Our staff work hard to foster an environment of warmth and acceptance. Patients often tell us how safe and cared-for they feel in the office setting and with our practitioners. Even so, occasionally a patient feels discomfort at the idea of sharing personal things about themselves. This is sometimes a barrier to seeking therapy, but can also be a barrier to succeeding in therapy. Patients are sometimes wary to open their inner thoughts and feelings which they consider “private property,” especially if they worry about exposing personal behaviors or mistakes. Whatever the concern, we want to empower you with the information you need to address your discomfort so you can make an educated decision about your current or future therapeutic care, and allow for optimum success in therapy. If you have any concerns, we’d like to reassure you by clarifying the parameters of a patient’s right to their privacy.
What protections do I have?
Your care provider is bound by laws called HIPAA, or the Health Insurance Portability and Accountability Act. HIPAA is not specific to the mental health field- you may have heard of it in the context of medical doctors as well, as it protects all people receiving medical treatment. HIPAA has been expanded to include the Privacy Rule; together, these are the most widely known of patient-protective laws. Unfortunately, not everybody understands what is involved in HIPAA and the Privacy Rule. Therapists study the laws during their training, but ins-and-outs are not always explained to potential clients. This is unfortunate, as people may needlessly feel apprehension toward beginning or continuing therapy!
What do these laws mean practically?
HIPAA privacy laws actually benefit both you and your therapist. Your therapist is benefitted because they are able to communicate with members of your care team when appropriate in order to better care for you. This potential collaboration would be to your benefit. At the same time, though, the laws ensure that your information remains carefully protected unless there is a reason for it to be shared. There are circumstances under which your information may be shared by your treatment provider, as with medicine- certain caveats allow for openness with family members as well as other care providers.
Therapists may share treatment information with people involved in client’s care, if: client has agreed, client has had the chance to object and has not, client has initiated involvement of this family member/representative, or client is incapable of making decisions.
20 years ago, the Privacy Rule was added on top of HIPAA. It filled in several holes not covered by HIPAA, such clarifying in which contexts therapists were allowed to share treatment with a client’s family members and other healthcare providers, and ensuring the confidentiality of therapist’s notes.
Importantly, HIPAA laws also have some overrides which protect your safety and well-being. If your therapist believes that they must share information for your best interest, for example to reduce suicide or homicide risk, the therapist may involve anybody who is able to help avoid harm to you or others. Parties privy to involvement can include parents, doctors, emergency services, and so on.
As you can see, much effort has been expended to advocate for your privacy rights as a patient.
What if my child is under 18 years of age?
Information directly related to care of minors, or clients unable to make decisions about their own healthcare, may be shared with client’s caregiver or representative. This opportunity is rescinded if there is a reasonable concern that the representative is not acting for the client’s best interests. Information regarding symptoms, treatment, or progress may be shared, but psychotherapy notes may not.
Takeaways:
Many patients feel uncomfortable initiating therapy or sharing personal information during therapy, partially because they worry that embarrassing or uncomfortable information is safest when not shared. Don’t be held back by this misconception! At Park Avenue Psychotherapy, we are bound by law and professional codes of conduct to keep all patient information strictly confidential except for certain extraordinary circumstances outlined above. In short, the general rule is that we’d share information only with your agreement and endorsement. Under certain rare circumstances we are required to disclose information to the authorities, in order to prevent harm to yourself or to others. If you have any questions regarding confidentiality, feel free to contact us.
References:
HIPAA for Mental Health Professionals: The Basics. https://www.goodtherapy.org/for-professionals/software-technology/hipaa-security/article/hipaa-for-mental-health-professionals-the-basics. Accessed June 2020.