Most people want to know that everything they tell their therapist will be kept strictly confidential. You need to know that there are some things that cannot be kept confidential; if you appear to be a danger to yourself or are threatening to hurt someone else, your therapist is legally required to report this to law enforcement. Similarly, if you talk about a child or dependent adult being abused, whoever is doing the abusing, your therapist must report it to law enforcement or protective services. You can understand that these laws are made to protect people from harming themselves or each other.

There is one other situation that you should think about carefully. If you pay your therapist yourself she will not share your records or any information about you with anyone else. Your rights to confidentiality are protected by state law. However, if you use your health insurance, particularly if you are enrolled in an HMO, she will have to provide regular reports to your insurance company. She may have to tell them more than you want them to know, so that they'll reimburse her. If you don't want information about your problems in the hands of people you don't know, it may be better for you not to go through your insurance company, especially if you are enrolled in an HMO.