Client Confidentiality

As a Marriage and Family Therapist in the State of California, I am legally and ethically required to maintain my client’s confidentiality. It is the foundation of the therapeutic relationship. You need to feel safe to express anything you need to.

However, there a few very important exceptions. Because I am a Mandated Reporter, I am legally required to break confidentiality and file a report with law enforcement and/or state agencies in the following cases.

Abuse:

If a Client tells me he/she/they or someone of their immediate acquaintance is abusing: a child under the age of 18; a dependent adult between the ages of 18 and 64; or an elder, aged 65+, I am mandated to report this to the proper authorities and am not required to discuss this with the Client.

Intention to commit homicide:

If a Client tells me that he/she/they have the plan, intent, and means to kill an identified victim, I am mandated to report this to the proper authorities and am not required to discuss this with the Client.

Threat of harm to an identified victim or their property:

If a Client tells me that they have the plan, intent, and means to harm an identified person or their property, I am mandated to report this to the proper authorities and am not required to discuss this with the Client.

Other Situations:

Suicide:

This is a special case. If a Client is suicidal, I am not legally mandated to intervene, but I am allowed to, and I will! Your safety is my number one concern. This usually involves spouses, partners, and/or family members in creating a safety plan. If I believe that suicide is immanent, I will first try to get the Client to go voluntarily to the emergency room to be evaluated and admitted if necessary. I require that a family member or trusted friend take them to the ER. If a Client is unwilling or unable to go voluntarily, then I can initiate a “5150,” the code for involuntary commitment. The Client will be taken to the hospital by family, trusted friends, or the police and admitted for 72 hour observation. This is the extreme circumstance. I work closely with Clients who are having suicidal thoughts and ideation without a clear plan, means, and time to alleviate the distress and stop the ideation.

Consultation:

It is legally and ethically allowable for me to consult with other mental health professionals about a case. This is done in the best interests of the client and does not violate confidentiality. The client’s name and personal details that do not pertain to the issue at hand are not revealed. A signed Release of Confidential Information form is not required.

Coordination of Care:

There are times when it would be therapeutically useful for me to talk with a Client’s other health care providers (ex: physician, psychiatrist, endocrinologist, social worker) in order to better serve define the treatment plan for the Client. In order to do this, I must discuss it with my Client, get their permission, and have them fill and sign out a Release of Confidential Information form.

Other:

In any case in which a Client asks me to release their confidential information to a third party, they must sign a Release of Confidential Information form.