When a therapist breaches confidentiality – top 6 instances

Nobody wants their innermost secrets to be accessible to the world, particularly when they are divulged in therapy. As a result, therapists are legally required to safeguard their clients' information. However, there are occasions in which therapist confidentiality may be breached, as stipulated by the norms of a certain organization or the state legislation of a specific territory. As a therapist who desires to expand his practice within the bounds of the law and ethics, it is essential to grasp the boundaries of therapist confidentiality.

This article explores client-patient confidentiality and the limitations of secrecy in therapy.

What does client-patient confidentiality mean?

Client-patient confidentiality ensures that information given during therapy is not disclosed to any third party without the client's prior consent. According to the common law duty of confidence, a person who obtained information from another individual in confidence is obligated not to use or disclose the information to any third party without the prior consent of the person who gave the information. Confidentiality is the core pillar upon which therapy is conducted. In that it helps psychotherapists and counselors to provide necessary care for their clients effectively. Every therapist is under an ethical and legal duty of care to protect the privacy of their clients. However, this duty of care is not absolute. As a result, there are circumstances upon which a therapist is under a legal and ethical duty to deviate from the principle of therapist confidentiality. Of course, breaching confidentiality without a good course will open the floodgates of legal suits, and you certainly wouldn't want that!

Then, when can a therapist break confidentiality, or what are the limits of confidentiality? Let's find out.

Boost therapist-patient confidentiality with secure Workee video calls

When can a therapist break confidentiality?

Although patient-client confidentiality is an integral part of therapy and counseling, there are a couple of limits to confidentiality governed by different state laws. Below are the core limits of confidentiality in counseling:

Domestic violence and child neglect

Regardless of the provisions of various state laws surrounding when to breach confidentiality, this point transcends all state laws. A therapist must report child abuse and neglect if they suspect that a child's (a child under 18) caregiver is abusing or neglecting the child during therapy. Such incidents must be reported to a child protection agency. Here, a therapist is not required to wait for proof of the alleged abuse or neglect. If the therapist suspects that a child is in danger, they should immediately notify the appropriate authorities, as delay can be risky. However, notifying the child's parents is important even if they are responsible for the alleged abuse.

Violence and neglect of elderly and disabled persons

Just like with the case of abuse and neglect against children, most state laws have provisions that protect elderly and disabled persons from abuse and neglect from their caregivers. Im most jurisdictions, therapists who fail to report information or suspicion of abuse against elderly and disabled persons are guilty and may be charged with a class B misdemeanor.

Threat to self

The position of the law on breaking confidentiality concerning threats of self-harm is dicey. Only a few states have laws that mandate breaking confidentiality when clients have threatened to inflict harm on themselves. In other jurisdictions, it is more a choice for the therapist. There are certain variables to consider before a therapist can violate confidentiality. 

For instance, in counseling, you discover that your client has suicidal thoughts. Do you break confidentiality in this case? Absolutely no! What if you discover that your client has been cutting himself occasionally without any intention to harm himself grievously? Will that be sufficient enough to validate breaking confidentiality? That is quite unlikely. The right question then is what do therapists have to report?

Therapist-client privilege can be revoked in the following situations:

  • If a client is showing suicidal behaviors

  • If a client has expressed not just the intent to harm himself but has formulated a detailed or specific plan on how to bring hurt to self

  • If the client has begun inflicting grievous bodily harm on himself.

If any of the above scenarios is playing out with your client, you are obligated to exercise your duty to protect by reporting to the appropriate quarters.

Boost therapist-patient confidentiality with secure Workee video calls

Threats to others

According to state laws, therapists or counselors are mandated to break confidentiality when their clients make a direct and legitimate threat to cause harm to a specific person. However, the therapist is not mandated to report to the authorities if the threats made were in general and not towards a specific person. For example, suppose a client during therapy reveals the intention to cause harm to a specific person. In that case, the therapist is mandated under the duty to protect to break counseling confidentiality and alert the potential victim or respective authority. On the flip side, if the threat was made to a general class of people without any specific person in mind, the therapist can exercise his discretion to break therapist confidentiality by alerting the local law enforcement agent.

Court injunctions

One of the major limits to confidentiality in therapy is court injunctions. While a therapist can choose to protect his client's privacy by fighting off subpoenas from lawyers in certain circumstances, it may be futile if the judge orders the subpoena. As a therapist, you stand the risk of serving jail terms if you disobey an order of the judge to provide clients with confidential information during a court proceeding.

Professional misconduct

Professionals may break confidentiality when they discover the misconduct of assisting professionals with their clients. According to the State of Florida law, therapists are mandated to report certain misconduct by any health care professional. For instance, if your client confides in you or you discover that their psychiatrist is indulging in sex with them. You are mandated to report such misconduct to the relevant licensing authorities.

Boost therapist-patient confidentiality with secure Workee video calls

How to use Workee to scale your therapy business

In a digital-centric world, offering therapy care need not be done only physically. While it is a good way to start, it limits your scope of reach. With advances in technology, you can reach more clients and even see your patients online. To achieve this, you need Workee. Workee is an all-in-one client management platform optimized to help you scale your therapy business by helping you reach more clients and even work more efficiently. Below are some of the ways Workee can help you  manage and grow as a therapist:

  • Workee helps you build and grow client relations using in-built CRM.

  • It helps you develop a  personal website where clients can directly schedule online video sessions with you. Interestingly, you don't need to code to achieve that, and it also doesn't take much of your time.

  • Workee helps you manage and schedule meetings with your clients, allowing you to attend to more clients. 

  • With Workee, you can manage your tax payment routine without any hassle.

  • Workee makes it easy for your clients to make purchases directly from you. Also, your clients get issued invoices when they pay for services.


It is no secret that confidentiality in therapy is essential to providing proper care. While the law protects and respects therapist-client confidentiality, it is critical to be aware of the situations in which you are required to disclose information held in trust for your clients. Working within the above-mentioned confidentiality limits will assist you in maintaining a healthy relationship with your clients. Nonetheless, it will protect you from a slew of lawsuits.

Ihor, CEO at Workee

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