Theraverse . May 30, 2025

You’re baring your soul, talking about your ex, your boss, or that thing you swore you would never say out loud. And suddenly, a thought creeps in with apprehensions about whether or not it is safe to share such personal information.

Therapy is designed to be a psychological safe zone, a place where your thoughts, fears, confessions, and contradictions can be aired without judgment or consequences. In short, what you say in the therapy room stays in the therapy room.

Well, for the most part.

While confidentiality is a core pillar of the therapeutic relationship, it’s not an absolute, impenetrable wall. Think of it more like a secure vault, with a few hidden escape hatches for emergencies. Most therapists will go to great lengths to protect your privacy, but there are specific situations, outlined by ethical codes and legal requirements, where breaking confidentiality isn’t just allowed, it’s necessary.

These aren’t loopholes meant to trap you, they’re safety measures designed to protect you and others when harm is at stake. So, whether you’re starting therapy for the first time or are years into your journey, understanding what your therapist can (and can’t) keep confidential is a powerful part of informed consent and of building real, grounded trust.

In India, confidentiality is a fundamental ethical and legal principle, safeguarding the privacy of clients’ mental health information. The Mental Healthcare Act of 2017, specifically Section 23(1), ensures this right. While confidentiality is generally upheld, exceptions exist, such as reporting suspected child abuse or when a client poses an immediate threat to themselves or others.

Here are the most common situations where confidentiality may need to be broken:

1. Risk of Harm to Self or Others

If you tell your therapist, you’re seriously thinking about ending your life, or harming someone else, they’re legally and ethically obligated to act. That might mean doing a risk assessment, contacting emergency services, or notifying a third party. Because your safety matters more than silence.

2. Abuse or Neglect of Vulnerable Populations

Therapists are mandated reporters. If you reveal that a child, elderly person, or dependent adult is being abused or neglected, your therapist may have to report it to the appropriate authorities or help you report. Because those who can’t protect themselves rely on others to speak up.

3. Legal Obligations (e.g., Court Orders)

If a court demands access to your therapy records via subpoena, your therapist may have no legal choice but to comply. That said, many therapists will advocate to release only the minimum necessary information or challenge the request if possible. Because the legal system sometimes intersects with mental health care.

4. Supervision and Professional Consultation

To ensure quality care, therapists often consult with supervisors or peers. But don’t worry they share only what’s necessary and never reveal identifying information.

These exceptions aren’t meant to scare you, they are meant to protect you and others from real danger. An efficient therapist will always try to keep you informed and included in any step they may need to take. And most importantly, these exceptions are rare. For the vast majority of your sessions, your words stay exactly where they belong: in the therapy room.

Myths vs. Facts

Myth 1: “Everything I say in therapy is 100% confidential, no matter what.”
Fact: Almost everything is confidential—but certain safety-related disclosures (harm, abuse, legal mandates) can require a breach. These exceptions are narrow, necessary, and always handled with care.

Myth 2: “If I talk about self-harm or suicidal thoughts, they’ll hospitalize me immediately.”
Fact: Therapists don’t sound the alarm every time you express distress. Many clients talk about suicidal thoughts without needing hospitalization. It’s only when there’s a clear, imminent risk that therapists take further steps. And they’ll usually try to collaborate with you first.

Myth 3: “Therapists talk about their clients with friends and family.”
Fact: Absolutely not. Ethical therapists do not casually share client stories. Even when they seek supervision or support, they remove any identifying details. Confidentiality is not just professional it’s personal for most therapists.

Myth 4: “If I committed a crime in the past, my therapist is required to report it.”
Fact: Generally, no unless it involves ongoing harm to others (especially children or vulnerable people). If it’s a past action with no present danger, therapists are usually not mandated to report it.

Myth 5: “Online therapy isn’t as confidential as in-person therapy.”
Fact: Reputable online therapy platforms and therapists use secure, encrypted platforms that follow privacy standards. Confidentiality is just as much a priority online as it is face-to-face.

In essence, confidentiality, explained early in therapy and upheld throughout, forms the foundation for effective work. It protects client rights, defines clear boundaries, and helps build a secure space for exploration and healing.

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By,

Jensita Grace,

In-house Psychologist, Theraverse

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Resources:

https://counsellingtutor.com/confidentiality-in-counselling/

https://ensorahealth.com/blog/when-you-have-to-break-confidentiality-as-a-therapist/