Michael R. Kandle, Psy.D.
The psychological services I provide are strictly private and confidential. Clients can only feel safe sharing personal and sensitive information when they can trust that it will not be disclosed to others without their expressed written consent. I will maintain the highest standards to ensure that your privacy is safeguarded. At the same time, it is my duty to inform clients of the legal limits to their confidentiality, which are explained below.
to Release Information
The vast majority of instances when information is shared outside the treatment office are when clients provide 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, psychiatrists or other therapists. For children, this may include communication with school personnel to gather assessment information or offer educational and/or behavioral recommendations. Any signed consent to share specific information can be revoked at any time.
Whenever clients choose to utilize their insurance benefits to pay for mental health services, the insurer will require some basic information from the provider in order to pay your claims. Typically this only includes your name, a diagnostic code, and the date of your visit. On some occasions your insurer may request a basic treatment report in order to authorize the continuation of care. These reports typically include a description of specific symptoms and their severity, specific treatment goals, risk assessment information, and some measure of the client's progress in therapy. The consent for me to provide this information will be on my "Intake Form" that you sign prior to beginning treatment. However, if you have any questions or reservations about this sharing of information with you insurer, please discuss this with me ahead of time. Clients are also free to review and participate in the creation of these brief reports prior to their submission.
Duty to Warn and Protect
Federal and state laws require mental health professionals to disclose information when there are credible threats of harm or death to another person or themselves. NH State law further requires disclosure when there is a threat of substantial property damage. Under such circumstances, only the minimum degree of information required to protect life or 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 protective 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.
The law requires mental health professionals to release confidential information when ordered to do so by an authorized court of law. However, 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, and clients will be notified in advance of any such disclosures.
Confidentiality of Minors
The law does not protect the confidentiality of minors as far as their parents or legal guardians are concerned. These adult parties have the right to access information in the minor child's record if they choose to seek access to it. That said, it is important to understand that many adolescent clients will not share important personal information with their therapist if they expect their parents to insist on being notified of it.
Because of the sensitive nature of parent/adolescent privacy and relations, it is suggested that parents offer their adolescent children the reassurance that they will respect the privacy of their communications with their therapist. Parents will also need to trust that a therapist will disclose vital information necessary for parents to protect the health and safety of their children. Wherever possible. When I believe that information needs t be shared with parents, I will seek the understanding and permission of the teenager to share this information so that their therapeutic trust is not betrayed. Any questions or concerns that parents or teens may have about treatment privacy may be discussed with me at any time.