I have been having a few problems with anxiety and my doctor gave me some antidepressents that work great. He also asked that I consult a therapist, just for an initial session. Seeing as my insurance wouldn’t pay for any psychological services, I went to the state agency run thru the county
I live in Chicago (Cook County)
Anyway here is my question.
The person doing the intake told me…
"We will not discuss what we talk about with anyone, with the following exceptions. I may consult other doctors associated with this clinic, and my superiors for your treatment. Also if you tell me anything about wanting to kill/harm yourself, kill/harm others or anything related to child abuse, physical or mental, I am required to report this to the police.
No that’s fine and well he told me cause that doesn’t pertain to me, but I got to thinking, if I DID have problems in that area, all that statement would do is PREVENT me from seeking help.
I had therapy sessions years ago, around 1990 and 1982 and they were with the county government (they have sliding fees) and I never heard those statments before.
Is this a relatively new thing? I mean disclosure of information to the police
A lot of this is the outcome of a case called the Tarasoff case, in which a young girl was murdered by her ex-boyfriend who had told his counselor what he was planning. THe counselor told the police, but after interviewing him, they did not act The counselor was found liable, and at least part of the current duty to warn comes from this precedent. Alot of it is out of general concern for the client, and a lot of it is about the worry about being sued.
I’ve known some counselors to fail to disclose this, either because they forgot or because they didn’t want to damage the therapeutic alliance. Either way, it’s unethical not to inform the client of what can and can’t be disclosed.
If you mention you plan to kill yourself, you will be locked in a psychiatric ward for evaluation for a few days. I know this first-hand even though I knew what was coming and welcomed it.
For the other stuff, you are correct. It is best to keep it to yourself even if you really want help but bad things have happened. There really isn’t much way around that from an outside point of view.
You may be interested to know that the fairly new HIPAA guidelines protect psychiatric session notes as the most protected class and they cannot be used against you or shared even in things like court cases.
The child abuse refers to when a paediatric patient reports it, or an adult says that they might be an abuser. It does not relate to an adult patient disclosing information relating to any abuse they may have suffered as a child. Just to clear that up.
IIRC Catholic priests must disclose if someone states that they intend to kill someone else, but not if they have killed someone else. The sanctity of the confessional does not take precedence over preventing a murder (and from a Catholic standpoint, by alerting the authorities the priest is possibly preventing the victim being sent to hell or purgatory and preventing the murderer from comitting a mortal sin).
Anecdotally, I started therapy in 1997 and these were the guidelines told to me then. I would think in some cases someone who is going to therapy wants to change and wants to resolve feelings of harming themself or others.
As far as Catholic confession, yes, the priest must keep the confession secret, but part of the process is urging the penitent to “come clean” and confess to secular authorities as well.