Teens share concerns about therapy
Q. My parents are sending me to a therapist. My family doctor thinks it would help me with my social anxiety. I’m afraid to go. What if the therapist tells my parents what I say? I don’t want anyone to know what bothers me. Will my friends know? Will my teachers know? I really don’t want anyone to know. – 13-year-old
Q. My coach suggested I see a therapist for my anxiety. I admit I get nervous before games but that’s only because I want to play well. Coach says there’s a difference between what he calls butterflies in my stomach and feeling so scared I have a hard time going up to bat. It’s not that I disagree with him. I would like to feel less anxious. It’s just that I don’t want the rest of the team to know. He told my parents privately, but won’t people find out? – 13-year-old
Mary Jo’s Response: I placed your questions together because they are so similar. You’re both concerned about confidentiality in a therapeutic relationship.
In the United States, the Health Insurance Portability and Accountability Act (HIPAA) is a law that protects patients’ privacy. Mental health professionals (including therapists, psychiatrists, counselors, and more) are subject to HIPAA privacy laws in the same way that other health care providers like physicians are. That means that, in general, a therapist may not share personal information about you or your health records or contact information without permission. If your therapist wants to share your information with another health care provider, your consent must be obtained first.
Confidentiality extends to members of your community, your school, and your friends/team. Your therapist may not share what you discuss during a session with anyone without your consent, including your parents.
In a few situations, mental health professionals are allowed (or even required) to break confidentiality. These rules can vary according to different state laws. Some circumstances where mental health professionals may be required to disclose information may include:
A patient is under a criminal investigation or involved in state-mandated counseling.
The therapist believes a patient is a threat to self or others.
A patient shares information about child abuse.
Dealing with anxiety can make life challenging. I recommend connecting with a therapist you trust and developing a healthy relationship. Seeing a therapist isn’t a reason to be ashamed; indeed, seeing a therapist means you are taking charge of your life and striving to have a better outlook. When I did the graduate work for my master’s in counseling, my first professor said, “Everyone could use a therapist at one time in their life,” and I agree. Mental health is no less important than physical health. If you had a broken leg, you’d seek a medical doctor; you wouldn’t hobble on it!
I hope you both have a very positive therapeutic experience.
Have a question? Send it to Dr. Mary Jo Podgurski’s email podmj@healthyteens.com.