What an individual tells his or her therapist is confidential; however, there are limitations to the confidentiality between a therapist and a client. Laws in all 50 states require a therapist to contact authorities if a patient is a danger to him/herself, to others, and/or if the therapist suspects that a known child is being abused. These reporting laws, as they are applied in your state, are explained to all adults and to guardians of children who seek professional counseling for any reason. Understanding this limitation to confidentiality is important, and applies to anyone seeking medical care or mental health services.
Most of the time professionals need specific information about a particular child who is at risk or who has been already harmed along with information about who is being abusive in order to take the step of filing a report. In most situations the “victim” must be clearly identified. For example “I’m concerned about my child’s sexual behaviors towards other kids,” or “I’m having disturbing thoughts about being sexual with a child” are not statements that would typically trigger a report. However if someone says “My 16-yr-old son told me that he touched my sister’s 5-yr-old daughter” or “I have touched my son in sexual ways” or “My daughter disclosed to me that her grandfather has been playing sexual games with her” then a therapist may have enough information to file a report.
There are slight variations state to state regarding when mental health professionals must file. Please ask your therapist about their policies and review the statutes for mandated reporters in your state so that you can be informed. In addition, the therapist may not be required to inform a client or his/her family that a report is being made. You can ask ahead of time about how this would be handled should the therapist consider filing.
If therapists or clients have questions about under what circumstances reports are mandated, contacting the licensing organization for that professional is a good place to start. For example, in some states confidentiality is only broken if abuse is occurring within the family. Understanding these mandates in your state allows you to make informed decisions about your interactions with a therapist and not be caught off-guard by these laws.
Before beginning therapy clients or guardians (if the client is a minor) should be asked to read and sign a consent form that explains the circumstances under which your therapist must break confidentiality. If the client is a minor then the information should be clearly explained to the parent or guardian. If at any time you have questions about what is confidential and what is not, try not to be intimidated, and please be sure to get your questions answered.