Confidentiality Unbreakable: Therapists Keeping Secrets

Most people, whether ever in therapy or not, are aware of the code of confidentiality. States therapist Daryl in my novel Minding Therapy, “Keeping secrets about you not keeping secrets is one of the therapist’s main obligations…”

As stated by

Confidentiality includes not just the contents of therapy, but often the fact that a client is in therapy. For example, it is common that therapists will not acknowledge their clients if they run into them outside of therapy in an effort to protect client confidentiality. Other ways confidentiality is protected include:

    • Not leaving revealing information on voicemail or text.
    • Not acknowledging to outside parties that a client has an appointment.
    • Not discussing the contents of therapy with a third party without the explicit permission of the client.

For licensed mental health professionals, confidentiality is protected by state laws and the Health Insurance Portability and Accountability Act (HIPAA)

In a Frasier episode of 1996 called “Frasier Loves Roz,” psychiatrist Niles (David Hyde Pierce) learns that his patient is someone friend Roz (Peri Gilpin) shouldn’t be dating. But he can’t, of course, break the patient’s confidentiality by trying to warn her away from him.

Does that stop him and psychiatrist brother Frasier (Kelsey Grammer) from looking for a loophole? There are in fact some exceptions to confidentiality, which can vary from state to state or be different within the same state depending on what discipline a therapist belongs to, e.g., psychology, social work, psychiatry, etc..

Pertinent to the video clip (Update: no longer available), two common exceptions to confidentiality are when the client is a danger to him/herself or others and when the client can be shown to be mentally incompetent.

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