Therapy Confidentiality Agreement Template

As a therapist, maintaining confidentiality is crucial for establishing trust with your clients. One way to ensure you protect their privacy is by using a therapy confidentiality agreement. This is a legally binding document that outlines the terms of confidentiality and serves as a contract between you and your client.

If you don`t already have a confidentiality agreement in place, don`t worry! We`ve got you covered. Below is a template you can use to create your own therapy confidentiality agreement.

Therapy Confidentiality Agreement

This Agreement (“Agreement”) is made and entered into as of the date _____ by and between [therapist’s name] (“Therapist”) and [client’s name] (“Client”).

WHEREAS, the Client desires to seek the professional services of the Therapist in connection with difficulties or issues that they are experiencing, and the Therapist is willing to provide such services.

WHEREAS, the Therapist and the Client desire to establish and maintain a relationship of confidentiality between themselves.

NOW, THEREFORE, in consideration of the mutual promises and covenants contained in this Agreement, the Therapist and the Client agree as follows:

1. Confidentiality

The Therapist agrees to keep confidential the Client`s personal and private information. This includes all verbal, written, or electronic communications, as well as all records and notes related to the therapy sessions. The Therapist is required to maintain confidentiality throughout the course of therapy and also after the termination of therapy.

2. Exceptions to Confidentiality

There are certain circumstances, as required by law, when the Therapist may need to disclose confidential information. These circumstances include:

a. If the Therapist believes that the Client poses a threat of harm to themselves or others.

b. If the Therapist suspects that the Client is involved in child abuse, elder abuse, or neglect.

c. If the Therapist is ordered by a court to disclose information relating to the Client.

3. Limits to Confidentiality

The Client acknowledges that confidentiality cannot be guaranteed in all situations. Should the Client choose to communicate with the Therapist via electronic means, i.e., email, the Client acknowledges that there is a possibility that the communication may be intercepted or read by third parties.

4. Acknowledgments

The Client understands and agrees that they have read and understood the terms of this Agreement. Additionally, the Client understands that this Agreement is intended to establish confidentiality and is not intended to provide legal advice.

5. Termination of Therapy

The Client acknowledges that upon termination of therapy, the confidentiality provisions of this Agreement will continue to apply.

6. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of [state], and any actions related to this Agreement shall be brought in the state or federal courts located in [county], [state].

IN WITNESS WHEREOF, the Therapist and the Client have executed this Agreement as of the date first written above.

Therapist:

[therapist’s name]

Client:

[client’s name]

By signing this Agreement, both the Therapist and the Client acknowledge and agree to the terms of confidentiality outlined above.

In Conclusion

The confidentiality agreement template provided above is just a starting point. You may need to modify it or seek legal counsel to ensure it meets the needs of your practice and clients. However, ensuring confidentiality is paramount to maintaining the trust of your clients, and using a therapy confidentiality agreement is an essential step in protecting your clients` privacy and establishing a professional and ethical practice.