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Zaku's avatar

What do you know (or think) about a therapist recording and sharing what's said in a session?

Asked by Zaku (30353points) 1 month ago

Where the therapist is typing a record of everything a patient says in a session, and saying they’re going to attach it to their record to be shared with the patient’s health “care team” (other doctors, etc).

(I have though such a thing would be 100% illegal in the USA. No?)

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10 Answers

janbb's avatar

Under HIPPA it should be illegal unless the patient agrees to it; the sharing in particular. I believe they can take notes on what is said.

Hawaii_Jake's avatar

I work in a state healthcare agency and have annual HIPAA training.

If the therapist is part of a treatment team, it is completely legal to share details from therapy sessions with other members of the team. For those individuals being treated by a team, it’s an excellent idea for all records to be viewed by all members of the team.

The important fact must be that these are members of a team. My PCP and my therapist are not part of a team. They are only linked by my patronage. Teams are usually members of the same hospital or other healthcare-providing organization.

This is important, because person’s diagnosed with a Serious Mental Illness (SMI) die 25 years sooner than the average population*. The problem has been that they often lack adequate insurance to obtain good quality medical care. The therapist often knows about physical ailments of the patient, but they are prevented from relaying that information to doctors by HIPAA.

There is a very large movement in mental healthcare to integrate mental health and physical health in clinics that serve persons with SMI. This is being done nationwide and is an excellent thing.

*Statistic taken from The President’s New Freedom Commission on Mental Health from 2003

Zaku's avatar

What if the person isn’t diagnosed with a Serious Mental Illness, and would prefer not to have what they talk about in therapy be shared with other people?

This just happened to someone who had no expectation anything from a therapy session would be shared with anyone.

seawulf575's avatar

If I had a therapist and they were doing this without my consent, I’d probably look to sue them. There are ways you can inadvertently give consent, like being part of the treatment team as was noted before. If I went to a therapist, opening up to him/her, telling them stuff, I would expect it to be kept in confidence.

The obvious exception is that there Duty to Protect laws in many states that say the psychologist/psychiatrist has a duty to report to the appropriate people if he/she believes the patient is a threat to themselves or others. Though, to me, those can be problematic as well. It boils down to opinion and their view of things could cause you all sorts of problems. That would put you in a position of trying to prove your innocence effectively.

Hawaii_Jake's avatar

@Zaku If the person is being treated by a team who all work in the same organization, all notes can be viewed by anyone on the team at any time. If a person is being treated by a private therapist, then nothing gets shared without written consent. The important factor is team. They must be linked within an organization.

I can think of a scenario where a patient might say to a therapist they want to say something but they don’t want it to go in the notes. That will be something for the therapist to consider on a case-by-case basis. If the information is about harm to self or others, the therapist would usually include it in the notes and then inform other team members.

It’s a bit of further information that PHI is very broadly defined by the law. A person’s initials are PHI. A person’s family member’s name is PHI. If I write a patient’s name and phone number on a post-it note, that by itself is not PHI, but if that post-it note is on my desk, it becomes PHI, because I’m a healthcare provider. There are a total of 18 signifiers that are PHI. I don’t have them memorized.

I work in a secure building with 2 security guards at the front door. Further, my office that I have my desk in has another lock on the door, because we view PHI on our computers, and we have to keep people from seeing things over our shoulders. When I leave my desk, I have to lock my computer.

HIPAA is a big deal.

I get phone calls from family members about loved ones weekly. Many will say “my family member is being treated at your clinic”, and then they want information. I’m not even allowed to acknowledge that the person is indeed being treated. I can only say “I can neither confirm nor deny that he/she is being treated here.”

Zaku's avatar

I’m thinking that even before/without HIPAA, talk therapy is about providing a confidential listening space, where the patient can feel entirely free to speak with complete trust that only the person will hear, and that person won’t ever tell what they said, with the possible exception of an immediate serious threat of violence or something along those lines.

Also, that therapy is mainly effective in the space for reflection that it allows the patient – it’s not about providing relevant health information.

At most, I’d think that in a “team” setting, a therapist might ask permission to shape specific things that might seem relevant to other areas of health.

Should I seek therapy for this? Because it seems insane to me that it’d be normalized that someone would go for therapy have to find out by asking, that the therapist was transcribing the whole session to share with a team of non-therapists.

Hawaii_Jake's avatar

haha! No, you don’t need therapy.

It’s important to note that the vast majority of therapy in the US happens with private therapists. They’re not sharing anything from their sessions without written consent.

I bet the percentage of therapists working in larger organizations is very small.

Zaku's avatar

Glad to hear that! :-)

MrGrimm888's avatar

My therapist claims our conversations are not recorded.
He takes notes. So. He types occasionally, during our meetings.
Admittedly. I thought I was going to die, so u didn’t care for a couple years if it was recorded.
Now.
I would be open to discussing recording sessions.
The therapist would lose a patient like me, and like Wulf, I’d likely become litigious.

Forever_Free's avatar

What @Hawaii_Jake said. The field is so specialised now that you have countless medical professionals on your team. My PCP can see notes of treatment with my nutritionist or cardiologist or any other person on my team that provides care. That is because I allowed the sharing.
Private Therapy is a different realm. They are typically not in the mix of the PCP or specialist. They also do not typically audio record the session. They take their notes typically after you leave. They are not shared unless you release them or they are subpoenaed for good cause.

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