Confidentiality & Security

Your confidentiality, privacy and security are extremely important, and I do everything within my power to protect them. These concepts vary from country to country, so I will briefly explain the standards that I keep.


Confidentiality in health care refers to the obligation of professionals who have access to patient records or communication to hold that information in confidence.* What we talk about stays between us. Not only that, but without your permission I may not reveal even if I know you. If your doctor, family member, or anyone else calls me and asks about you, I will answer neither yes nor no; I will not even say if I know you. I talk to no one about you, not even your existence, without your permission. In the U.S. this tends to be supported by our highest law.

An example is the landmark Jaffee v. Redmond decision where the U.S. Supreme Court upheld a therapist’s refusal to disclose sensitive client information during trial (Beyer, 2000). In writing the majority opinion, Justice Stevens said:

Effective psychotherapy… depends upon an atmosphere of confidence and trust in which the patient is willing to make a frank and complete disclosure…The psychotherapist privilege serves the public interest by facilitating the provision of appropriate treatment for individuals suffering the effects of a mental or emotional problem (Jaffee v. Redmond, 1996, p. 9).*

There are some limited and specific exceptions to confidentiality, and we will talk more about these in our first session to answer any questions you may have. These exceptions are about life and death, and protecting vulnerable individuals from abuse. It is not about crime and punishment.


Privacy refers to how your information is used. I will not, and may not, use any of your information for anything other than your treatment. For example, I will never use your information for research without your knowledge or written agreement. I will never use your information for marketing purposes, nor sell it or give to others for any purpose.


Security refers to how I make sure your information isn’t accidentally or inadvertently released to someone else. Whether your information is in paper or electronic form, I do everything reasonably possible to keep it safe. This includes, for example, having locked file cabinets, encrypted computer and cell phones, encrypted email, video service that does not keep records of our communications, and policies and procedures documenting the steps I have taken, as well as contingency plans.

 Gold Standard — What is HIPAA**?

In the United States, HIPAA is the gold standard, defining best practices for security and privacy in health care, and has legal authority behind it.  It requires that we protect the confidentiality, integrity and availability of protected health information (any information that could be used to identify you, for example, name, date of birth, age, address, phone number, etc).  It is likely to be recognized in any given case as the standard of care, and many parts of the world look to HIPAA when developing their own standards.  There are multiple pieces to establishing and maintaining compliance, especially with technology. According to U.S. law, psychotherapists and other health care providers must establish administrative, technical, and physical safeguards that follow HIPAA/HITECH requirements.

These protections of your confidentiality, privacy and security are not as strong in all countries, but I act as if they were. You and your safety and security are important to me.


* Biomedical and Health Information Sciences, University of Illinois, Chicago, 2014

** HIPPA: Health Insurance Portability and Accountability Act

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