Patient Confidentiality

At any time you may question and/or refuse therapeutic or diagnostic procedures or methods or gain whatever information you wish to know about the process and the course of therapy.

I treat the information you share with me with the greatest respect. The confidentiality of our conversations and my records are protected by standards for professional practice established in the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association and by specific Maryland state law governing privilege and confidentiality. In most situations, I can only release information about your treatment to others if you sign a written Authorization form. However, there are some circumstances in which no authorization is required. These circumstances are specified by Federal Law (HIPAA). As you will see below, the Federal requirements are aimed at protecting the rights of patients and psychologists, and in some cases, the community at large. Most of them reflect the legal and ethical responsibility of a psychologist to take action to protect endangered individuals from harm when such a danger exists. Fortunately, such situations are rare. If a crisis of this sort should occur, it is my policy to discuss these matters fully with you before taking any action, unless, in my professional judgment there is a compelling reason not to do so. Confidentiality will be respected in all cases, except as noted below:

  • I may occasionally find it helpful to consult other health and mental health professionals. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are also legally bound to keep the information confidential. Unless you object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all consultations in your Clinical Record.
  • If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the psychologist-patient privilege law. I cannot provide any information without your written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
  • If a government agency is requesting the information for health oversight activities, I may be required to provide it for them.
  • If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself.
  • If disclosures are required by health insurers or it is necessary to collect overdue fees, I may disclose relevant information as specified elsewhere in this Agreement.There are some situations in which I am legally obligated to take actions that I believe are necessary to attempt to protect others from harm. In such situations, it may be necessary to reveal some information about a patient’s treatment. Again, these situations are unusual in my practice.
  • If I have reason to believe that a child or vulnerable adult has been subjected to abuse or neglect, or that a vulnerable adult has been subjected to self-neglect, or exploitation, the law requires that I file a report with the appropriate government agency, usually the local office of the Department of Social Services. Once a report is filed, I may be required to provide additional information.
  • If I know that a patient has a propensity for violence and the patient indicates that s/he has the intention to inflict imminent physical injury upon a specified victim(s), I may be required to take protective actions. These actions may include establishing and undertaking a treatment plan that is calculated to eliminate the possibility that the patient will carry out the threat such as seeking hospitalization of the patient and/or informing the potential victim or the police about the threat.
  • If I believe that there is an imminent risk that a patient will inflict serious physical harm on him/herself, or that immediate disclosure is required to provide for the patient’s emergency health care needs, I may be required to take appropriate protective actions, including initiating hospitalization and/or notifying family members or others who can protect the patient.

Should any of these situations arise, I will make every effort to discuss my concerns fully with you before taking any action. If it becomes necessary to release information about your treatment, I will disclose the minimum amount of information necessary to resolve the issue.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, you may still have questions or concerns about the regulations. Please feel free to raise these with me at any time.

In some less urgent circumstances, it may be my best clinical judgment that the maintenance of confidentiality is counterproductive to your progress in treatment. In this case, I will request your permission to contact family members or significant other individuals. Of course, I will inform you of my concerns and outline the basis of my clinical judgment. You will have the final decision as to whether I may contact these individuals, and if you agree to the contact you will be asked to sign an Authorization Form.

If I think that it would be helpful to refer you to another professional for consultation (e.g., for medication) then I will discuss your case with the professional with your authorization.

If you use third party reimbursement, I am required to provide the insurer with a clinical diagnosis and sometimes a treatment plan or summary.