The psychological services I provide are strictly private and confidential. Clients only feel safe sharing personal and sensitive information when they can trust that it will not be disclosed to others without their clearly expressed permission. I will maintain the highest standards to ensure my clients privacy. At the same time, it is my duty to inform clients of the legal limits to their confidentiality, which are explained below.

Written Consent to Release Information

The vast majority of instances when information is shared outside the treatment environment are when a client provides a written consent for me to communicate with another party. Often this is for the purpose of organizing or coordinating health care with other professionals such as physicians or other therapists. For children, this may include communication with schools. Any signed consent to share specific information can be revoked at any time by written or verbal notice by a client.

Insurance Carrier Requirements

Whenever clients choose to utilize their insurance benefits to pay for mental health treatments, the insurer will require the identification of the client, a diagnosis, and a treatment date, at a minimum. Most managed care plans will require more information in order to determine the necessity of care and to issue an authorization for continued treatment. Typically these insurers will request a list of symptoms that support a diagnosis, information on the limitations to a client’s ability to function, substance abuse, and other risk factors. If you have any concerns regarding the release of this type of information, you are urged to discuss this with me within the first 5 sessions of treatment (as insurers are not entitled to request this information within this phase of care.

Duty to Warn and Protect

Federal law requires mental health providers to disclose information when there is a threat of harm to another person or themselves. NH State law further requires disclosure when there is a substantial threat of property damage. Under circumstances like these, only the minimum degree of information required to protect life and property would be disclosed. The appropriate parties contacted might include family members, an identified victim (or potential victim), emergency health care personnel, or the police.

In addition to the requirements to report future potential harm/danger, NH State law requires that past and present acts of abuse or neglect to children and/or incapacitated adults to be reported to state authorities. This includes all acts of physical or sexual abuse. It also requires reporting of prenatal exposure to controlled substances that are potentially harmful to a fetus.

Court Order

The law requires mental health professionals to release confidential information when ordered to do so by an authorized court of law. Even under these circumstances, I will make every effort within my power to limit information from being shared that a client does not wish to have disclosed.

Confidentiality of Minors

The law does not protect the confidentiality of minors as far as their parents or legal guardians are concerned. These parties have the right to information in the minor child’s record if they choose to access it. That said, it is important to understand that many adolescent clients will not share important personal information if they expect their parents to insist on being notified of it.

Because of the sensitive nature of parent/teenager privacy and relations, parents are encouraged to reassure their adolescent children that: 1) they will respect the privacy of their treatment, and 2) trust my professional judgment to disclose information to parents if and when the risks warrant such a disclosure (and outweigh the risks of not disclosing information). If parents or teenagers have questions or concerns about the boundaries of confidentiality, they are urged to discuss them with me prior to disclosing sensitive information.