Therapist violates confidentiality. Any laws applicable?

Question

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.

Answer 1

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.

Answer 2

If any of the information disclosed was Protected Health Information (PHI) under the federal HIPAA law, the disclosures might violate that law. Providers, which would usually include therapists are subject to HIPAA. However, HIPAA has several permitted grounds for disclosures, and this case might well fall under one of them.