How much should you tell a therapist?


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By David Joel Miller

Do you wonder how much you should tell your therapist? What is it ok to talk about and what should you keep to yourself? Here are some guidelines.

1. The more you are able to talk about with your therapist the more likely the process is to help you.

If you feel the need to hold back on something you need to ask yourself why. Consider if this is something that might really affect your life or is it just embarrassing. You shouldn’t be embarrassed to talk with your counselor. They have probably heard it all before so they are not likely to be surprised. Their goal is, or should be, to be helpful. They can’t really help you if you won’t tell them things that are bothering you.

2. Ask them about confidentiality

When you first came to meet the counselor they should have covered the rules and the limits of confidentiality. Some things are confidential, meaning the therapist won’t tell anyone else, some things are not. When you meet your counselor for the first time there is so much on your mind that you may not have understood it all. If you signed a copy of a confidentiality policy you should have received a copy. This is a part of the “informed consent” they are supposed to do. If you have any doubts about this ask them.

There are certain things that counselors can’t keep secret. By law most counselors are required to report child abuse and the abuse of elderly or disabled people. If you have done something like that or know about someone who was abused, the counselor can help you by working on the reasons you acted that way. They should try to help you change. They can help you with the process of admitting what happened and helping the victim get treatment. If you were the victim of abuse when you were a child most counselors will not have to report that unless the abuser is still around and might be abusing someone else.

My suggestion to you is to ask the counselor about their procedures before you tell them something you might regret. This will give them a chance to explain the rules of their profession and the laws in their jurisdiction. Consider that even if there are consequences to you for telling it still may be worth doing. They say we are only as sick as our secrets.

If you are suicidal counselors are supposed to report this. Not to hurt you or take away your will but to try to save your life. Most times the client will report afterwards that they were glad someone cared enough to prevent their suicide.

In most places the relationship between a patient and their therapist is protected by law. So outside of specific things they must report like child abuse, therapists are not supposed to disclose other things you talk about. They are not police investigators and they don’t have to report most crimes.

3. How much do you trust them?

The whole process of therapy depends on the trust between you and your counselor. Despite all the laws requiring therapists to keep things confidential some people are not trustworthy. If you don’t feel you can trust your therapist– don’t tell them your secrets until you have resolved that issue. Now some of you have “trust issues.” You have trouble trusting anyone. Working with a counselor to learn to be more trusting should help that. So start by telling the counselor a small thing and see how that feels. You can work on the bigger things later on.

When I first started in this field I went to see a therapist. We are all supposed to have that experience if we want to understand how it feels for the client. The therapist should also work out their own issues in their own therapy not in sessions with clients. I asked the therapist I was seeing if what we talked about was confidential. Their response was to ask me what I meant by confidential. They never did answer my question. So I avoided talking to that therapist about anything which might reflect on my future career. The lesson I learned was that if my therapist would not give me a straight answer about my questions I did not feel like trusting them. I make an effort to never do that to one of my clients.

P. S. I did eventually find someone I did trust to talk to about those issues and everything worked out just fine.

4. What is the consequence of this getting out?

If you might be embarrassed by a revelation say that you had a crush on some movie star when you were eight, even if the therapist did slip and tell your family you might be embarrassed, you might never trust that counselor again, but your life should not be ruined. If you cheated on your taxes or your wife and now feel guilty, having that reveled might be life changing. Think long about telling your therapist where you buried the body unless you need them to help you confess that to the police and clear your soul. While therapists are not supposed to violate confidentiality and tell about clients past crimes sometimes it happens. When this happens the therapist loses their license and the client gets to feel really happy about that the whole time they are in prison. Neither of those outcomes is what therapy is supposed to be about.

The point of requiring therapist to keep clients secrets and to tell them up front what will and won’t be kept secret is to make it possible for them to discuss their problems without fear of reading about their issues in the local paper. Without that level of trust most therapy would not be helpful. This is similar to doctor-patient or lawyer-client privilege.

5. Who do they work for?

If you want your counselor to keep the secrets you tell them within legal limits, then you need to hire and pay them.
If you visit a court appointed therapist or one at the school or CPS they are working for the agency that referred you. They may have a duty to tell the court, CPS or the school what they think and what you said. They should be clear about this when you go to see them but if they are not – be careful and ask about confidentiality before you “spill the beans.”

