Judith Rosen Counselling & Therapy

Individuals - Couples - Adolescents

Ethics and Confidentiality

Making the decision to see a psychotherapist in order to talk about very personal issues and experiences can be scary.  Most people want to know that what they say to their therapist or even the fact that they are seeing a therapist is kept confidential.  Licensed psychotherapists are required to keep all information confidential unless they have good reason to believe that a person's life is in danger, a child is being sexually or physically abused, or they receive a court order for information pertaining to a case for trial.  If therapists do not keep strict confidences, they are in danger of losing their licences.

This means that a therapist cannot divulge any information about you or what you have talked with them about to anyone unless you have first given them signed permission to do so.  If you are under 18 and seeing a therapist, your parents do have access to your records.  (Most therapists discourage parents from trying to obtain this type of information and encourage them to ask their children instead).

If you decide to use your health insurance to pay for psychotherapy, be aware that your insurance company and, in some cases, your employer, will now have access to information about your mental health. Therapists are required to provide information so that individuals can receive benefits and this typically involves making a diagnosis from the DSM IV (Diagnostic and Statistical Manual of Mental Disorders) and giving treatment information. Some people choose to pay for therapy themselves so that their mental health treatment will not become a matter of record. Many therapists work on a sliding scale with individuals who do not have access to insurance.

It is important for a therapist to avoid getting into a dual relationship with you.  A dual relationship means that you would be connected to your therapist in another way other than a client.   Examples of dual relationships include becoming "friends" with your therapist.  It is very common for people to want to be friends with their therapist if they trust and have come to like and respect their therapist.  For the relationship to remain therapeutic, it is necessary for the therapist to prevent this from happening and keep good boundaries.  Examples of boundary crossings would be: entering into business agreements, your therapist calling you "just to talk," your therapist becoming your supervisor, being invited to a party or social gathering by your therapist, and your therapist hiring you to work for them. 

Other boundary crossings might include a therapist hugging or touching a client in any way, especially if that client has expressed discomfort with being touched.  Some clients want to shake hands or give their therapist a short hug after a session.  Since everyone is different in the area of touch and affection, it is important for you as a client to let your therapist know what you want and what you do not want. It is important for a therapist to respect your need for space as well as your need for touch. 

Some therapists practice out of a home office.  It is important for you to feel comfortable in this type of setting and know that your sessions will not be interrupted by phone calls, children, animals, etc.  It might be helpful to talk with your therapist about how you will handle the situation of seeing each other in public. 

Some people do not want anyone to know they are in therapy and some people want to introduce their therapist as their therapist.   Whatever you prefer, your therapist should respect your wishes.