how confidential are therapist visits?

[Olivia]

I attended a professional development workshop a couple years ago. A psychologist there reminded us that whatever is divulged in a visit to a psychiatrist or therapist is available to the entity that helps pay for the visit, ie. employer paid insurance. Does anyone know if that's really true? If my employer pays for part of my health insurance, does that give the employer access to my records at the therapist? Laws may be different from state to state I guess, but he said that's how it is in Texas. Thanks for your help girls, Olivia.

[Clare]

Here in Australia, there are two exceptions to confidentiality.

If a therapist detects a child molester during sessions, they are obligated by Law to report their suspicions. The second is where a Court of Law issues a subpeona for the therapists records' during Court proceedings (but rarely enforced to my knowledge).

Otherwise, whether you pay direct to the therapist or claim on health insurance for the expense, everything remains confidential.

Then again, i'm no legal expert either!

Christine

[Lady Jayne]

In the uk if it's payed for by a company scheme the therapist will produce an in depth report for the company. I believe if you specificaly ask the therapist not to divulge certain info he's obliged to comply however anything that goes in the report can and does get seen by veriouse people within the company. when I was a shop steward/ union rep I often saw things that I thought were of an unnessesarly personal nature while representing someone as did the personnel manager,shift manager ect ect.you have to relay on the proffesionalism of the people involved to be discrete, never a good thing!

[Olivia]

Christine and Jayne, thanks for your replies. I suspect that what you said might be true of Texas as well. Can any of you smart, Texas gals (or just smart gals period, lol) confirm that for a fact? I've considered talking to a therapist recently but was concerned about information getting back to my employer. Any advice on how to handle that? Thanks a bunch, Olivia

[suzym4u]

Olivia, I think the best course of action, being that every state may have it's own laws regarding this situation, would be to read everything in your company's health insurance profile and if you can't find any information there, contact the insurance company itself.

They would have to know if a company they do business with is allowed to request such information.

[Wendy me]

my therepest is just too cool as to let certen things out i totaly trust him after all why would i see him if i did not trust him???

[KewTnCurvy GG]

Well, I am a therapist and that is only partially true. First off, a therapist is obligated to report the following: if you threaten to harm someone else (e.g., you say "I am going to kill my ex-wife."), if the therapist believes you are going to hurt yourself, if you report to the therapist that you have hurt or will hurt a child or vulnerable adult (e.g., "I threw my son down the stairs.") In other words they have a duty to report abuse and to take actions to protect you or others if they believe you will harm someone else. Now that said, a therapist has to use there judgement. This doesn't mean if you say, "sometimes I could just choke my son he pisses me off so" that they are to report it. Again, it is whether what you say gives them sufficient reason to believe that you or someone else is truly in danger. Besides reporting or acting on these issues they do have to report information to your insurance company. HOWEVER, this information is in the form of a coded diagnosis and a coded procedural code. The diagnosis they report would be from what is called the DSM-IV-TR (e.g., Depression, Gender Identity Disorder, etc.) and the procedural code simply tells them what service was performed (e.g., 50 minutes of individual therapy). I think a good thing to always do is to talk to your therapist about what they are reporting. Any GOOD therapist should tell you up front. You have a right to know. Besides you could find out after the fact anyway. A therapist not willing to talk to you about what they are reporting is a therapist to stop seeing immediately. Therapy is about open communication and not just in your direction. Also, an insurance company can ask for additional information; HOWEVER, again, this should be discussed with you. Usually this information is about 'justifying'--in the insurance company's minds--why therapy is needing to continue or to approve a particular service. The bottom line is ASK the therapist up front what they are reporting and when they are asked to report anything additional. Hope this helps!

[Olivia]

Thanks Kew(yes, it does help!) and all you other fine sisters as well. That gives me some food for thought (say, is that fattening too?) and some ideas to mull over. I would really not like for my employer to know ANYTHING about Olivia. That really sucks but I'm afraid it would not be a good thing. I'm not cerain therapy is for me but it's an avenue I'm exploring. Thanks again everyone, I appreciate your help, Olivia.

[Julie]

I know I had to sign release forms for my therapist to talk to anyone, even my union, who paid 90%. But I had to go to the union first to get approval for therapy. They have the same confidentiality requirements. I figured if it got out and that made work an impossible place to be (I know construction workers and it would), I'd just sue them and I wouldn't have to work anymore. So far, no leaks, at least that I know of.

[Olivia]

Yeah Julie, I was a sheetmetal mechanic for 13 years and a house painter for more than 10. That kinda knowledge would be hell on the job site wouldn't it? You're right tho' in that any loose talk just might get a nice settlement in a lawsuit. I couldn't count on that tho', lol. Thanks for your help, O.

[StephanieCD]

This thread has been very enlighting! Great question Olivia :) I was hoping Kew would have answered by the time I found it... phew! I consider this one answered in my book.

I'll remember to discuss that with my therapist... when I get one (soon).

Another question... could a therapist help me find out what's available through my records? Like, what others could find out? I've been in therapy a few times (at least) and a couple of those times I reported gender dysphoria - I'd like to know who can find that out!

Kew?

[KewTnCurvy GG]

Hi Stephanie, well actually a therapist does not and SHOULD NOT have access to your full medical records. And an insurance company should not divulge what has been reported in the past. Like Julie said, you should always have to give written consent for your therapist to talk to anyone. And, your therapist should not be able to access other medical records without you giving written consent as well. HOWEVER, that said, there is a--what I call--little evil entity known as the Medical Records Bureau (http://www.mib.com/). They maintain a collection of your medical records. Now, I'm not an expert on them by any means. My wariness of them comes from the fact that it seems so Orwellian. And let me clarify, when I say "medical records" it does not mean that they have actual notes from your therapist.

[carson]

Hi Stephanie, well actually a therapist does not and SHOULD NOT have access to your full medical records. And an insurance company should not divulge what has been reported in the past. Like Julie said, you should always have to give written consent for your therapist to talk to anyone. And, your therapist should not be able to access other medical records without you giving written consent as well. HOWEVER, that said, there is a--what I call--little evil entity known as the Medical Records Bureau (http://www.mib.com/). They maintain a collection of your medical records. Now, I'm not an expert on them by any means. My wariness of them comes from the fact that it seems so Orwellian. And let me clarify, when I say "medical records" it does not mean that they have actual notes from your therapist.

Thanks Kew!

My therapist is the coolest and I've known him a long time (I'm deeply disturbed) :eek: :D But it's nice to have this additional info. Some of it I have heard and some of it I hadn't.

[Jasmine Marrie]

a therpest cann't develage any info inless you want to hurt you're self our others this is the law in californina and i belive elseware.

[tifftg]

I have been seeing a therapist for a few months. She is wonderful and speicalizes in gender issues. You always have a couple of possibilities. My choice, (fortunate this way), I pay privately so it is a non-issue. At the same time it is possible to discuss some of the issues in a non-specific way, depression or anxiety as opposed to a gender classification. Talk to your therapists directly about the issue, most sincere ones will be helpful.

Hugs,

Tiffany