Confidentiality
A private, confidential therapy experience from beginning to end
Q. How do you maintain confidentiality?
A. Because my practice is not affiliated with any other healthcare organizations or networks, your treatment records never go beyond my door. They won’t become part of your records with any other healthcare provider without your permission.
Records are stored using secure, HIPAA-compliant, HITRUST CSF® certified software accessible only to me. Scheduling, payment, and teletherapy are conducting using the same software. I will not confirm or deny that you are my client or send your records anywhere without your written permission. You’ll have the opportunity to read and discuss my confidentiality policies during intake.
Q. If I disclose X during therapy, will you keep it confidential?
A. Usually, the answer to this question is a resounding “yes.” Many people worry that therapists might be legally obligated to disclose their information. This is very rarely true. Nonetheless, this belief often prevents them from getting the help they need. Here are some situations I’m often asked about:
If you self-harm or have suicidal thoughts, I am not obligated to seek hospitalization for you—and, in fact, this is rarely necessary or desirable. Hospitalization is a last resort if there is an imminent threat to your life.
If you disclose a past crime, major or minor, I’m not obligated to report it. I’m only required to act if there is risk of serious future physical harm to another person.
If you’re an adult and you disclose abuse or neglect you experienced or witnessed as a child, that alone is not reportable. I will only report current, ongoing danger to a minor child or vulnerable adult.
If you disclose that you are attracted to minors (or if you have OCD with obsessive fears of being a pedophile) or have other atypical sexual interests that cause you concern, I do not have to report this information to anyone. I am only required to act if I believe that a specific child is in immediate danger of being harmed.
If you have thoughts of doing harm or violence to others, I am not obligated to report this to authorities. I am only required to report imminent threats to a known person’s safety, and thoughts do not qualify unless you express the immediate ability and unambiguous intent to act on those thoughts—and for what it’s worth, this is basically never true of people with intrusive thoughts of harming others (informational video link opens in new window). Harm and violence obsessions and compulsions are not reportable or concerning in any way. If you struggle with these thoughts, learn more about my OCD treatment strategies here.
I’m not required to report domestic violence between adults that does not involve minors. Your safety and privacy come first.
If you have HIV or any other health condition, I won’t disclose this to your partner, former partners, or anyone else.
Q. Will you tell my spouse, partner, or family I’m in therapy?
A. No. If you are an adult, unless it’s a life-threatening emergency, I will not disclose information about your treatment or the fact that you are my client to anyone without your written permission, including your spouse or other family members. Your emergency contact does not have to be a spouse or family member.
If you are under 18, you have the right to privacy in treatment. My policy is not to disclose information about your treatment to your parents or caregivers against your wishes unless I believe you are in danger.
Q. How does insurance affect confidentiality?
A. You are not required to use your insurance to pay for treatment. If you do use insurance, I’m required to share a small amount of information with your insurance company to process your claim.
Because I’m an out-of-network provider, I provide all clients with a document called a “superbill” for them to submit for insurance reimbursement. A superbill is required to contain a diagnosis code, which tells your insurance why you’re being treated, and a procedure code, which tells your insurance the length and type of session (e.g. individual, family, group) that I provided. I am not obligated to include every one of a client’s past diagnoses on superbills, and I am often able to exclude certain diagnoses at a client’s request.
Occasionally, insurers request that I share more information about a client’s treatment in order to determine whether the treatment is medically necessary, such as treatment notes. Anytime this happens, I will contact you and discuss how you would like me to handle the request.
If you receive health insurance through an employer, your employer cannot access your medical records or information about your insurance claims, such as where you were treated, who treated you, and what you were treated for.
Q. What if someone else is paying for my treatment?
A. If someone else is paying for your treatment, such as a family member, I may provide them with superbills to submit to your insurance. As mentioned above, these documents contain diagnosis and procedure codes. However, the person paying for your sessions will not have access to your treatment notes or other records. I will not speak to them outside of communication needed to receive payment.
If you are on a family insurance plan and you file claims for reimbursement, the other people on your plan will not have access to your treatment records. They may have access to basic information about your claims through your insurance company, which may include provider name, dates of service, length of session, session fees, and diagnosis codes. However, they will not be able to access your session notes or details about anything you might disclose in treatment.
Q. What should I do if I have confidentiality questions before scheduling an intake?
A. Contact me through my online form or call me at (212) 203-7072 if you’d like to discuss my confidentiality policy. You don’t have to give your real name.