6. Do they have a no secrets policy?

Some therapists, Marriage and Family Therapists and those working with children may have a no secrets policy. When I work with a couple I don’t want to be working on saving the marriage if I know that one of the parties is having an affair. I might tell both parties that I can’t keep secrets from the other partner if we are to work on improving the relationship.

This is a big issue when we work with children. Some parents want us to find out all the kids secrets. This does not work. After we tell the parent the first secret the child decides to never be honest again. This may require some balancing.

If an eight year old tells me they snuck a sip of dad’s beer or took some cigarette from a store and tried one, I don’t feel the need to tell the parent. I want to find out why the kid is doing this and work on that issue. What if the kids is injecting heroin in his arm? I think I should tell the parent that. So if it is life threatening I will tell the parent. I have covered this policy when I first start seeing the kid so he knows if it is life threatening or really scary stuff I plan to help him tell his parent but I can’t keep that secret. I do say that little stuff, the kind of stuff most kids do. That can stay just between us.

So there you have some guidelines for what to share with your counselor and when. Hope that was helpful.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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77 thoughts on “How much should you tell a therapist?

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  6. what if you tell your therapist that you want to be admitted …. what would happen then? and if your young like i am (14) would your parents know?

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    • Your comment raises some really important questions. Who goes to the hospital and why? What are the rights of a minor in treatment and can you expect confidentiality or will the therapist tell your parents? Sometimes a person under 18 can seek their own treatment and sometimes they need their parents’ permission. Since I don’t know you, your parents or your therapist I can’t give you specific advice or treatment. I think your questions will interest others also so over the next few days I want to post some things on this topic. Since you are currently seeing a therapist I suggest you discuss the issue of what they will tell your parents and what they can keep confidential with your therapist. But if this is an emergency, if there is any chance you would hurt yourself or others I would urge you to tell the therapist and let them help you and then let them help you with your parents afterwards. Watch for my first post on hospitalization coming soon.

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  7. i will be 18 soon, like, in a couple weeks, so disregard my current state as a minor. will my therapist have to report any of the following if he is informed once i am a legal adult?
    – past sexual abuse (during teenage years)
    -self injury addiction (without suicidal intent)
    -any drug or alcohol use?
    thank you very much! (i live in ohio, BTW. we have most of the ACA rules are actually laws here.)

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    • Some general answers here. I am not up on laws in your state. One major factor is who is paying for your therapy and why you were referred. If it is court ordered then probably the drug abuse or results of any tests will be reportable. You should be asked to sign informed consent and releases when you turn 18 if you have not done so already. You should probably ask the counselor to explain the rules of confidentiality and how they have changed since you are now 18 before you go any further.
      Generally past abuse is not reportable if you are an adult when the counselor learns about it. The exception to that would be if you know of other minors that same person is abusing. Then that abuse of other minors will get reported. Counselors are mandated reporters in most places. The client is not. Clients or private citizens can make anonymous reports in most places; a mandated reporter is not allowed to make an anonymous report. They need the proof they did what the law required.
      Insurance companies need the diagnosis for payment. So they might get something like 309.81 Post-traumatic Stress disorder 305.20 Alcohol abuse. That’s all the details they normally get.
      I do not know of any place where non suicidal self-injury is reportable unless the injury requires emergency medical treatment. If you are bleeding to death the counselor will call an ambulance to keep you from dying, that is about the only thing they are likely to do.
      If you are in a drug and alcohol treatment program voluntarily you get an even higher level of confidentiality under 42 CFR than a mental health client gets under HIPPA (45 CFR) unless you were court ordered to the drug treatment.
      When in doubt ask the counselor to explain confidentiality. If they can’t or won’t explain it to make you feel comfortable consider looking for another counselor. Hope that helps.

