Frequently Asked Questions
Is Therapy Confidential?
Confidentiality is one of the most important components between a client and a psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but within the therapy relationship. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent”. Sometimes, you may want your therapist to share information or give an update to someone on your healthcare team (e.g. your PCP, Medication Prescriber, Nutritionist, Business Coach, etc.), but by law, your therapist cannot release this information without obtaining your expressed written permission. The only legal exceptions to maintaining confidentiality are: when a mandated reporting concern arises (see below for more information), or if a judge compels the release of clinical documentation by subpoena.
What does it mean to be a “Mandated Reporter”?
State law and professional ethics maintain that therapists must maintain client confidentiality except for situations that are considering “mandated reporting” issues. These include suspected past or present abuse or neglect of vulnerable people including children, adults and elders. And, if the therapist has reason to believe the client is seriously in danger of harming self or another person. By law, these instances would be reported to the local authorities including Child Protective Services (CPS) and/or the law enforcement, based on the information provided by the client or collateral sources.
How is therapy different than other personal relationships?
The boundaries and expectations of our treatment relationship are unique from any other personal relationship. In therapy, the focus of conversations is on you with the goals of increasing your self-awareness, emotional regulation skills, development, and healing. In a relationship outside of therapy, we usually expect more of a back-and-forth in supporting one another, and taking emotional risks to be open and vulnerable. It is normal for this to feel uncomfortable or confusing at times, but that doesn’t mean you aren’t safe, and we can always talk about these experiences as part of your healing.
Sometimes, this can feel like a parent/child relationship because I am ‘the helper,’ kind of like the way we naturally expect our caretakers to meet our needs when we are kids. I hope to help guide you in learning to meet your own needs, but depending on your relationships with the people who took care of you growing up, you might experience a whole mix of feelings about that parent/child experience being recreated. I encourage you to take notice when and if that happens, and to feel free to openly share that awareness at any time, knowing it’s perfectly normal and even expected to happen. Usually, if it seems like those thoughts and feelings won’t go away, they represent some part of you that needs to be healed.
Sometimes, therapists can seem like the perfect romantic partner too. If you think about it, it makes sense that it feels good to get undivided attention, care, and respect for your needs, especially if you aren’t used to that. If you put a person who feels chronically misunderstood, longing to be known, with a history of feeling abandoned and rejected, and we sit that person down with a professional listener who understands what trauma can do to a person, of course this is going to feel positive and affirming. And if you haven’t yet been able to get that kind of validation from other social supports, it might feel like you want to get this feeling with me all of the time. Again, that is normal, and to some degree these feelings may be showing you what you value in a close, safe relationship. Though our professional relationship can not extend beyond therapist and client, I encourage you to share any confusing or complex feelings you might have about me or our working relationship, as it would represent aspects of yourself that need healing and attention.
I cannot disclose personal information about my life, as this would take away from the focus on your treatment. However, I can give you feedback on how I perceive our dialogue, and I invite you to give me feedback regarding your perceptions as well. Further, I realize that, as humans, just because we think or feel something does not mean we are going to act on it. Actually, this is a major concept in feeling better too! Sometimes thinking and talking about things symbolically or metaphorically can give us a lot of insight, though consequences come in when our thoughts or feelings are acted on. You are allowed to think, imagine, or feel anything in the safety of this room. I will never act on thoughts or feelings you might have about our relationship that go outside of the professional boundaries of therapy that we have agreed to. I never want to exploit the power you are granting by trusting me with your story and your vulnerability.