Is therapy confidential?

Yes. Everything you share with your therapist is protected by professional ethics, HIPAA, and Virginia state law. Your therapist cannot share your name, your diagnosis, or anything you disclose without your written permission — with a small number of legally defined exceptions. Click the link to learn more.

When can a therapist break confidentiality in Virginia?

Virginia law requires therapists to break confidentiality in specific situations: if a client poses a credible threat to an identifiable person, if a client is in imminent danger of harming themselves, if there is reasonable cause to suspect child abuse or neglect, if a vulnerable adult is being abused or exploited, or if a colleague is practicing while impaired. Courts may also order disclosure in certain legal proceedings. Click the link to learn more.

Does using insurance affect therapy confidentiality?

Yes, to a limited extent. When you use health insurance, we are required to share certain information such as your diagnosis and session dates with your insurer to process claims. Self-pay is an option for clients who want to keep that information private. Click the link to learn more.

Confidentiality and Your Rights as a Client

Confidentiality is one of the foundations of therapy. What you share with your therapist is protected by professional ethics, federal law under HIPAA, and Virginia state law. This page explains what confidentiality means, when it has limits, and what you can expect from us.

As a general rule, your therapist will not share anything about your sessions — your name, your diagnosis, what you have disclosed, or even the fact that you are a client — without your written permission. This applies even when requests come from family members, employers, attorneys, or other providers.

Exceptions to Confidentiality in Virginia

Virginia law defines specific situations where a therapist is required or permitted to share information without your consent. These exceptions are narrow and exist to prevent serious harm. Your therapist will review these with you during your first session.

Threat to an Identifiable Third Party

If you communicate a specific and credible threat of harm toward another person, your therapist has a legal duty to take reasonable steps to protect that person. This may include warning the potential victim, contacting law enforcement, or pursuing voluntary hospitalization. This obligation applies when the threat is serious and directed at someone who can be identified.

Imminent Danger to Yourself

If your therapist believes you are in imminent danger of harming yourself, they may disclose information to emergency services, a family member, or a treatment facility in order to initiate an emergency evaluation. Depending on the circumstances, this could result in an Emergency Custody Order or Temporary Detention Order.

Child Abuse and Neglect

Licensed mental health professionals in Virginia are mandatory reporters. If your therapist has reasonable cause to suspect that a child has been abused or neglected, they are required by law to report this to the Virginia Department of Social Services or to law enforcement. This obligation applies regardless of whether the child is a client or someone you have shared information about.

Abuse of Vulnerable Adults

Virginia law also requires therapists to report known or suspected abuse, neglect, or exploitation of adults who are incapacitated or who reside in licensed care facilities. Reports are made to the local Department of Social Services or Adult Protective Services.

Court Orders and Legal Process

A subpoena from an attorney does not by itself require your therapist to disclose your records or testimony. Your therapist will assert your privilege and notify you whenever possible before responding to legal process. However, a valid court order issued by a judge generally must be complied with.

Judicial Discretion

Virginia courts have discretion to order the disclosure of mental health records in certain proceedings, including custody disputes, criminal cases, and civil litigation where mental health is directly at issue. Even when therapist-client privilege applies, a judge may determine that the need for the information outweighs the privacy interest and issue an order compelling disclosure. Your therapist will work to protect your records in any legal proceeding and will consult with legal counsel when appropriate.

Medical Emergencies

If you experience a medical emergency, your therapist may share relevant health information with emergency responders or medical providers to protect your life or health.

Clinical Supervision and Consultation

Therapists regularly consult with supervisors and colleagues as part of providing good care. Identifying information is protected and minimized during these consultations, and all parties involved are bound by the same confidentiality requirements. This is a standard part of ethical professional practice.

Insurance and Billing

If you use health insurance or an employee assistance program, we are required to share certain information — such as diagnosis codes and session dates — with your insurer to process claims. We will discuss this with you before submitting any claims and can talk through self-pay options if privacy is a concern.

Duty to Report an Impaired Healthcare Professional

Virginia law requires licensed mental health professionals to report a colleague when they have reasonable cause to believe that colleague is practicing while impaired by a physical or mental condition, substance use, or any other factor that poses a risk to patients. Reports are made to the relevant Virginia licensing board. This obligation exists to protect the public and applies even when the information was learned in a professional context.

Your Written Authorization

You may authorize the release of your information to a specific person or organization at any time by signing a Release of Information form. This is always your choice and can be revoked in writing at any time, except where action has already been taken in reliance on it.

A Note on Minors

When the client is under 18, parents or legal guardians generally have the right to access their child’s records under Virginia law. We take the therapeutic needs of younger clients seriously and discuss how confidentiality will work with both the client and their family at the start of treatment. Some exceptions may apply for older adolescents. Please ask your therapist if you have questions about this.

What You Can Count On

We will explain all exceptions to confidentiality during your first session and answer your questions before treatment begins. When a disclosure becomes necessary, we will involve you whenever it is safe to do so, share only the minimum information required, and document what was disclosed and why. We will push back on subpoenas and informal requests for your records that are not legally compelled.

Questions

If you have questions about your privacy rights or how your information is handled, bring them up with your therapist at any time. There is no question too small when it comes to your confidentiality.

This page is for informational purposes only and is not legal advice. Laws and regulations may change. The terms of your care are governed by your signed informed consent documents.