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    • Maybe yes. Maybe no. Counseling and psychotherapy is all about the relationship. Once a counselor reveals something about a client to someone else that relationships is probably damaged, maybe irretrievably. The professional should have told you at the beginning of counseling what they would tell and not tell. Personally, whenever possible, I would discuss the issue with the client before I made that call. Sometimes I even encourage to client to make the call to law enforcement or Child protective services themselves and I sit by while they make the call or have them listen while I make the call so they know exactly what I said.
      Reasons why a counselor would disclose something to someone else and not tell the client would include a potentially dangerous client. If they plan to go home and kill someone I would first try to talk them out of this. If that does not work I might wait for them to leave the office and then make the required and permitted warnings to the intended victim and law enforcement. If a child victim is involved I might also not tell the client to try to protect the child.
      Here in the U. S. potential terrorists do not get confidentiality under the patriot act and we are not allowed to tell the client that homeland security came around to ask about them. I do not know if this has ever happened as I don’t think terrorists go for therapy very often.
      Past crimes do not get reported unless child abuse was involved.
      The sticky area is minors who tell the counselor something and then the parent wants to know. Parents can get awfully demanding, wanting to know what their child says and the laws can get extremely complicated. I prefer to have a discussion with the child, the parent and me all in the room together before we ever start therapy. That way we all know up front what will be told and not told to the parents. This still does not keep the child from trying to tell me something and asking I keep it a secret from the parent or the parent changing their mind and demanding to know something.
      Most common parent questions are 1. Are they having sex? 2. Are they doing drugs? If the parent is asking the chances are the answer is yes and so a better question is what we should be doing about this activity.
      Hope that helps you. The laws and customs in your area may be different. Ask your counselor for more clarification if you are not sure.

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  10. I am 15 and i live in Indiana. I have a history of alcohol use, self-harm, a violent past that nobody knows, and suicidal thoughts. Would i be able to talk to a therapist without them telling my parents anything? Like not even telling them that i went there?

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    • With that list of problems Charlie I strongly believe that you need to seek help. Without help those problems will only get worse. With counseling it is very possible for you to live a happy positive life.
      I am not sure about the laws in your state. You would have to ask a lawyer or counselor in your state about that. Another question that comes to mind is your parents. Do they care? Would they care if they knew? A counselor might be able to help you tell them and set up treatment that they could agree to.
      If you have been abused in any way that will get reported to the authorities in most any place I know of. If you are currently suicidal then any professional will follow the procedures for notifying authorities in your area. Those authorities will have to talk to your parent.
      In some places you could talk to the professional without telling your parents but then you need to pay for the counseling or see someone that will do it for no fee. At 15 the standard for you consenting will probably be very high. You need to think you are in danger, but then they will need to do anything and everything to protect you.
      That past violence stuff does not need to come out until your get a working relationship with the counselor established unless you have been the victim of the violence and the person who did it was an adult.
      I can’t do counseling over the internet but I would urge you to find an adult you can trust and talk to. That might be a school counselor, teacher, religious person or even someone at a boys club or mentoring program. You might also be able to walk into Children’s mental health or a mental health clinic in your area. Also check your local listings, there should be a local A.A. or N.A meeting and some of those meeting have a teens or young people’s meeting. If you are old enough to drink or use then you are old enough to go to meetings.
      Please keep looking for help because I can promise you that it can get better.
      If there are any readers in Indiana who can hook this kid up, please leave a comment with suggestions or numbers he can call.

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      • Thank you for the advice. And im afraid my parents would treat me differently if they knew and i dont want the way they treat me to change. I havent been abused in any way. The violent past was with teenagers when i visited Illinois for 3 months. It’s all said and done now. My school counselor tell parents everything in a situation so I’m crossing that off my list of where to turn to for help. And thank you again for the help. Very much appreciated.

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    • Rules may vary from place to place but generally the answer would be no. What you may be talking about is deliberate self-injury sometimes called cutting. I have had clients who rage all the way from scratching their arm with a paper clip to serious deep cuts all over there body. Most cutting comes from deep emotional pain not a desire to die or really harm themselves. Unfortunately some people who cut get carried away and cut to deep and could bleed to death or get infected. Sometimes people who cut also become suicidal and that has to be reported. A good counselor should want to know a lot more about why and how risky this is before deciding if this meets a criteria for being reported. This gets problematic if the self-harming person is under 18. Then the counselor may want to put a plan in place to keep the person safe and therefore will need to tell the parent or parent. Also some kids, but not all, who cut are being abused or neglected in some way. That abuse or neglect is reportable if the victim is a child, senior or a disabled person.
      Some people think that counselors should report or try to stop any dangerous behavior. Doing drugs or driving drunk is risky behavior. So is unprotected sex. Most of the time counselors try to help the client through the pain but do not report the behavior unless there is a legal mandate to do so. If in doubt ask the counselor what things they have to report and what is confidential. Remember also that if you pay there is more of a relationship. School counselors may have to report more things than those in private practice.
      I hope that helps a little. I encourage you talk this through with a professional who is willing to help you with whatever your problems are.

