Disclosures

Limits of Confidentiality

Verbal and written content of therapy is considered confidential material/information; however, 

there are legal exceptions to this which are as follow: 

• You authorize release of information in writing with your signature (or parent/guardian). 

• You present a physical danger to self: if the client discloses or implies a plan for suicide, 

health care professionals are required to notify legal authorities and make reasonable 

attempts to notify the family of the client.  

• You present a danger to others: health care professionals are mandated by law to inform 

the legal authorities and required to warn the intended victim so that protective 

measures can be taken.  

• Child, or elder/vulnerable-adult  abuse is suspected 

• When a client’s records or other information are sought by Federal law enforcement 

under the USA Patient Act, and where you make your mental or emotional state an issue 

in a legal proceeding. 

* Using your insurance also may forfeit confidentiality should your insurance company request clinical records 

Limits of Confidentiality in Couples and Family Therapy

When the treatment unit (the “patient”) is a couple or family, there might exist a clinical need for 

part of the unit (e.g., an individual member of a couple or siblings) to be seen separately from 

other members of the unit. In such a case each member of the unit understands that the 

therapist does not “hold” secrets from other of the treatment unit. Thus, the therapist may decide 

to disclose, when clinically appropriate and at her discretion, information that has been revealed 

during a session when all members were not present. I have received a copy of the “No 

Secrets” form with a detailed explanation of this policy.  

Minors/Guardianship Confidentiality

Communications between therapists and clients who are minors (under the age of 18) are 

confidential. However, parents and other guardians who provide consent for their child’s 

treatment are often involved in their treatment. Consequently, your therapist, in the exercise of 

his or her professional judgment, may discuss the treatment progress of a minor client with the 

parent or caretaker. Clients who are minors and their parents are urged to discuss any 

questions or concerns that they have on this topic with their therapist. Minors 12 and older who 

meet the requirements set forth in California Family Code Section 6924 shall sign consent to 

release information forms. 

I have read the disclosures above and fully understand the ramifications of each