Rehab often requires being open about the parts of our lives we would prefer to avoid. Fortunately, confidentiality allows us to do this with dignity and privacy.
Shame About Substance Use
Many people arrive at treatment frightened about the emotional, financial, and legal consequences of their use. Most of us are still experiencing profound shame around using. Some are outright traumatized.
Therapy is an essential component of recovery. However, therapists can only be effective for the problems they know about. Let’s talk about how confidentiality improves your care.
What Is Patient Confidentiality?
Healthcare facilities, including accredited treatment centers, are legally obligated to preserve confidentiality around your private health information. In fact, a professional who breaches confidentiality can lose their credentials.
The set of laws governing health privacy known as HIPAA were created to protect patient rights.
Who Is Required to Respect Confidentiality?
Because the law is abundantly clear, you control who knows your private healthcare information beyond your therapy room. Your counselors, like attorneys, clerics, and doctors, are professionally required to respect your autonomy. To be compliant with the law, they must take appropriate measures to protect your treatment records from others.
Peers do not hold the same obligation. This means that you can decide when to share your healthcare information with others, including information about your recovery. For example, you may choose to trust only your recovery team with certain intimate details of your recovery story. While sharing in group therapy is useful, a reputable center endeavors to keep sessions in-house. Group members may later talk about group therapy content but are asked not to.
By contrast, your professionals may not even be permitted to acknowledge you on a city street. You need not fear that your therapist will tell anyone about your substance use. This is true even if you committed drug-related crimes during addiction. Their job is to treat the disease of addiction, not police the past.
Are There Exceptions to Confidentiality?
Confidentiality is not without its limits. In some situations, a therapist may disclose information with or without your consent.
Therapists are mandatory reporters. This means they can breach confidentiality in certain circumstances. While mandatory reporting laws vary from state to state, the Federal Children’s Bureau sets the standards of what must be reported nationwide.
The following are extreme but common scenarios your credentialed counselors must report, even if they learned the information in a therapy session.
#1. Abuse of Vulnerable People
This includes abuse of a child or an elderly or disabled person. Caregiver abuse is frighteningly common with these vulnerable populations. Whether the patient is a victim or witness of the acts, a therapist may disclose this information to appropriate authorities. State child welfare agencies, adult protective and elder services, and law enforcement may respond.
In most places, ongoing abuse is a must-report situation. You are still free to discuss drugs or alcohol, including mistakes like drinking in front of children, in treatment. Indeed, your professionals want you to open up to help you avoid these issues moving forward. After all, if you are a parent, your recovery will be impacted by the stress of parenthood.
When in doubt, ask before disclosing.
#2. Imminent Harm
Therapists can also break confidentiality in cases of threats of (or steps toward) imminent harm.
While emotional thoughts such as “I want to kill him after his betrayal“ are idiomatic expressions rarely reported, actual threats must be. The practitioner must use their discretion and knowledge of the patient to assess whether that patient is likely to cause harm to another person. If a person has a clear plan, such as “I am leaving to beat Jack with a baseball bat,” the therapist must act. That is an emergent situation where anyone with the means can cause harm.
An imminent threat means a plan that can materialize soon. For example, “I paid Mr. Black to shoot my mother by noon tomorrow for sending me to rehab.” If you provide concrete evidence or the therapist believes you, they‘re obligated to take action.
Even if statements made are untrue or a result of mental illness, this practice of mandated reporting protects the other person.
Threats of imminent harm can include self-harm or suicidal ideation. Preventing suicide is the primary goal.
#3. Permission from the Patient
A patient can also voluntarily waive confidentiality. Typically, to do so, the patient must be lucid and sign a form known as a “Release of Information” (ROI). Total confidentiality is presumed without this document. Even your other medical practitioners need an ROI to communicate with a treatment center.
In some instances, a patient may want to allow family or other loved ones to view certain information. After all, in treatment, many of us need our support structures to be involved with our care. While some subjects in recovery may not feel comfortable to share, you may specify what can and cannot be released. For example, you may decide you want your family to see clean drug tests, but not treatment notes or HIV status. It’s up to you to determine healthy boundaries for your relationships.
Confidentiality at Dream Recovery
Dream Recovery is a multi-accredited treatment center, where total confidentiality is the standard. Our inpatient clients can trust that our therapists are allies. Breaking confidentiality would cost them their careers, possibly permanently.
Many who have suffered from chemical dependency still feel profound stigma around discussing the details of using. But we must have these discussions openly to understand and heal. The purpose of preserving your patient rights is to allow space for a productive therapeutic relationship.
Trusting your treatment team will obey confidentiality allows you to freely address even your darkest issues. We are all as sick as our secrets. Exploring them in the light and safety of rehab is objectively the most private, direct path to help.
At Dream Recovery, we take matters of patient confidentiality extremely seriously. We believe that honesty is a crucial part of the recovery process and keep all client affairs private. We want you to feel safe knowing you can share embarrassing or sensitive information during recovery. Secrecy makes anyone sick, with or without substances. The professionals at Dream Recovery are here to assist you at every level or recovery, whether you need inpatient, outpatient, or MAT care. We strive to provide you with the solid foundation you need to build the skills for long-term recovery. If you or a loved one need help, don’t wait. Contact our team of experts with any questions you may have at (657) 216-7218 today.