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  12. So a not so friend of mine had sex with a minor, my daughter. He was 24, she was 16. It has been 2 years since I last heard from him and he asks me if he can talk about this to a therapist. He was a close friend of mine and I care about him. I encorage him to seek help and my daughter and I did not and still do not want to press charges. So my question is this, will his thrapist report him for this crime?

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    • Laws vary a lot so I can not be sure about the laws in your area but here is the basic idea. Counselors do not report crimes. If we did not one would be able to tell us much of anything and then we could not help people who have done something wrong in the past change. We do report child sexual abuse. While sex with a 16 year old is a crime (statutory rape) in most places it is not child sexual abuse. A 16 year old is supposed to know enough about sex to be able to say yes or no. Child sexual abuse laws, as I understand them are meant to protect the weaker from the predator. So in Californian we have some extra protection for children when the “perpetrator” is at lest ten years older than the “victim.” Children under 14 get extra protection.15-16 year old get a all little less protection and over 16 get less protection yet. The only exception to that would be any age retarded or disable person may get extra protection.
      FYI laws in some places are different depending on the sex act. Vaginal intercourse is less likely to be reportable child abuse than anal or oral. As a counselor I don’t need those details unless this is sounding like reportable child abuse. This is not sounding like reportable child sexual abuse to me but it could be a crime (statutory rape) if someone wanted to press charges. Not sure it that answered your question but for more details you need to ask someone in your legal jurisdictional, a lawyer or therapist.

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  14. Hi,
    I was recently reading about OCD and sexual thoughts. If a person was experiencing obesssive thoughts that they will act out sexually towards a child, and shared that information with their therapist what would happen to them?

    Never having acted on them, and completely disgusted by them but they are still there.

    Thanks!

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    • Thoughts are not acts. The therapist is prohibited by confidentiality laws from disclosing that clients thoughts to anyone else. A good therapist would want to work with the client on ways to avoid acting on those thoughts and possibly a safety plan if they become concerned they will act. Who will they call, what will they do, and so on. Lots of people struggle with thoughts for many years and never act on them. Being afraid they will act on those thoughts sounds like a good thing because they are working on controlling themselves. The point of keeping this sort of thing confidential is to allow that person to work with a therapist on reducing or controlling those thoughts. Hope that helps explain the process. If some one is having those sort of thoughts I would urge them to talk with a licensed counselor.

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      • I’m a mom, I know deep down I am a good mom but I don’t think I believe it as much as I know logically. I have obsessed about being a phedophile since I was molested, and for some ungodly reason, told that “phedophiles were usually abused as children.” This to me translated to, “you will probably become one.” Even though I know that isn’t at all what they meant.

        Now that I have a child I am even more obsessed that I too will become a phedophile. I know I should talk to my therapist, and I do believe it would help. I am just TERRIFIED of losing my daughter. I would have no reason to live without her.

        Thank you so much for responding right away. I know I need to speak up; I’m just so scared of what I have to lose. Also just to be clear, I have never acted on them or even thought at the action, just the thought that I could. If that makes sense.

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  15. In case it helps Pedophile is not the same thing as child molester. A huge number of women have been molested as children and it is extremely rare for them to go on to molest anyone. A counselor can talk you through all of this. Absolutely you should talk with a counselor and unless you act on those urges there is no reason for the counselor to report anything. Best wishes on getting over your past and your fears.

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  17. I’m 15 and I live in Alabama. I want to go to therapy to deal with sexual abuse that I suffered when I was young. The perpetrator is not a danger to anyone else now. I do not want to report this to police, but I do want to work through it. My parents know everything, by the way.
    Thank you so much!

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  19. This is something that I’ve been curious for awhile. I saw my previous therapist during most of my childhood. He, I believe was a family therapist, and there seemed to be zero confidentiality between us. I don’t even remember this man telling me that there was a law for confidentiality between patients and their therapists. At the end of each and everything session my family would be called in, sometimes I was told to manual do this and once everyone was seated he would proceed to tell them everything that was said between us! I didn’t like this and I was lead to believe that this was how all therapy sessions were. I didn’t find out about the law until about the last or second to last year of me seeing this man. Besides this, there were many times where he tricked me into saying things and accused me of terrible things like me and my friends being drug addicts, which wasn’t true, and me accidentally telling him that I was suicidal in the past. He tricked me into saying that las bit because 1. I felt that I wouldn’t get the diagnoses I believed I had at the time and 2. because he promised that it would stay between us. However, I soon as I told him he did a 360 and told me that because I was a minor at the time that because of the law he HAD to tell my family. I panicked and desperately tried to get him to understand that he had misunderstood. He tend told me that he wouldn’t tell them, but I was betrayed again because as soon as they were brought in he told them and as well as told other lies on me. I am wondering if what he did was illegal.

