Risks of Counseling

"Recovery is learning to function in relationships."

Talking with someone to better ourselves may seem harmless. Just the thought of risks may seem ridiculous?! It’s not. Counseling is a different risk than we’re used to encountering. Did you ever:

  • Hear the phrase "If I could only go back." - risk of rearranging your life.
  • Say something in "confidence" you thought would never be used against you, but it was!? - risk of your sessions being reported to authorities or subpoenaed in court.

These are the risks we talk about involved in all counseling branches: counseling, psychiatry, psychology, social work, alternative therapies.

The risk most referred to in counseling is that of "life-change"; our mental and emotional health affects how we act, react, and how other people (especially people who are close to you) act and react to us. Therefore, as we grow, we can upset the delicate balances we have with other people. Our friends and family are used to us behaving in certain ways. Change that, and you risk changing all of your relationships. While a complete overhaul rarely happens, it is best to be forewarned.

Privileged Information: not subject to disclosure in a court of law.

Confidential: entrusted with confidences (medical and psychological records can be subpoenaed).

While your counseling visit is referred to as Confidential Information (next best thing to being privileged), it may be subpoenaed by a court of law for things like child-custody, or criminal cases. Your counseling records in these court cases could help you, but they could also cause a decision against your wishes. Counselors argue that these records should be privileged (not released under any circumstance), like discussions with lawyers, and priests. However, current law still dictates that psychological and medical records can be released with just cause in some court cases.

One camp of counseling professionals disagree with psychological records being held only as confidential information, they believe it is vital to human health to have someone to share deep secrets with without ever having fear of retribution. Another camp of professionals see the personal mental health benefits to privileged information, but believe that when the safety of others is at risk, it is important to release mental health records.

Confidentiality still requires counseling professionals to report three circumstances to authorities (police, state abuse agency, state health board, spouse - to whomever the case concerns):

  1. suspecting child abuse or endangering
  2. elderly abuse
  3. an IMMEDIATE threat to your life or someone else’s life.

It's important not to confuse the above 3 circumstances with general crime and other misconduct under the law. These are the only three circumstances counseling professionals are required to report.

And with very little exception, counselors always tell their clients when such information will be released, and to whom. Counselors, psychologists, psychiatrists (remember, we're talking about all counseling professionals) also give their clients the option to tell authorities themselves. There are a lot of uncertainties both in determining these circumstances and in the methodology of reporting. Making these difficult decisions is a fine skill that counselors are at times, forced to use.

Most state laws require counseling professionals to reveal the three mandatory reporting circumstances (abuse and threat to life) BEFORE they begin therapy, and to have clients sign a release form to this affect. While this risk of confidentiality may be explained clearly, many clients aren’t as aware of how the legal system could subpoena records, or how rearranged our lives can become when we start becoming healthier (changing our interactions with others).

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