Helping Children, Teens, Adults, Couples, and Families reach their full potential through healing and hope in League City, The Woodlands & Midland Texas
Confidentiality and Informed Consent in Therapy: Why Safety Comes First
Starting therapy can feel intimidating, especially when it comes to sharing personal information. One of the first things we talk about together is confidentiality—the understanding that what you share in session stays private. This privacy is what helps therapy feel safe.
At the same time, it’s also important to know that there are a few specific situations where confidentiality must be broken. That conversation is called informed consent, and while it might feel a little heavy at first, it’s really there to protect you and everyone involved.
What Is Informed Consent?
Informed consent means that before we begin therapy, I explain what you can expect from the process, including your rights as a client and the responsibilities I have as your therapist. This helps us both start on the same page.
When we talk about informed consent, we’ll cover things like:
- What therapy is and how it works
- What you can expect from me as your therapist
- The limits of confidentiality (when I may have to share information)
- The goal is simple: I want you to feel safe, respected, and fully informed about how therapy works so you can decide if it’s the right step for you.
The Limits of Confidentiality
As your therapist, I take confidentiality very seriously. I will not share anything discussed in our sessions, except in a few situations where the law and my ethical responsibility require me to. These limits exist to keep you and others safe.
The main exceptions are:
- Harm to yourself: If you are at serious risk of suicide or self-injury, I may need to take steps to help keep you safe.
- Harm to others: If you threaten to seriously harm another person, I may have to warn them and/or notify authorities.
- Abuse or neglect: I am a mandated reporter of child abuse, elder abuse, or abuse of dependent adults.
- Court orders: In rare legal situations, records may be required by a judge.
These situations don’t come up often, but knowing about them from the beginning means there are no surprises. You can trust that what you share stays private—unless there is a risk of harm.
Why This Matters for You
Informed consent is not just paperwork—it’s a way of building trust between us. When you understand the boundaries of confidentiality, you can:
- Share openly, knowing most of what you say will remain private
- Feel reassured, knowing that my top priority is your safety and wellbeing
- Trust the process, because you know the rules upfront and won’t be caught off guard
- These boundaries aren’t there to punish you or to limit your voice. They exist because therapy is about protecting people—protecting you, and protecting others when necessary.
A Real-Life Case That Changed the Law
The importance of informed consent became especially clear in a well-known case from 1976: Tarasoff v. Regents of the University of California.
In this case, a college student told his therapist that he intended to kill a woman named Tatiana Tarasoff. While police were notified, no one warned Tarasoff herself. Tragically, the threat was carried out.
Because of this case, informed consent now includes this information. You’ll always know that:
- Your information will stay private unless there is a risk of harm
- I am legally and ethically required to act in situations of serious danger
- These guidelines exist to keep people safe and to give therapists clear rules to follow
- This case changed the way all therapists practice, making safety the top priority.
Other Important Cases That Protect You
While Tarasoff is the most famous, there are other cases that shaped how therapists balance privacy and safety:
- Jaffee v. Redmond (1996): The Supreme Court confirmed that therapy conversations are protected by federal law. This means your sessions are confidential in most legal settings, with limited exceptions.
- Ewing v. Goldstein (2004): The courts decided that if a credible threat is reported by a family member or third party, therapists still have a duty to act. This ensures safety even when the warning doesn’t come directly from the client.
- HIPAA Privacy Rule (2003): Federal regulations set strict standards for how health information is protected. You’ll usually see this explained in a HIPAA notice as part of informed consent.
Each of these developments reinforces the same balance: your privacy is protected, and your safety comes first.
Bringing It Back to You
Informed consent is not just a formality—it’s about you having the knowledge and confidence to step into therapy knowing what to expect. You can trust that:
- What you share is treated with care and respect
- Confidentiality is taken seriously
- The few exceptions exist only to keep you and others safe
Therapy is a space for healing, growth, and honesty. Informed consent is one of the ways we create that safe space together. It ensures that we start our work with clarity, openness, and the understanding that your wellbeing is at the center of everything we do.
At Therapy for Families, with offices in League City, The Woodlands, and Midland, Texas, we know that starting therapy is a brave step. That’s why we make sure you understand the process from the beginning, including confidentiality and the ways we keep you safe. Our team of experienced therapists provides care for individuals, couples, teens, and families, offering support for anxiety, ADHD, relationship challenges, grief, trauma, and more. Whether you are seeking counseling for yourself, your child, or your relationship, we are here to provide a safe and supportive space where your privacy and wellbeing are our top priorities.
If you’re ready to begin your journey toward healing and growth, we invite you to reach out to us today.