When an individual client enters into a therapeutic alignment with a Therapist confidentiality is very important. With the Health Insurance Portability and Accountability Act of 1996 (HIPAA) the confidentiality of the client’s health information is protected by law. Whether a client is a minor or an adult their information is confidential. In the case of a minor under the age of eighteen years, parents and guardians can, following the proper protocol, secure access to their child’s information. Although parents have a right to their child’s information, most therapists do their best to help maintain confidentiality even with minors for therapeutic reasons. Be aware that if you are a parent and want to know about your child’s therapy, if you get all the information from your child’s therapist, your child may stop talking to that therapist. If there is not a trusting environment where rapport between client and therapist exists, then therapy may become very difficult or may no longer be therapeutic. Therapists will typically share information with parents when, in their professional judgment, something should be revealed. Whether minor or adult, should the client sign a consent form allowing their information to be shared in any form or verbally with another, then their information can be shared with the person designated. Should the client not want their personal health information shared, they have the right to prevent sharing, except in the case of a minor or in the case of commitment or interdiction. Often times a person, whether minor or adult, begins therapy and wants to maintain confidentiality. Under these pretenses, anyone even calling in to check and see if the person is receiving therapy will be told by staff that they cannot divulge any information in that regard. Mental Health Professionals cannot confirm or deny whether a client is a client or not, to others requesting information, unless there is a signed consent of some kind designating who information can be released to.
With HIPAA laws and the need for responsibility to clients for confidentiality, professionals take seriously what information, if any, is released to others. In the case of a parent or family member helping a loved one find and receive needed therapy the helping person may find themselves left out of the loop and feel like they are treated differently than they would have expected, given the fact that they may have coordinated the therapy for the client in the first place. Often times parents are excluded from knowledge of their child’s health care if they are over eighteen. Parents often become angry about not knowing what is going on with their adult child and even though they ask, they are not told anything.
Any client / patient can sign a consent form for their loved ones to be allowed in on their treatment but that is up to the client/patient. Loved ones and caring others must realize that they can help with supporting the designated client but that their knowledge of what actually takes place in therapy may be off limits to them, depending on the client’s/patient’s wishes. Often times the loved one or caring person that helped the client come in for therapy is excluded from what happens in therapy because the client doesn’t want them to know anything about what goes on. So, therapy is confidential and it is up to the client to share or not. A caveat here, if your loved one is the client and you feel that they are not getting the proper treatment, or that they are doing poorly in some way, that they may be a danger to themselves or others, or that they may be gravely disabled, and you are left out of the loop; then talk to other professionals, consult with your coroner or your attorney, and find out what your rights are as far as making sure that your loved one is being treated properly and professionally and receives the help that they truly need.
If you are a loved one or caring person that has helped the client / patient begin therapy you have helped them to seek the help that they may need. This is a huge help. They may not have sought out the help if it weren’t for you assisting them to do so. Although you may be the one person who the client / patient trusts the most, you may be excluded from knowing what goes on in therapy. When the client is in session and making progress you may become aware of changes in mood, behavior, thinking, speech, their level of anger, or other noticeable changes in the client. As you become aware of positive changes you can make your observations known to the client if they are open to your comments but any comments should be subtle and gentle, allowing the client to slowly warm up to the idea that they are making progress. If you’re not sure what to say then make general statements such as “I hope things are going ok,” or “I’m glad you’re ok,” or don’t say anything at all. Just be yourself around them and don’t focus on “them being in therapy.” Sometimes people begin to change and don’t want to accept that a change was necessary or warranted. No one wants to admit that their behavior wasn’t up to par. You must allow them to become accustomed to the new changes that take place, in their own time, slowly.
Sometimes when a client comes in and therapy begins to help, loved ones begin to question them after sessions and interrogate them. I would discourage this completely and hope that loved ones can respect the privacy of the individual client and allow them to share what they want to share, when they want to share it but not before. When a client feels watched, judged, interrogated, questioned, they tend to be affected by these types of treatments. These things slow the progress in therapy and may even prevent progress. Although loved ones care about the client and only want the best for them, they must understand that the journey that is taking place in therapy is for the client and the client only, for the time being. When the client chooses to share, they will share. So don’t ask the person you care about what is going on in their therapy sessions. Show them support but allow them their privacy because although they know that you know they are going to therapy, they may not like it that you know.