This information covers some of the questions that occasionally arise during the course of psychological treatment. It is helpful to have information at the beginning about some of the expectations that govern the practice of psychology both psychologically and legally. Some of the situations described arise very infrequently. I am also available to discuss questions as they arise at any point during our work together.
Individual sessions are 50 minutes; sessions with a couple or families may be longer, 1 ½ - 2 hours. A session scheduled for 1 ½ hours is actually 80 minutes, and a two-hour session is actually 110 minutes. Sessions are scheduled at regular intervals, usually once or twice per week, and occasionally less frequently.
Psychological treatment is confidential and what we talk about may not be revealed to anyone without your written permission. There are a few exceptions to this strict confidentiality.
When insurance companies cover costs of therapy they usually require additional information such as a diagnosis, timing and dates of sessions. I would want to discuss this with you prior to providing that information to them.
Parents or guardians of a child generally hold the privilege of confidentiality, and with a few exceptions are entitled to information communicated in the treatment with their children. However, ethics require psychologists to use their best judgment to communicate such information in ways that are helpful. Special circumstances pertain when parents are divorcing and in dispute about their children. Neither parent then clearly holds the privilege for the child or children, and if a dispute arises about the confidentiality of the therapy, it might need to be resolved by a judge instead.
Couple and family therapy occasionally raises minor concerns about confidential information being shared with family members after information has been communicated to the therapist in private. Absolute rules of confidentiality are difficult to apply in advance in family situations. In general, it should be assumed that information communicated to the therapist in private will be shared or withheld from other participating members at the discretion of the therapist. Again, ethics require that the therapist use his or her best judgment so that such information is shared or not shared in ways that are helpful to the family.
For adults and adolescents and children in psychotherapy, everything said in the context of psychotherapy is confidential, except the following situations in which I am legally required not to keep confidential, information that I have received.
If I have reason to believe that a child under the age of 18 is suffering serious emotional or physical injury as the result of child abuse or neglect I am required by law to file a report with the appropriate governmental agency.
I must also file a report if I learn that an elderly person is suffering physical abuse.
If I believe you are threatening immediate harm to yourself or another person I am obligated to take some action to protect you or that person. Any action taken under these provisions will be discussed with you fully and in advance whenever possible.
Mary A. Duryee, Ph.D. 2014 San Francisco Bay Area Psychologist and Mediator PSY 7975