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    • Complicated situation and this deserves a full answer. Unfortunately in the space and time I have it will have to be a brief one. The legality is an issue for a lawyer. Your description does not sound like the process was as helpful for you as it should have been. One factor to consider is the age you were at the time. The younger the child the less the child will understand the whole issue of confidentiality. One thing this therapist should have been doing is helping you be able to express your feeling and what was going on with your parents. This should not be done as prying out the secrets and telling them but as helping you feel confident to tell your parents how severe your problems really were. He may have explained the requirements of confidentiality and what he was required to report to your parents but that information was not passed on to you, or if it was you did not catch the significance of this. The sick person in the hospital does not usually understand what the doctor is trying to explain. The circumstances also would depend on what the therapist thought your “diagnosis” was. Someone will severe impairment may need a different approach than someone who is bright and high functioning. You sound older now and wiser. I hope that you do not let a bad past experience deter you from using counseling or any other form of help for your emotional problems. Now that you know more make sure to ask more questions upfront and if you do not feel comfortable adjust your behavior accordingly. Hope that helped answer your question and thanks for sharing your comment with the rest of us.

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      • I’m a minor, 15 in New Jersey. I regularly talk to the counsellor in my High School about my life and what not. If I tell her about PAST experimentation with prescription drugs does she have to report? What if I tell her I have no intentions of moving forward with taking drugs? Which I don’t. I don’t want any problems whatsoever but I want to get it of my chest. By law must she divulge this information to my parents? What about to authorities? It is considered theft I guess. I’m a honor roll, intelligent charismatic kid and I really don’t need problems over things I tried. Thank you.

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      • You probably need to ask the counselor you are seeing what things they will tell your family and what things they will keep confidential. Many school counselors here in California are not licensed and while they had some training in law and ethics their requirements are different from those of a licensed Therapist or Licensed Counselor. They may have the added duty to tell the school administration if things you did in the past could involve other students or activities on school grounds or on the way to or from school. I have no idea about the laws in your state. The school counselor may also have a requirement to tell your parents certain things. Ask first in a general way and if you are uncomfortable with the answer find a person you can trust to talk this through. At your age you probably need your parent’s permission to see and outside therapist. If you have a religious faith consider talking to someone in your faith or telling God (or your higher power) about this and see if that is enough to clear your need to tell. Hope that helps.

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  23. What about a therapist telling a client something they should not have. This was not what I wanted to here. It looks like there’s a trend towards therapists disclosing more but some things are just way too much to hear.

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    • Not sure what you are referring to here. This might depend on whether this information was about them or about you. If all therapists did was listen, then you could get that advantage from talking to a dog or cat. We should model health behavior and it is not health to have someone who always agrees with you about everything so sometimes we need to let you know that not everyone would agree with what you are saying.
      I think counselors need to give people feedback. Unfortunately sometimes we have to tell clients things that they do not want to hear. Say they are telling us about doing something and we tell them that as long as they keep up that behavior they will not get their children back from Child Protective Services. If your therapist has talked about something that made you feel uncomfortable then talk with them about this and see if this is something they shared trying to be helpful or if this is something they really feel you need to face. Hope everything works out for you.

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  25. I am 15, and currently seeing a psychiatrist. I don’t tell her that I am currently self harming or that I was sexually abused on New Year’s because I am afraid both of those give her a reason to break confidentiality. I would like to be admitted into a psychiatric facility for a short span of time or at least until some paranoia and other symptoms go away. How can I go about being admitted without telling her about self harm or abuse or suicidal thoughts ect.?

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    • Not sure how to help you here. It is hard to get into a psychiatric hospital these days and it is expensive, thousands per day sometimes. You will only get in if you have some very severe symptoms. Once in you will not get out till the symptoms get better. You will not get to chose, the staff in the hospital will make those decisions for you. My suggestion is to be as honest as possible with your psychiatrist and let them help you.

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  26. What if an adult patient enters therapy and it becomes a sexual relationship that continues in therapy. The therapist many years later has to leave the the practice so the patient now needs a new therapist. The patient wants to talk about the years of what has occurred not to file any law suits ever just to deal with the emotional pain. but would the new therapist be obligated to report this?

