does what we talk about in therapy remain confidential?

Confidentiality is one of the most important components of therapy. Successful therapy requires a high degree of trust between a therapist and a client, considering the highly sensitive subject matter. Every therapist must, by law, provide you with a written copy of a Health Insurance Portability and Accountability Act of 1996 (HIPAA) Statement, which explains that what you discuss in session will not be shared with anyone outside that room (with exceptions, listed below).

Sometimes, however, you may want your therapist to share information with someone on your healthcare team (for example, your physician, naturopath, or attorney), but by law your therapist cannot release this information without your written permission.

State law and professional ethics require therapists to maintain confidentiality except in the following situations:

• If you are using insurance to pay for therapy, your insurance carrier will request the dates of your visits and your diagnosis. Insurance companies gather this information in order to determine that therapy is medically necessary and to arrange payment. 
• A therapist must report to the appropriate authorities, including law enforcement and child protection agencies, if s/he suspects past or present abuse or neglect of children, adults, or elders based on information provided by the client or collateral sources.
• A therapist must report to law enforcement and/or medical providers If s/he has reason to suspect a client is seriously in danger of harming himself or herself or has threatened to harm another person.