As a therapist, you understand the importance of confidentiality. Your clients share vulnerable, personal information with you, and it’s your responsibility to keep that information private. Trust is a key factor in the therapeutic relationship, and maintaining therapist confidentiality allows your clients to open up without fear.
Therapist confidentiality can be complicated, though. Although the general rule is to keep your clients’ information private, there are situations in which you may have to share it. Maintaining privacy means more than simply not speaking about your clients, too. You have to consider your written documents and digital communications as well.
There are a number of rules, laws, and regulations when it comes to therapist confidentiality. To be a safe and effective practitioner, you should understand and adhere strictly to these guidelines.
Here Are Seven Tips for Maintaining Therapist Confidentiality
1. Consult the code of ethics.
Fortunately, you’re not on your own when it comes to setting privacy guidelines. Section 1.07 of the Code of Ethics from the National Association of Social Workers is dedicated to privacy and confidentiality, so it should answer most of your questions.
Here are some of the most important points outlined in the code:
• Only solicit private information from clients when it’s necessary for treatment.
• Only disclose a client’s private information with their consent or when there is a compelling legal or ethical reason to do so.
• If you do need to disclose confidential information, only reveal the essential information that’s relevant to the situation.
• If possible, inform your client beforehand if you have to disclose their information.
• Discuss your clients’ rights to confidentiality with them.
• When providing counseling to families, couples, or groups, create an agreement for all participants to protect the each individual’s right to privacy.
• Protect the confidentiality of written and electronic records and communications. If you experience a breach in confidentiality, notify your clients.
2. Follow HIPAA.
HIPAA, or the Health Insurance Portability and Accountability Act, is a law that outlines what health information must remain confidential and what measures you must take to protect your clients’ privacy when sharing their information with third-party payers. This should be your baseline for establishing the privacy rules of your practice. According to the law, therapists can share information related to treatment with others involved in the client’s care only if the client consents.
One of the most important components of HIPAA for therapist confidentiality is Title II. This section lists the specific pieces of information that can identify your client and regulates how and when you can share that information. There are 18 protected identifiers, including name, street address, birth date, Social Security number, and others.
3. Inform your clients of your therapist confidentiality rules.
Before beginning treatment, your clients should be aware of your policy on therapist confidentiality. This allows them to feel safe and secure during the session. When they know that the information they reveal will stay between you and them, they’ll feel much more comfortable opening up.
Additionally, it’s important that your clients understand that there are situations in which you may have to divulge their information. For example, if they threaten to hurt themselves or someone else, you will need to report the situation. You may also have to share a client’s diagnostic information with their health insurance provider to get the therapy sessions covered. Always make these rules clear so that a client doesn’t feel surprised or betrayed if you have to speak with someone else about them.
Many therapists provide their clients with forms that detail their privacy policies and the rules of therapist confidentiality. It can be very helpful for your clients to have a written explanation of the rules to clear up any confusion. You could include this information in your informed consent forms, or you could offer it as a separate document.
4. Ask permission.
Some therapists find that recording sessions helps them provide a better service, and some choose to consult with colleagues or supervisors when they need a second opinion on a client. If you plan to do anything that may put a client’s privacy at risk, ask for their permission first. Explain why you think it will be beneficial for the therapeutic process, and tell them how you plan to protect their information to the extent possible.
Asking permission in these situations is a key step toward building trust with a client. It communicates to your client that you value their input and respect their wishes, and it shows your transparency.
5. Consider your surroundings.
You may need to speak with someone else on your client’s treatment team, or you may want to consult with a colleague to get their input on a situation. In these moments, you should always reveal only the information that is strictly relevant and necessary, and you should ask for permission from your client. Even if you have the go-ahead from your client to discuss their treatment, though, you have to be mindful of your surroundings.
No matter how vaguely you speak, you should never discuss your clients in break rooms, hallways, lobbies, or other public spaces. Before you say anything to a colleague, look around the room and consider whether or not it’s an appropriate location. Try to limit your conversations to your office or another private space, and speak quietly to avoid being overheard.
6. Keep your recordings secure.
Recording your sessions can help you review and reflect between meetings with the client, but it also can be a privacy issue if you’re not careful. If you use recorded tapes for your sessions, keep them in a lockbox or another secure space. If you keep the videos or audio recordings on your computer, use a unique and secure password for every file. Your computer itself should be password protected, too.
Try not to hold onto recordings for longer than necessary. As soon as you no longer need them for treatment purposes, erase the files.
7. Be careful with papers.
In this day and age, many therapists keep all of their documentation and client intake information on their computer. Your computer should be password protected and kept in a secure space. If you leave your laptop at work, make sure you lock your office when you leave. If you take your laptop home with you, never leave it unattended.
If you use paper notes, be meticulous with security. Keep your notes in one notebook or folder if possible, and put these pages in a locked drawer in your desk. Once the documents have served their purpose and are no longer needed, shred them.
No matter where you work, maintaining therapist confidentiality is critical. Your clients trust you with their private information, and you’re expected to keep that information secure to the extent possible. If you ever have questions or concerns about confidentiality rules, don’t take any chances. Consult HIPAA, your Code of Ethics, or a supervisor to make sure you’re doing what’s right for your clients and for your practice.
Blue Moon Senior Counseling provides therapy for older adults facing depression, anxiety, loneliness, stress, and many other concerns. To learn more about our mental health services, reach out to us today.