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    • In California the new therapist would NOT be able to break confidentiality and report this. They are required to give the client the book or pamphlet “Professional Therapy Never Includes Sex.” It is up to the client to decide if they want to pursue an action against that therapists license or a legal action. I would suspect the rules are very similar in other places.

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  27. I’m 19 20 in June I’m in new Zealand I am currently seeing a counselor and I was abused in my younger years must of been at least 10 yrs ago now the person is no longer around if I tell her am I able to refuse her to tell anybody including law? or is there a way I can tell her that she can’t say anything like if I don’t admit it is there a way around it I need to tell her as its making my life difficult

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    • Not sure about the laws in New Zealand. You would need to ask someone there. In the U. S. and most other places, you are over 18. After 18 you are not a child. No report. Counselors do not report crimes. They only report abuse of a child to prevent the child from being further abused. If you do not give details, who and when, there is not much to report. What is important is to work through the trauma, not to go into all the specific details unless that is important to you. You can always ask the counselor to tell you first what they are required to report and what they do not. Hope you get the help you need to get better.

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  28. I’m 15 and I’m thinking about seeing a therapist, I basically know where most of my emotional problems stem from, and all I really want is someone I can trust to tell about these things and these problems, without weighing my personal friends down. The problem, is the root of my problems may be something that could make the therapist break confidentiality. Basically, an adult in my life has a substance abuse problem, they’ve never really gotten physically violent, it’s more of a mentally abusive relationship and I would need to tell my therapist about this adult, but I need to know if they’d get authorities involved, because to outsiders it seems like there’s a pretty big chance for physical abuse, but I know there isn’t a real chance for physical abuse, otherwise I’d have told someone. I kind of understand that they won’t tell about me, but there are two more minors, one who has experienced what I have mentally and another who may end up growing up by themself and having to deal with the mental abuse on their own. Would the therapist have to tell someone about this if they thought there was a chance of physical abuse, even if I assured them there’s not?

    P.S. I know I was kind of vague with gender and other details, but I don’t want to go into too much detail.

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    • From your description I am hoping you get the help you need. It is not just physical and sexual abuse that gets reported but emotional abuse also. Yes it is possible that this would get reported. Sometimes getting the authorities involved can be just what the person abusing substances needs to seek help. You also need to consider the effects this may have on a younger person when the rest of the family is gone and they are alone in a possibly abusive situation. Look for someone you trust. Get to know them and then see if they cant help you work through all of this. A good therapist should be able to help all the family members involved.

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  29. im 13 and should i tell my counselor about my parents drug abuse because that is basically the only reason i got into counseling. my mom told me not to talk to counselors about it because i will get took away but i dont know what to do anymore. i am tired of dealing with my mom and supporting her drug habits

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    • Hi Gloria.
      Sounds like you have a difficult situation there. Since I am not there and don’t know you I can’t give you specific advice. Hopefully you have a good enough relationship with your counselor that you can talk this through with them. Just because a parent does drugs does not automatically mean a child should or will be taken away. Sometimes the thing that gets a parent into treatment is the pressure of losing their child. If this is as difficult a situation as it sounds then I think you need to tell the counselor what is going on and see if they can help you help your mother. Addiction is, in my opinion a disease that does not get better without treatment. Unfortunately not everyone with an addiction can get clean. Hope this short answer helps you in some way and that you can find someone close to you who can help you get through this.

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  30. Hi! I’m noticing you still respond to a lot of these comments, so maybe you can help me out. I am 16, and I recently asked for therapy. Here are several things I want to know about confidentiality in. I live in NC if that helps in any way. And when I say reported, or confidentiality, I mean, will the therapist tell my parents.
    1. Self harm. I am not in any danger when it comes to self harm. I already have several adults who know about it and can help me out at any time. I even know an EMT who can patch me up if I really needed it. I don’t want my parents to know. Specifically my mom, She simply isn’t strong enough.
    2. Substance abuse. I smoke weed on the regular, and I drink a lot when I hang out with my friends. Since hanging out with my friends is a big part of my life, I want to know if I can be honest about that part of my life. Smoking and drinking aren’t things I think I need help for, and they aren’t endangering me in any way. I simply see it as a phase.
    3. Past abuse. Abuse from when I was very young, or when I lost my memory. We’ve since moved away from those places, those people are no longer an issue. If the person is no longer in the picture, and no longer near where I live, will my therapist tell my parents?

