Yes, you can tell your therapist about illegal things you have done, but it's crucial to understand that there are specific and legally mandated limits to therapist-patient confidentiality. While much of what you share remains private, certain disclosures require a therapist to take action, including reporting to authorities.
Understanding Therapist-Patient Confidentiality
Therapist-patient confidentiality is a cornerstone of effective mental health treatment. It creates a safe and trusting environment where individuals can openly discuss their thoughts, feelings, and experiences without fear of judgment or disclosure. This privacy is generally protected by law and ethical codes.
However, this confidentiality is not absolute. Therapists are bound by legal and ethical obligations to break confidentiality in specific situations where public safety or the well-being of vulnerable individuals is at risk.
Key Exceptions to Confidentiality
While therapists maintain strict confidentiality for most disclosures, including many past illegal acts, there are legally mandated exceptions where they must report information to appropriate authorities. These exceptions are primarily designed to prevent harm and protect vulnerable populations.
A therapist is legally obligated to break confidentiality and report if they believe what you have told them indicates:
- Imminent Harm to Self or Others: If you express a serious intent to harm yourself or another identifiable person, the therapist must take steps to ensure safety. This can involve notifying the potential victim, law enforcement, or initiating involuntary hospitalization.
- Child Abuse or Neglect: If you disclose information about current or past abuse or neglect of a child, the therapist is a mandated reporter and must report this to Child Protective Services (CPS) or law enforcement. This includes situations where you disclose that you have previously abused a child.
- Elder or Dependent Adult Abuse: Similarly, if you disclose current or past abuse or neglect of an elderly person or a disabled/dependent adult, the therapist is often legally required to report it to Adult Protective Services (APS) or law enforcement.
- Specific Criminal Activities: Certain types of severe crimes, particularly those involving exploitation or harm to vulnerable individuals, may also trigger a reporting requirement. For instance, if you disclose that you have intentionally downloaded or viewed child pornography, a therapist is mandated to report this to law enforcement.
- Court Orders: If a court issues a subpoena or order for a therapist's records or testimony, the therapist may be legally compelled to disclose information.
What's Confidential vs. What Must Be Reported
To illustrate the distinction, consider the following:
| Generally Confidential | Must Be Reported |
|---|---|
| Past illegal drug use (not ongoing intent to harm) | Expressed serious intent to commit future harm to an identifiable person (e.g., plans for violence) |
| Past shoplifting or theft | Disclosures indicating intentional download or viewing of child pornography |
| Past financial crimes (e.g., embezzlement, fraud) | Disclosures of current or past abuse/neglect of a child, elderly person, or disabled/dependent adult |
| Thoughts or feelings about illegal acts | Direct threats or plans that indicate serious intent to harm oneself (e.g., specific suicide plan with means), requiring intervention to ensure safety |
| Admissions of past minor offenses with no ongoing threat | Court orders that legally compel the therapist to release information (though therapists often try to limit disclosure to what is absolutely necessary and may advocate for their patient's privacy). |
Why These Exceptions Exist
These exceptions are not designed to punish but to protect. Therapists have a "duty to warn" or "duty to protect" when there is a credible threat of harm. This ethical and legal obligation overrides confidentiality to ensure the safety and well-being of the broader community and vulnerable individuals who may be unable to protect themselves.
Before You Share: Important Considerations
If you are contemplating discussing illegal activities with your therapist, consider these practical insights:
- Discuss Confidentiality Limits Early: At the start of therapy, your therapist should explain their confidentiality policy and its limits. Don't hesitate to ask clarifying questions about specific scenarios.
- Focus on Therapeutic Goals: Therapists are there to help you process emotions, understand behaviors, and develop coping mechanisms. If past illegal actions are contributing to mental health challenges (e.g., guilt, anxiety, trauma), discussing them in the context of your therapeutic goals is often beneficial.
- Be Mindful of Intent: The distinction between past actions and current/future intent to cause harm is critical. Therapists are generally not law enforcement and are focused on your mental health journey. However, if disclosures indicate ongoing dangerous behavior or future harm, they are obligated to act.
- Prioritize Safety: If you or someone else is in immediate danger, seeking help from emergency services or law enforcement directly is always the first priority.
Understanding these boundaries allows for a more informed and productive therapeutic relationship, balancing your need for privacy with the therapist's ethical and legal responsibilities. For more detailed information on confidentiality and ethical guidelines in therapy, you can consult resources from professional organizations like the American Psychological Association (APA).
