Confidentiality and Limits on Confidentiality

The laws governing confidentiality can be quite complex and differs depending on the nature of our relationship. Generally, if our contact is for clinical services (e.g., psychotherapy, psychological assessment) then you are entitled to confidential services with the usual limits. If you are a forensic referral such as an officer ordered in for a fitness for duty evaluation or mandated by court to be evaluated then there is a very limited expectation for confidentiality. The nature of our relationship and confidentiality issues will be discussed and clarified at our first meeting and at subsequent meetings as needed.

 

The law protects the privacy of all communications between a client and a therapist. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on the “Therapy Agreement” provides consent for those activities, as follows:

1. I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my client. The other professionals are also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all consultations in your Clinical Record.
2. Disclosures required by health insurers or to collect overdue fees.

 

There are some situations where I am permitted or required to disclose information without either your consent or authorization:

1. If you are involved in a court proceeding and a request is made for information concerning the professional services I provided to you, such information is protected by the marriage and family therapist-client privilege law. I cannot provide any information without your (or your legal representative’s) written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
2. If a government agency, pursuant to their lawful authority, is requesting the information for health oversight activities, I may be required to provide it for them.
3. If a client files a complaint or lawsuit against me, I may disclose relevant information regarding that client in order to defend myself.
4. If a client files a worker’s compensation claim, I must, upon appropriate request, disclose information related to the claim to appropriate individuals, which may include the client’s employer, the insurer or the Department of Labor and Industry.       

 

There are some situations in which I am legally obligated to take actions, which I believe are necessary to attempt to protect others from harm and I may have to reveal some information about a client’s treatment.

1. If I know or have reason to believe reason a child is being neglected or physically or sexually abused or has been neglected or physically or sexually abused within the preceding three years, the law requires that I file a report immediately with the appropriate government agency, usually the local welfare agency. Once such a report is filed, I may be required to provide additional information.
2. If I have reason to believe that a vulnerable adult is being or has been maltreated or if I have knowledge that a vulnerable adult has sustained a physical injury which is not reasonably explained, the law requires that I file a report immediately with the appropriate government agency, usually an agency designated by the county. Once such a report is filed, I may be required to provide additional information.
3. If I believe that you present a serious and specific threat of physical violence to another, I may be required to disclose information necessary to take protective actions. These actions may include notifying the potential victim, contacting your family or others who can help provide protection, contacting the police, or seeking your hospitalization.

 

If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary.

 

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex, and I am not an attorney. In situations where specific advice is required, formal legal advice may be needed.

      Gregory Irving Mack, Ph.D. is a New York State licensed clinical psychologist and a retired NYPD Detective Specialist and Police Psychologist  with an independent practice in Westchester. He specializes in treating police officers and other public safety personnel utilizing cognitive behavioral therapy. "In my private practice I provide a range of Clinical, Poice & Public Saftey and Forensic Psychological Services."