    I’m beginning to regret my decision to get therapy. I didn’t realize on how many topics a therapist could break confidentiality. And most of the things I desperately need help with are the ones that will go back to my parents.

    Like

    • Thanks for commenting. Sounds like you have things you need help with. You probably need to get clear what it is you want help with. The more you can be honest with the counselor the more likely it is they can help you. Say you are failing in classes and you see the counselor for help with that. The fact that you are smoking weed is affecting your memory, past traumas may be impacting your learning also. The counselor needs to know that stuff to be effective in helping you with your studying. You thinking that your mother is not strong enough to hear something is concerning to me also. If so, she needs help also. Your counselor may be able to arrange that if they know the situation. I would discuss your concerns with the counselor and what they feel the need to tell. Yes, since you are still a minor if you report abuse this will legally need to be reported. How the agency in your area handles this I can’t tell you for sure but you can ask your counselor before you disclose the details. One thing to consider, if someone abused you, they may still be abusing other children. Your speaking out, ever though it is difficult, may prevent the same thing happening to another child. Hope it all turns out well for you. The younger you are when you deal with this stuff the more happy-life you are likely to have. Best wishes.

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  31. Pingback: Top Mental Health Blog Posts – counselorssoapbox.com 2015 | counselorssoapbox

  32. I recently received my second D.U.I. and am going to substance abuse rehab for at least three weeks in April. Until then, I want to pursue individual counseling for a special concern I have; my multiple sclorosis. I’m waiting to hear if a neuropsychologist is going to admit me to her program but I also want to pursue family counseling. My ex-girlfriend and I have a 4-year old son but she just got engaged and doesn’t want my help. My son witnessed some domestic violence in the form of yelling and slapping, but that was 2 years ago. I guess my question is how can I convince my ex it is beneficial for my son to see me and maybe participate in family therapy?

    Like

    • Very hard to convince someone else of something. You have a second DUI. Pretty clear that sometimes when you drink it is a problem. My suggestion is that this all takes time. First work on yourself and all your issues. then work on being a part of your sons life. You and your former girlfriend may or may not ever talk about anything again other than your son. Keep working on your life and see what happens.

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  33. Great advise and helpful for most. For me, telling all didn’t help. The therapists didn’t like what I said. They also chose to not bleive me. Why would a 45 year old wife and mother who wants help, who is responsible and dependable and sharp lie in therapy? I’m the pson who has kept neighbors key if they have an emergency, the one who babysits for people’s kids, also if they have an emergency. So why wold someone choose to think I lied to her?? Many people don’t understand each other. Sad when you pay for this treatment!!!

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    • Sad that a professional would think that a client is intentionally lying. Someone who is forced to therapy but does not want to be there may mislead the counselor but then the therapy is not likely to be helpful. Sometimes I have clients tell me things and I know they believe it but it does not seem likely to be true. To be helpful I need ot understand why the client thinks of feels that way. Sometimes it is easier to think the client lied than to admit we don’t know how to help them. I hope you find someone to work with that can be more helpful.

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  34. My partner is a psychologist who is a colleague with my psychiatrist, & I have admitted some past illegal drug use to my partner who is a psychologist. I am currently actively in drug abuse treatment counseling. Does my partner the psychologist have a moral and ethical responsibility to tell my psychiatrist of my past drug use? Would there be any negative or professional implications if he did not disclose this information?

    Like

    • Therapists have to maintain confidentiality unless it is a mandated exception. Past drug use over 30 days makes it substance use disorder in early remission, over a year is in full remission. Generally these confidentiality and exceptions requirements only apply to clients not family and friends. I do not see any reason that your partner needs to or is required to disclose communication from a partner. I am not familure with psychologists code of ethics bur that should not apply here.

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  35. Hello,
    I am 27 y.o F from Michigan. I am debating to see a counselor for a number of reasons. My question is does my therapist have to disclose information about my childhood molestation. It has been over 11 years and I have no contact with this person. My family members are aware of it, but due to cultural reasons, its been talked about and brushed under the rug. I feel like with my recent problems, its important to bring that up, but again I am worried about it being disclosed and have to go through the trauma again. Thank you for your time.

    Like

    • Once you turn 18, no things that happened to you as a child should not be reported by your counselor. You are an adult now and confidential info can not be disclosed unless it meets a legal exception to confidentiality. The only way it would become reportable now is if there is a child being abused now.

