The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
However, as you are probably aware, there are several exceptions, such as:
- Suspected child abuse or dependent adult or elder abuse, which I am required by law to report to the appropriate authorities immediately.
- If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
- Because I work with children and adolescents, I often must utilize my clinical judgment in determining the severity of self-harmful behaviors. Sometimes clients are in serious danger but minimize their own behaviors. Sometimes they state that they are safe but I might not come to the same conclusion. It is my clinical responsibility as well as professional duty and obligation to then contact a parent or responsible adult to determine how to proceed.
- In addition, in working with adolescents and children, many unique circumstances could occur. It is clear that there are, unfortunately, a wide range of behaviors which, in my clinical judgment, I might need to either report or call in a responsible adult to help the adolescent manage their own behaviors. I have learned that it is impossible to ask specifically about every potential harmful behavior, because adolescents can be endlessly inventive and evasive. Most of the time, youth and adolescents in danger of serious self-harm are at least partially aware of their dangerous situations. It has been my experience, over 25 years of working with youth, that it is entirely possible to both challenge their sometimes-skewed self-perceptions and nonetheless continue to work constructively with them.
- If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. This would include trying to identify a family member or loved one who might be able to assist that client throughout that day.
- However, if they do not cooperate, I will take further measures that are provided to me by law in order to ensure their safety. In my practice, this occurs rarely and I am most often able to work with the client and his or her family to make an immediate safety plan.