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A friend is doing counseling as a domestic violence victim at a domestic violence aid agency. The therapist recently disclosed her information, including what they have talked about in counseling sessions, to other people in the agency. Being confronted, the therapist pointed the finger back and accused her of false things and refused to see her again.

We would like to know if there are laws and regulations applicable in this situation. Are there federal level regulations applicable in this situation? The agency is responding indifferently. We are considering filing a complaint with the state board of psychology. We found several possible names on the state's professional licensing website, but can't be sure which one is the therapist, since the therapist keeps her full name from us.

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We're missing a lot of information that we'd need to offer a full answer. Here are some of the things that will probably drive the analysis:

  • the type of counselor we're talking about;
  • the types of information the counselor disclosed;
  • the reason she disclosed it;
  • the job functions of the people to whom she disclosed it;
  • the reason the client is bothered by the disclosure.

Generally speaking, a mental-health counselor has a fiduciary duty to maintain the confidentiality of patient information, but my understanding is that in most cases, the counselor would be allowed to discuss a case with colleagues for the purposes of advancing the patient's treatment. So discussing the facts of a tough case with a supervisor is not going to be as problematic as idly gossiping about clients with custodial staff.

Beyond the permitted disclosures, there are also situations in which counselors are required to disclose confidential information, including cases where the counselor suspects child or elder abuse or where the counselor believes the client poses a danger to herself or others.

If the disclosure was truly not permitted, then it may be that the client has a claim for breach of fiduciary duty. In Georgia, proving that case requires evidence that:

  1. That the counselor had information relating to the client that she knew or should have known was confidential;
  2. That the counselor communicated the client’s confidential information to third parties;
  3. That the client did not give informed consent to the counselor’s conduct;
  4. That the confidential information was not a matter of general knowledge; and
  5. That the disclosure harmed the client.

As you noted, the client could also file a complaint with the state licensing board. I don't know of any federal laws or regulations that would come into play in the situation you've described.

  • Thank you for the detailed answer. I initially included more details in the question but removed them to avoid making it off-topic. My friend (the client) told the counselor that she is applying for help with food and support from other organizations and she is working with state legal aid on divorce and immigrant status (her status in the U.S. is dependent upon her marriage). Legal aid has suggested she get an evaluation letter from her counselor/psychologist. She simply relayed that to the therapist. The counselor was taken aback and made excuses to not see her for the next appointment. – Eddie Kal Dec 6 '18 at 0:48
  • After repeatedly requesting new appointments in her attempts to get help with her depression and repeatedly being told to wait a little longer for her next session, the client sent an email stating she would like to address her concerns to a supervisor. The counselor shut down communication and had other people tell the client that the client needs legal and other services which the counselor can't provide and that the counselor will not write anything unless subpoenaed by court. The people who talked to my friend apparently knew she was seeking legal/financial help which made her feel ashamed – Eddie Kal Dec 6 '18 at 0:57
  • A key point is that the matter was disclosed to "to other people in the agency" where the professional worked. Usually, confidentiality requirements are implemented at the level of an entire firm or office, rather than an individual. So, usually, a communication to a fellow professional in the agency or to an administrative employee in the agency would not be considered to be a disclosure at all because the information stayed within the bounds of the entity that provided the counseling. Also, I know of no law that says that a therapist is not allowed to discontinue working with someone. – ohwilleke Dec 6 '18 at 9:15
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If any of the information disclosed was Protected Health Information (PHI) under the federal HIPPA law, the disclosures might violate that law. Providers, which would usually include therapists are subject to HIPPA. However, HIPPA has several permitted grounds for disclosures, and this case might well fall under one of them.

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