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1. How does confidentiality work in therapy?

Seeing a counselor is sort of like being in the witness protection program. Even the fact that the counselor knows you is kept private and confidential. That means that when they run into you out in public, the counselor does not flag you down and say– “Hey! It’s me, your therapist! Remember me from counseling?” (How awkward would that be!?)

Instead, therapists wait for you to initiate “hellos” and are usually glad to say “hi” right back. Counselors don’t ever want to put you in that uncomfortable position where you have to explain how you know them to the people you are with.

As you may have heard, there are some exceptions to confidentiality, especially when safety is at risk.

  • If you talk about children, elderly people, or disabled people that are being abused or neglected, your counselor is considered a mandatory reporter.
  • Your counselor would also break confidentiality if you disclosed plans to harm someone else. Counselors really don’t want anyone to be murdered! (That’s a good thing, right?!)
  • Counselors often see clients with thoughts of suicide. That really doesn’t freak us out. It’s more common than you’d think! When we DO break confidentiality is when that person is losing the ability to keep themselves safe. Because teens are a high risk population when they have thoughts of suicide, it’s common for therapists to seek coordination with family supports whenever risks of harm are involved.
  • Counselors are required to provide you with a copy of their privacy practices where you can read in more detail about how confidentiality works in this unique setting.


2. Why can’t I be Facebook friends with my counselor?

Counselors have to abide by professional standards and ethical guidelines. The 2014 ACA Code of Ethics introduced a requirement asking counselors to separate their professional and personal social media profiles. Those ethical guidelines do not permit counselors to communicate with clients via personal social media accounts. Counseling is unlike other relationships in your life, different from friendships and different from family connections. Part of what makes it effective is that separation and neutrality. Those boundaries help make therapy a safe place to express yourself without worrying about what your therapist is going to think, which can be triggered by social media comparisons. It’s for these reasons that your counselor cannot connect on Facebook or similar platforms.


3. What should I get my counselor for Christmas?

Okay, this was a trick question. Please don’t get your counselor anything for Christmas (or any other special occasion). Our ethical codes discourage counselors from receiving gifts from clients. We see some very generous people come through the door who love to show appreciation and gratitude by gift giving. When counselors decline your gift, know that it is not a personal rejection. It is instead another one of those professional boundaries drawn from the ACA Code of Ethics, which advises counselors to remain mindful of putting the therapeutic relationship first. More than anything, your counselor wants to avoid any situations that may cause a conflict of interest.