YOUR RIGHTS IN THERAPY
What you talk about in therapy is private with a few exceptions called limits to confidentiality. Even when a therapist has to share personal information, they will only share information relevant to the issue and maintain confidentiality as much as possible. If you ever want to say something but don’t know if that means your therapist will have to report it, ask them for clarification before continuing.
Limits to confidentiality:
If you say something to give your therapist reason to believe you are going to seriously harm yourself or someone else they will have to report it. This means having a plan, intent, and means: having a plan for how you’ll do it, giving the therapist reason to believe you intend to do it, and having the means to follow through with it. For example, saying “I am going to take all my medication to kill myself” would have to be reported but saying “I feel like I want to die sometimes” is not. Similarly, saying “I’m going to use my gun to shoot my mom this weekend” would have to be reported but saying “I want to kill my mom” is private. Having thoughts of suicide or hurting others is something many people experience, this should be processed in therapy. As long as your therapist doesn’t have reason to believe anyone’s life is in danger, they are required to keep this information private. Keep in mind, if you say something like “I want to die sometimes” or “I want to kill my mom”, your therapist will ask you follow up questions to make sure you don’t intend on harming anyone.
If there is reasonable suspicion of child abuse (anyone under 18 years old), elder abuse (anyone over 65 years old), or dependent abuse (anyone who relies on someone else for their care).
If a judge requests your records.
If you sue your therapist.
If you sign a Release of Information agreeing that your therapist can share specific information with a specific person or agency. This permission is valid for one year and can be revoked at any time before then.
IF YOU ARE UNDER 18 YEARS OLD: Your parent/s or guardian/s is entitled to your records however, your therapist is able to limit information shared (and likely will). If there is something you don’t want your therapist to share with your parent or guardian, tell them.
Aside from these exceptions, what you talk about in therapy is in between you and your therapist. If you plan on stealing, not a great idea, but your therapist can’t say anything if nobody is in danger. If you're harming yourself, process this with your therapist. Unless it's a threat to your life this information is private. Therapists are also not allowed to report violence between independent adults meaning if you tell your therapist about abuse, unless it involves a child, dependent, or elder, your therapist is required to keep that information private. If you want to report the abuse, your therapist will help you with that but it’s your choice.
TO NOT CARRY THE BURDEN OF COMMUNICATION
Many of us are used to worrying about how others will react to what we say or that if we use the wrong words we'll be misunderstood. One of the greatest parts about therapy is that is no longer your burden, you can express yourself freely without worrying about hurting your therapist's feelings, being judged, or being misunderstood. If your therapist is unsure of what you mean they will ask for clarification or if you feel misunderstood you can always clarify but in therapy you don't need to have the "right" words.
TO BE AN ACTIVE PARTICIPANT IN YOUR TREATMENT
This is your life, you have to do the hard work and deal with the results, so the treatment plan and goals should be yours. Collaborate with your therapist to create a plan that you’re comfortable with.
TO FEEL RESPECTED
Part of being a therapist means having unconditional positive regard for clients. This means that your therapist should accept and support you for exactly who you are-the good and the bad. If a therapist has beliefs that contradict yours, it is their responsibility to put their biases aside to provide you with the care you deserve.
TO DISAGREE OR SAY "NO"
You don’t have to answer a question just because your therapist asks. If it’s a safety concern they might need to ask more questions to make sure nobody is in danger, but you can always tell your therapist if you don’t feel comfortable answering a question or doing an activity. Your therapist should be respecting your right to self-determination. Tell your therapist if you disagree with them or if you’re uncomfortable with something. Therapy works best when there’s honest communication. Also, your therapist is human-they will be wrong sometimes.
TO KNOW WHAT'S GOING ON WITH YOUR TREATMENT
As a client, you are entitled to a copy of your therapy records. If you want to do so, submit a written request to your therapist asking to access your records. If the therapist thinks this would be damaging to your progress or the therapeutic relationship, they can decline but you still have the right to have another therapist review those records.
TO A SAFE SPACE
If your therapist says or does something that makes you uncomfortable, tell them. This is your space and if you don’t feel safe in it, therapy won’t work.
*Your therapist should never engage in a sexual relationship with you. If you ever feel sexually violated by your therapist, contact your state’s Board of Behavioral Sciences to report it.
TO FIND THE RIGHT THERAPIST FOR YOU
Your relationship with your therapist is similar to any trusting relationship in that someone can be nice, you like them enough, but they’re just not the person you want to be vulnerable with. That doesn’t mean anything is wrong with you, with them, or that therapy doesn’t work for you. It just means no therapist is the right fit for everybody. If at any point in therapy you feel uncomfortable or that it’s not helpful, talk to your therapist about it. Maybe that will lead to a great therapeutic conversation or maybe you'll realize you're better off with another therapist. If you're uncomfortable having this conversation with your therapist you can email them to let them know you want to discontinue treatment. You get to prioritize yourself here.