In general, the law protects the confidentiality of all communications. No information is disclosed without written permission from the client.
The exceptions to this law are as follows: If someone is harming you, If you are harming someone else, or If you are harming yourself. In these situations, I am required by law to report it.
Psychotherapy notes are a special form of treatment information:
Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date (45 C.F.R. § 164.501).
Authorization is a special and rigorous form of consent, which must include a description of the information to be disclosed, the identity of the person or class of persons who may disclose the information and to whom it may be disclosed, a description of the purpose of the disclosure, an expiration date for the authorization, and the signature of the person authorizing the disclosure (45 C.F.R. § 164.508(c)). In general, the individual signing the authorization may revoke it at any time, a provider cannot condition treatment on the willingness of an individual to sign an authorization for the release of psychotherapy notes, and an authorization for the release of psychotherapy notes must be a separate and independent document (45 C.F.R. § 164.508(b) and (c)).