalizing over SI. An experienced T won't be so reactive. You can always ask your T hypothetical questions.

[MobiusPsyche]

One way to get this question answered is to ask your therapist.

ETA: I'm not trying to be unhelpful; it's just that they would know the laws in their state and they would know how they view this like self-injury.

[sarah5147]

Thanks to everyone so far. I have asked my therapist and she is vague in her answer. Several years ago she did freak out over something I said and called my emergency contact to try to get them to commit me. Needless to say it didn't happen. It took me a while to trust her again but I know she wants to keep me safe. Now I said a few things about cutting and she got those panicked eyes. I keep assuring her it isn't enough to die, it's just how I'm expressing my emotions right now, but I'm afraid to talk anymore about it since I know she tends to blow things up. I like her as a person/therapist but I get the feeling after these years she still doesn't know what to do with me. My pdoc doesnt seem too worried but Nothing seems to rile him up, but I just never know and don't want them to contact anyone or be shoved in the hospital. Frustrated wth trying to figure this out. Is it a sign that I don't trust them? Ugh.

[Ididitmyway]

You may find what you are looking for in these couple of posts on my blog

Therapy Consumer Guide | Does Everything I Share With My Therapist Stay Confidential?

Therapy Consumer Guide | When Is A Therapist Allowed to Break Confidentiality?

What's described there pertains to CA but, I believe, in other states, the laws are similar. If you want to know about confidentiality laws in your state specifically you need to contact your state licensing board your therapist is registered with.

[sarah5147]

Originally Posted by Ididitmyway

You may find what you are looking for in these couple of posts on my blog

Therapy Consumer Guide | Does Everything I Share With My Therapist Stay Confidential?

Therapy Consumer Guide | When Is A Therapist Allowed to Break Confidentiality?

What's described there pertains to CA but, I believe, in other states, the laws are similar. If you want to know about confidentiality laws in your state specifically you need to contact your state licensing board your therapist is registered with.

That was actually a helpful post and website. Thanks!

Hi, I am familiar with these official regulations but in my experience with therapy so far, I don't see how they could possibly be applied to me. I'll explain. I've only seen therapists in private practice so far. None of them had ever made me read or sign any consent forms or confidentiality statements. They never asked for my home address or emergency contact. So I doubt they could go forward with any of those actions, simply because they don't know where to find me other than phone numbers, email addresses, and the name of my employer. Are these therapists doing something wrong?

When it comes to confidentiality, expect that reports be shared amongst your entire health-care team. I am aware my two psychiatrists and family doctor correspond between one another after my appointments. This makes sense to me as my physical and mental health no doubt affect one another - especially if both are prescribing medications.

[stopdog]

In my jurisdiction a non md cannot admit you to a facility - they can call 911 and report you to get the police to pick you up or swear out an affidavit to get you picked up and held. There is a certain amount of time where the facility can involuntarily hold a person and they must file paperwork with the court as soon as an involuntary hold is there. The facility mds do not usually bother getting records from a therapist nor do they bother talking to the therapist unless there is already some prior communications between them (usually there is not). I always ask an md if they have gotten outside records about my client and 99% of the time, they have not - even where the client has requested they do so. I have called therapists to testify on behalf of my client in some instances.

[Ididitmyway]

Originally Posted by Xynesthesia

Hi, I am familiar with these official regulations but in my experience with therapy so far, I don't see how they could possibly be applied to me. I'll explain. I've only seen therapists in private practice so far. None of them had ever made me read or sign any consent forms or confidentiality statements. They never asked for my home address or emergency contact. So I doubt they could go forward with any of those actions, simply because they don't know where to find me other than phone numbers, email addresses, and the name of my employer. Are these therapists doing something wrong?

They actually can (and must legally) proceed with actions as long as they know your name and phone number. When they have to report something they'd just give whatever information they have and then the police or other agency like CPS or APS will find whatever other information they need.

But to answer your question if they are doing something wrong by not having you sign forms about their policies including confidentiality and by not getting your home address and emergency contacts, it's not wrong in the sense that it's not illegal but it's a very unwise practice. If anyone ever files a complaint or lawsuit, they wouldn't be able to build a strong defense if they can't show that the client signed that he or she understood their policies. The major reason why we sign papers in our society is for legal defense.

[Lola5]

Is a therapist allowed to share information about you with a psychiatrist she knows (but you don't)? I had this happen to me. She told me she talked to her psychiatrist friend about what we discussed in therapy. Is there any law that allows her to get a "consult" like that?

[kecanoe]

Originally Posted by Lola5

Is a therapist allowed to share information about you with a psychiatrist she knows (but you don't)? I had this happen to me. She told me she talked to her psychiatrist friend about what we discussed in therapy. Is there any law that allows her to get a "consult" like that?

Yes, a client's issues can be discussed as long as your identity is protected. T could say "I have a client who..." as long as the hearer can't figure out who you are from the description. For example, in our area a child was run over by a school bus and killed. T could not say "my client whose child was run over..." but could say "A client whose child was accidentally killed..."

[Ididitmyway]

Originally Posted by Lola5

Is a therapist allowed to share information about you with a psychiatrist she knows (but you don't)? I had this happen to me. She told me she talked to her psychiatrist friend about what we discussed in therapy. Is there any law that allows her to get a "consult" like that?

Yes, professionals are allowed to consult with each other about their cases as long as they protect the identities of their clients meaning they don't name names and don't share any other easily identifiable information.

The cases in which such consultations might be unethical is when, f.i., one therapist is working with a couple and the other one is working with one of the partners. In those kinds of cases, they have to obtain their clients' permission to talk to each other because they both know the people they are discussing and so sharing information about them may affect both couple's and individual counseling, therefore, clients have to be informed about it. They shouldn't discuss them secretly behind their backs.

It may also be allowed for professionals to share information about a particular client if they work for the same agency and the client is receiving services at that agency. But that would also fall under category of professional consultations.

[nottrustin]

In my area a blue paper (involuntary commitment papers printed on blue paper) has three parts. The first section is the person initiating the paperwork, the doctor or nurse practitioner who then assesses the patient and then the judge or lawyer who is permitted to sign the papers. Legally the first section can be filled out by family members, outpatient providers etc. However, we never use anybody outside the facility so typically it is the patient's nurse. The reason we don't use people outside the facility is because we don't want to break down relationships. Once the patient is discharged we don't want them to break off contact with family and friends or even outside providers.

[sarah5147]

Originally Posted by stopdog

In my jurisdiction a non md cannot admit you to a facility - they can call 911 and report you to get the police to pick you up or swear out an affidavit to get you picked up and held. There is a certain amount of time where the facility can involuntarily hold a person and they must file paperwork with the court as soon as an involuntary hold is there. The facility mds do not usually bother getting records from a therapist nor do they bother talking to the therapist unless there is already some prior communications between them (usually there is not). I always ask an md if they have gotten outside records about my client and 99% of the time, they have not - even where the client has requested they do so. I have called therapists to testify on behalf of my client in some instances.

I think that's how it is here too as far as the police, my T had mentioned that at one point. I find it odd that my T and PDoc have never talked at all. I wish they did coordinate a bit more, but my T has left short messages for my PDoc maybe 2 times in the past 5 years. Both at my request, but it's funny how my T still tells me all 3 of us work as a team. Lol. How is it a team if you never communicate except thru me or a message thru the office secretary? Oh well. Thanks for the insight! :-)