Confidentiality Issues and Concerns
Making the decision to see a psychotherapist in order to talk about very personal issues and experiences can be scary. Most people want to know that what they say to their therapist or even the fact that they are seeing a therapist is kept confidential. Licensed clinical social workers are required by law to keep all information confidential unless they have good reason to believe that a person's life is in danger, a child is being sexually or physically abused, or they receive a court order for information pertaining to a case for trial. If therapists do not keep strict confidences, they are in danger of losing their licenses.This means that a therapist cannot divulge any information about you or what you have talked with them about to anyone unless you have first given them signed permission to do so. If you are under 18 and seeing a therapist, your parents do have access to your records. (Most therapists discourage parents from trying to obtain this type of information and encourage them to ask their children instead).
Inappropriate Dual Therapeutic Relationships
Therapists should treat you professionally and with respect. THERE IS NEVER A THERAPEUTIC REASON FOR A THERAPIST TO DEVELOP A PHYSICALLY INTIMATE RELATIONSHIP WITH YOU! If your therapist tries to engage in a sexual relationship with you or even hints at the possibility, they are looking out for their interests and not yours and need to be reported to their licensing boards.
It is important for a therapist to avoid getting into a dual relationship with you. A dual relationship means that you would be connected to your therapist in another way other than as therapist-client. Examples of dual relationships include becoming "friends" with your therapist. It is very common for people to want to be friends with their therapist if they trust and have come to like and respect their therapist. For the relationship to remain therapeutic, it is necessary for the therapist to prevent this from happening and keep good boundaries. Examples of boundary crossings would be: entering into business agreements, your therapist calling you "just to talk", your therapist becoming your supervisor, being invited to a party or social gathering by your therapist, and your therapist hiring you to work for them. Other boundary crossings might include a therapist hugging or touching a client in any way, especially if that client has expressed discomfort with being touched. Some clients want to shake hands or give their therapist a short hug after a session. Since everyone is different in the area of touch and affection, it is important for you as a client to let your therapist know if it bugs you when they pat your arm, etc., and it is important for a therapist to respect your need for space.
Some therapists practice out of a home office. It is important for you to feel comfortable in this type of setting and know that your sessions will not be interrupted by phone calls, children, animals, etc. It might be helpful to talk with your therapist about how you will handle the situation of seeing each other in public. Some people do not want anyone to know they are in therapy and some people want to introduce their therapist as their therapist. Whatever you prefer, your therapist should respect your wishes.
Insurance and Confidentiality
If you decide to use your health insurance to pay for psychotherapy, be aware that your insurance company and, in some cases, your employer, will now have access to information about your mental health. (See HIPAA information). Therapists are required to provide information so that individuals can receive benefits and this typically involves making a diagnosis from the DSM IV and giving treatment information.
Some people choose to pay for therapy themselves so that their mental health treatment will not become a matter of record. Many therapists work on a sliding scale with individuals who do not have access to insurance.
For a phone consultation or information, call 301-625-9102 and begin your journey towards contentment, healing and change. Now serving Bethesda, Maryland and North West Washington D.C.
Just trust yourself. Then you will know how to live.