One hallmark of psychotherapy in our culture is the presumption of client confidentiality. It is an important part of the therapeutic relationship that the therapist will maintain to the utmost the privacy of any therapeutic communication.

In addition to professional ethics, the laws of the State of Michigan protect this.

We keep a written record of treatment and conditions, this r ecord itself considered confidential in accord with the laws of the State of Michigan regulating privileged communication, except when:

  - legal constraints apply

  - when a compelling need arises based on substantial probability of personal harm to the client(s) or others, or in cases of a life-threatening emergency,

  - when an insurance carrier asks to review the records to verify the services billed to it have been rendered, and/or

  - when the client has signed an appropriate form for the release of information.

We are very careful about the storage and protection of our client files. And it is also our policy that files in which there has been no client activity for a period of ten years, may be removed and safely destroyed.

A note about Insurance and confidentiality

When you wish us to submit a claim for payment to an insurance company, or any other third party payee, you will be asked to sign a release of information form that allows us to share with them certain information about you. This information generally consists of a diagnosis and a record of service dates and settings. In some cases, progress notes and evaluatory information is also requested. We are aware that at a practical level, this shared information cannot be considered as absolutely confidential. So you need to be aware that there is some risk involved, though generally minor.

For this reason, we have had clients who opt not to be involved in the use of their insurance benefits, so that the confidentiality of the client/therapist relationship is more absolute. You can be assured that we take this matter with utmost seriousness.

A note about confidentiality with Minor clients

When a client is of minor age, that is (in Michigan) under the age of 18 years, therapy can only be undertaken with the written consent of a legal parent or guardian. The parent or guardian also has a right to confidential information about the minor client.

As a matter of policy and practice, we inform a minor client that "we will not keep secrets" between him or her and their legal parent or guardian. However, we will tell the minor client that before we reveal significant confidential-type information, we will inform the minor client ahead of time (if possible). With many of our minor clients, it is very important that much of what they share with us is considered "private" - which is much of the value of "being in therapy." However this "privacy" is not an absolute right, and we use our discretion as to what is appropriate and useful to share with the legal parent or guardian.

William K. McDonald

Jane E. Kimball

ed, March 22, 2007