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  36. what if i tell my therapist i’ve been a frequent marijuana user for the last two years especially the last month, and have been on xanax for a couple of days that led to me to this point of seeing a therapist because i came home high? and had unprotected sex (twice maybe)? and i used to steal? will they tell my parents? by the way, the things i stated above are just the starters.

    Like

    • Lots of maybes here. Partly depends on how old you are, and where you live. If you are relatively young and the person you had sex with was a lot older then that part might be reportable as child sexual abuse. Your age would also determine your ability to give permission for counseling or whether you would need your parents consent. My recommendation is for you to ask the counselor what they would need to tell your parents and then see if you feel safe to disclose. Even if they believe it needs to be reported the counselor should help you do that in the safest way possible.

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    • Depends on what you mean by “self-harming yourself.” If you were currently trying to kill yourself, they would make the call and try to get you emergency psychiatric help. If you used self-injury as in cutting or burning to regulate emotions, they should work with you on other ways to manage emotions. Some self-harm falls in a gray area and it may scare the counselor. Even when the client does not mean to die some self-harm is so dangerous it may result in death. In that case I think most counselors would make the call and get the client medical and emergency psychiatric help. Two factors matter: your intent and the seriousness of the self-harm.

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  37. A close friend of mine just put herself into drug treatment a little over a month ago but is very distressed about telling her new counselor about her past drug use, which included some illegal activity to maintain her addiction. She very much wants to be honest about it, but fears repercussions if she tells her counselor about it. I want to help her but I’m not sure how to comfort her about it. Is the counselor mandated to report illegal activity with past drug use?

    Like

    • Counselors are prohibited from reported past illegal activity unless it is a mandate report as in abuse of a child. Believe me anyone who works with people in drug recovery know most of their clients have done things that were illegal. Tell your friend not to worry about being honest.

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  38. I turned 17 a few days ago (August 6th) and I had consensual sex with a 22 year old whose birthday was also a few days ago (August 4th.) I currently live in Wisconsin and he currently lives in Minnesota but is moving to Wisconsin in a few weeks. If I were to tell my therapist about this, does she have the ability to report this to the police? I haven’t been 100% clear on the consent laws in Wisconsin but I know in Minnesota it’s 16 or 17. I was in no way coerced or forced into having sex. I do want to talk about it but I will not risk telling her if it’s going to get him in trouble.

    Like

    • Sorry for the slow response. This sounds like a question for a lawyer. Each state has different laws and then you threw in people from two or more states. What I usually suggest, short of talking with a lawyer is to ask the counselor what they report and then decide what you want to tell. I see this as illegal, probably statutory rape but not reportable as child sexual abuse. I do not think most therapists would report this as it was consensual and you are over 16. But people do not always do the right thing. Eventually you need to talk about what happened. I would hate to think you would need to wait till you are 18 to be able to talk about it. Best of luck and thanks for commenting.

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  39. I am 18 years old from NJ. I’ve been seeing a therapist for two years now and have been hesitant to bring up something I did. I stole money a couple years back when I was 16 and I feel extremely guilty about it. I want to talk to my therapist about it but I am unsure if he is liable to tell authorities.
    Do you think my therapist will be required to tell authorities about this?
    Thank you and any response would be appreciated.🙂

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    • I do not think any therapist anywhere would tell about this unless there is something else involved. As long as they are not court ordered to report or a child was not involved not likely they could tell let alone would.

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    • I am not sure what the laws would be in the uk. Maybe someone from there will trad this and add to what I say. Most professionals could expect to report abuse of a disabled person. Emotional abuse is “ify” What one person considers emotional abuse might not bother someone else. Raising your voice might feel like yelling and be abusive to someone with PTSD. Yelling at players on sports teams is common. So yelling may or may not be emotional abuse. It is the impact it has on you. I suspect that if you describe this as abuse and the counselor agreed, it would get reported.

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  40. Hello,

    I’m 25 yo and just started seeing a new psychologist. I told her about how my parents use to abuse me both physically and emotionally (6-10 years ago) and that there’s no children in the house now. I also told her that I’m on speaking terms with my parents and my dad and I have a good relationship now. Is she required to report that or no since I’m over 18?

    Like

    • The general rule would be that once the client is over 18, it would not be reportable. The only way something would become reportable here is if you said something that indicated that a child was currently being abused. Thanks for commenting.

      Like

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