The MLRA Therapy Blog

Insights and ideas from the therapist team at Meghan L. Reitz and Associates.

Confidentiality in Counseling

You might be surprised to learn that your need for mental health services and getting engaged in the counseling process is more confidential than you think it is. When you meet with a counselor for the first time, he/she typically will review confidentiality policies with you. These usually include the following:

  • Your diagnosis, casenotes (counselor's clinical impressions), and demographic data will be held confidentially. Mental health professionals take certain measures to keep your information private which include locked cabinets where paper files are kept, destroying your information after seven years from time of terminating counseling, and utilizing proper fire walls and approved software for electronic files.

  • If using health insurance, insurance companies will request a billing code for services and a diagnosis code in order to process claims and pay for services. They may request casenotes for services. However, you give permission for your health insurance company to have access to this information when wanting to use health insurance to pay for your counseling. Your health insurance company will also keep your private health information confidential.

  • No person or entity can have access to your mental health file unless you have given written permission.

  • If a counselor is subpoenaed for your records, the counselor will consult legal counsel as to what can/cannot be divulged due to doctor/patient confidentiality.

  • Confidentiality may be broken if you indicate you are suicidal or homicidal or there is alleged child or elder abuse. The counselor is a mandated reporter and must seek assistance from mental health entities and department of child and family services if there is a risk of safety.

  • Your employer cannot obtain your mental health or medical records unless you have given permission to do so.

  • Just because someone calls on your behalf does not mean a counselor can even confirm or deny that you are a client. A Release of Information must be on file for your counselor to speak with any individual regarding your treatment.

Of course there are always exceptions to the rules, so it is important that you are up front and honest with your counselor about what is going on in your life and what issues need to be addressed. If the counselor cannot give you an answer, he/she should consult his/her legal counsel for advice. You are always entitled to seek treatment with whom you are most comfortable with and can pursue a grievance if you feel your confidentiality has somehow been compromised outside of the safety reporting guidelines.

Many clients are concerned about others knowing that they are receiving mental health services. There is nothing to be ashamed of or nervous about when obtaining counseling. As time proceeds forward, the stigma of counseling should continue to diminish. We all have life issues we contend with and often times need an objective party to speak with on how to cope and deal with these things. 

If you have further questions or concerns about how your medical/mental health information is kept private and confidential, check out this website:




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