Understanding the Confidentiality of Your Sessions

You’re sitting in your therapist’s office, about to share something deeply personal, something you’ve never told anyone before. A thought flashes through your mind: “Can they tell anyone what I’m saying? Is this conversation truly private?” This concern is completely normal, and the answer is one of the most important principles of therapy: confidentiality.

At Televero Health, we want every patient to understand that confidentiality is not just a professional courtesy; it is a legal and ethical requirement that serves as the bedrock of the therapeutic relationship. Knowing that your sessions are a safe, private space is what allows you to do the brave work of being vulnerable and honest.

What Is Confidentiality?

Confidentiality means that your therapist is legally and ethically bound to keep everything you say in your sessions private. They cannot share your personal health information with anyone—not your spouse, not your parents, not your employer—without your explicit written consent. This protection is enshrined in federal law through the Health Insurance Portability and Accountability Act (HIPAA), as well as in state laws and the ethical codes of every mental health profession.

This means you can talk freely about your fears, your mistakes, your relationships, and your history, knowing that what you say will stay in the room (or within the secure telehealth platform). This creates the psychological safety that is necessary for you to build trust with your therapist and to explore the issues that brought you to counseling.

Are There Any Exceptions? The Limits of Confidentiality

While the principle of confidentiality is very strong, it is not absolute. There are a few, very specific situations where a therapist is legally and ethically required to break confidentiality. These situations are rare and are all related to protecting you or others from serious harm. Your therapist will almost always review these limits with you in your first session so you are fully informed.

The main exceptions to confidentiality are:

  1. If you are a danger to yourself. If your therapist believes you are at imminent risk of suicide, they have a duty to take steps to keep you safe. This might involve contacting a family member, calling a crisis team, or facilitating a hospitalization. Their priority is to protect your life.
  2. If you are a danger to others. If you make a specific, credible threat to harm another person, your therapist has a legal “duty to protect.” This means they may be required to notify the potential victim and/or law enforcement to prevent the harm from occurring.
  3. If there is suspected child or elder abuse. All therapists are “mandated reporters.” This means that if they have a reasonable suspicion that a child, an elderly person, or a dependent adult is being abused or neglected, they are required by law to report it to the appropriate state protective services agency.
  4. If they are ordered by a court of law. In some legal proceedings, a judge may order a therapist to release your records. This is a very rare occurrence.

It’s important to understand that these are very high thresholds. Your therapist will not break confidentiality because you admit to having suicidal thoughts; they will only do so if they believe you are in immediate danger of acting on them. Their goal is always to work with you collaboratively to ensure your safety first.

Confidentiality with Insurance and Minors

If you are using insurance to pay for therapy, your therapist will need to share some basic information with your insurance company to get reimbursed. This typically includes your diagnosis, the dates of your sessions, and the type of service provided. They do not share the detailed content of what you discussed.

Confidentiality for minors (children under 18) can be more complex and the laws vary by state. In general, while the parents have a right to be informed about their child’s treatment, the therapist will work to create a confidential space for the child to talk openly, while also keeping the parents appropriately involved.

Trust is the cornerstone of therapy. The strong legal and ethical shield of confidentiality is what allows that trust to be built. It ensures that your therapy office is a true sanctuary—a safe harbor where you can be your most authentic self without fear of judgment or exposure.

Key Takeaways

  • Confidentiality is a legal and ethical rule that requires your therapist to keep what you say in your sessions private.
  • This rule creates the psychological safety needed for you to be open and honest in therapy.
  • There are a few rare exceptions to confidentiality, all related to preventing serious harm to yourself or others, such as in cases of imminent suicide risk or child abuse.
  • Your therapist will review these limits with you so you are fully informed. Your privacy is taken very seriously.

Ready to take the first step? We can help. Get started with Televero Health today.