Is Online Therapy Confidential? What You Need to Know
It’s natural to wonder how confidentiality works in therapy. With the added component of technology, many people have concerns about confidentiality with virtual therapy. Let’s start by answering the question succintly. Yes, online therapy is confidential, much like in-person therapy. Confidentiality has limits, and technology can introduce additional privacy considerations.
Our hope is this article answers all of your questions. If you find yourself wanting further clarification, please reach out to us. We’ll cover how confidentiality works in therapy, what is protected, the cases in which a therapist can break confidentiality, and how to make sure you are protected during online therapy sessions.
Is Online Therapy as Confidential as In-Person Therapy?
This is something many people ask in online therapy. A therapist’s duty to protect confidentiality does not change because sessions are online. Your online therapist will have the same guidelines as an in-person therapist. Protecting confidentiality may look different because of the technology, but the same rules apply to both in-person and online therapy sessions.
The biggest difference in confidentiality in online therapy actually doesn’t come from the therapist’s side. It is more common to have the person seeking therapy have someone enter the room, within hearing distance, or otherwise able to know they’re in therapy. We will cover this more at the end of this post.
What Information is Confidential in Online Therapy?
Much like in-person therapy, you have certain protections in seeking online therapy. We’ll cover in the next section when a therapist can break confidentiality. The information that is generally protected includes:
Your identity - A therapist cannot confirm they know you, that you’re a client, or provide any details that identify you as a client.
What you say - Your discussions with your therapist about relationships, emotions, mental health, personal experience, etc.
Your therapy records - All of your clinical notes and therapy records are subject to privacy and confidentiality requirements.
Your personal information - Any details such as contact information, intake forms, and health records are protected.
When Can a Therapist Break Confidentiality?
It’s important to understand a therapist can break confidentiality and may even be required to in some cases. Any person seeking therapy, whether it is in-person or online, should understand these points thoroughly.
Serious Risk of Harm
If your therapist feels that you are at risk of harming yourself or someone else, they may be required to report it to the appropriate authorities. This depends on the jurisdiction. To be clear, this generally doesn’t mean minor harm, but serious injury or abuse.
Concerns of Abuse or Neglect
In California, therapists are legally required to report abuse and neglect. This is especially true when it comes to certain populations, such as children and the elderly.
Legally-Required Disclosure
In some cases, a court may order a therapist to report something. This doesn’t mean every request from a court or outside party must be granted. But some, such as subpoenas, may require your therapist to break confidentiality.
With Your Permission
Finally, you may sign an ROI (Release of Information) for specific individuals or professionals. For example, you may sign a limited ROI to allow your therapist to let your parents know whether or not you attended a session. Or you may sign an ROI to allow your therapist to communicate with your psychiatrist. These are up to you, and only when you decide it is okay to share information.
How to Protect Your Privacy in Online Therapy
If privacy is a concern, the first thing you should do is ask your online therapist about the steps they are taking to ensure confidentiality. Make sure they are using secure meeting rooms, email clients, and record-keeping software. As the client, there are a few things you can do to ensure privacy in online therapy. These are things you can do to prepare for your first online therapy sessions and be ready to protect your privacy.
Find a private space - This is perhaps the most important piece of protecting your privacy during online therapy. For your session try to find a private space where nobody can hear you, will walk in on you during session, or know what you are doing.
Use wired headphones - Use headphones instead of your computer or phone audio. This keeps the conversation private to you. Furthermore, wired headphones have much less risk of interception or accidental connection with another bluetooth device like a nearby speaker.
Use a personal device - If you have a personal computer or phone, this will be your best choice for privacy. Using a public, shared, or workplace device may leave signs that you were in a therapy session.
Secure your devices - On this note, secure your devices with passwords. This ensures your browsing history, messages, emails, etc. remain private to those that have the password.
Use a private connection - Like using a shared computer, using a shared network can leave you potentially exposed. This is only generally a risk if someone is actively trying to hack into your device, but worth noting. We recommend using password-protected internet that isn’t shared, or your private mobile data. You also may consider using a VPN for additional security if you wish.
Turn off any nearby devices - You might consider doing your session away from smart devices. You also can shut them off. Many are recording constantly, and the therapist can not control confidentiality when it comes to those devices sharing data.
Let others know you’re unavailable - When going into your online therapy session, let others around you know you will be completely unavailable. This helps prevent people from walking in or interrupting.
