Do Therapists Tell Your Parents What You Say?
Over my decades of work as a clinical therapist, I’ve worked with many teens and young adults. One of the most common questions I’m asked at the beginning of our work together is what exactly I will be telling their parents. It can be a complicated question, so let’s dive into it. First, we will look at confidentiality and why it matters, and then discuss when a therapist might disclose information.
Understanding Confidentiality
Therapist confidentiality is an important part of the therapeutic relationship. Laws and ethics boards mandate therapists to keep confidential the information about a client. This is both a legal requirement, as well as an ethical requirement with state licensing boards. What this means is that what you share with your therapist is generally kept between you and your therapist.
Your therapist cannot tell anyone what are known as “identifying details” that would risk your confidentiality. For example, let’s say you are out in public with your partner and run into your therapist. Your therapist will not be able to introduce themselves as your therapist. If you wish to introduce them as your therapist, that is your decision!
Furthermore, let’s say your therapist has a consultation group of other therapists they speak with to find support or new ideas. If they share about you, they will not use your name or any other identifying details. The intention here is for other people to not be able to know who you are or associate you with therapy in any way.
The Importance of Confidentiality
Confidentiality allows the therapeutic relationship to be truly open and honest. When somebody knows what they say truly stays between them and their therapist, they are free to talk more freely. When you’re figuring out what to talk about in therapy, you don’t want to have the added pressure of knowing your therapist might tell a friend or parent.
With teens specifically, they may want to vent or share an experience that involves their parents. As the therapist cannot disclose the nature of the conversation to the parents, the person feels safe to express themselves. If a therapist were going to tell your parents exactly what you said, it wouldn’t create a very healthy dynamic!
When Can a Therapist Disclose?
Now, there are exceptions. Laws vary by state, but generally there are some cases in which a therapist actually HAS to disclose information. These ethical guidelines mean a therapist’s duty is to actually break confidentiality in some cases. In general, there are a few cases where a therapist has to break confidentiality.
First, a therapist may break privilege when the client is a danger to themselves or others. If your therapist feels you’re in imminent danger, they will likely have to break confidentiality to make sure everyone is safe. This can happen if you share intentions to harm yourself or others. The therapist may reach out to law enforcement, the potential victim, or your family.
Next, instances of abuse or neglect are reasons a therapist has to report to outside organizations. This may be child abuse or elder abuse. In either case, a therapist will have to notify the appropriate authorities.
In many states, professional misconduct may be reported. This is when another health care professional is behaving in an illegal or unethical way. For example, if you share that a past therapist made sexual advances, the therapist may report this.
Release of Information
There’s also the case of a Release of Information document (ROI). This is a document the therapist and client both sign allowing some information to be passed along. This may happen if you have both a therapist and a psychiatrist, for example. It allows your therapist to share status updates with your psychiatrist, and vice versa.
However, some parents will ask for an ROI. The patient has the final say in what they are comfortable sharing. I’ve had a few adolescent clients who have an ROI on file to simply let their parents know whether or not they show up to sessions. You also might sign an ROI to allow a therapist to share some information with your insurance company.
Age of Consent
States have different laws about age of consent for mental health treatment. The age of consent is the age at which a person may seek mental health treatment without approval from an adult or guardian. For general therapy in Idaho, the age of consent is 14. This means anyone 14 or older may consent themselves to psychotherapy. For peopel who are 13 or younger, they will need approval from their guardians.
This varies by state, and does not cover all mental health treatment. Although you may be able to consent to therapy at 14, you won’t be able to seek treatment at an inpatient facility at this age without your parents being notified.
If you’re a teen looking for therapy and have some questions, reach out to me. I’m happy to help clarify how it works and answer any questions you may have!
