Confidentiality and Disclosures

Confidentiality

The purpose of confidentiality in psychological counseling and psychotherapy is to encourage you to discuss the problems you are experiencing in a candid manner—not to withhold information out of a concern that it might prove embarrassing or detrimental to you.

Safeguarding the information you share in the context of the psychotherapist-patient relationship is an ethical and legal responsibility in the State of California.

Vaden’s Notice of Privacy Practices describes how CAPS strictly protects the confidentiality of information disclosed during sessions, consistent with applicable legal requirements. The following information summarizes CAPS practices regarding the legal and ethical aspects of confidentiality and the sharing of information. It is not intended as a summary of actual federal and state laws.

Release of Information

Information about you, including your use of the service, can only be released to anyone outside of Vaden as required or permitted by law as described below and in Vaden’s Notice of Privacy Practices or with your written permission. If you request that your chart be forwarded to another provider, you will be asked to sign a release of records. There is a fee associated with this service. You may also authorize contact between CAPS and outside persons by signing a release of information. You may revoke your authorization for release of information at any time by giving us written notice.

Limits of Confidentiality

There are exceptions to the confidentiality of therapist-patient information set by federal and state law, including but not limited to

• If you tell your therapist you were abused as a child, and you are under 18 years of age at the time you tell your therapist, the therapist must report the abuse to Child Protective Services. If you are over 18 when you tell the therapist and there is a child at risk by the same abuser, then the therapist may be required to make a report.
• If you tell your therapist about being sexually assaulted, the therapist is not required to make a report unless you are under age 18 at the time you tell the therapist.
• If you tell your therapist about abuse of an elder person or dependent adult, the therapist may be required to make a report.
• If your therapist becomes aware that you intend to cause imminent, life-threatening harm to yourself, the therapist is legally obligated to take whatever actions seem necessary to protect you from harm.
• If your therapist becomes aware that you intend to do imminent bodily harm to a person(s), the law requires your therapist inform the authorities and intended victim(s), and take additional action if necessary.
• When a court of law orders a therapist to release information, that person is bound by law to comply.
• In the event of a psychiatric admission to Stanford University Medical Center or a visit to the emergency room at Stanford Hospital for psychiatric care, Protected Health Information may be exchanged between providers to facilitate the continuity of care.

There are several professions in which you may be required to answer questions about your mental health during the application process. For example, during the application process for the California State Bar exam, you are required to answer “yes” or “no” to the following question: “Have you been diagnosed or treated for a medically recognized mental illness, disease, or disorder or for a chemical dependency that would currently interfere with your ability to practice law?” If you have concerns about this, please discuss this with your therapist at the first session.

Written/Electronic Records

Information in the form of chart notes from your sessions is recorded at CAPS in an electronic record and appointment scheduling system. The CAPS record is kept for 10 years as required by law. CAPS maintains strict security measures to protect this information, including physical safeguards, encryption, and password protection. Non-mental health clinicians at Vaden will have limited access to information about your visits to CAPS but will not have access to the content of CAPS notes without your consent. CAPS and Medical Services staff believe in an integrated care model, and we may share some mental health information with other Vaden clinicians on a need-to-know basis to facilitate your treatment or for referrals or consultations. For further details, please discuss this with your treatment provider.

Your right to access and obtain a copy of your CAPS records is described in Vaden’s Notice of Privacy Practices. CAPS has a separate form on which you can make a request for access or a copy.

Secure Messaging

CAPS is aware that communications by regular email may not remain confidential. Vaden has a secure messaging system, VadenPatient, where students and their providers can exchange information in a secure manner. CAPS staff will use secure messaging for matters related to appointments or other administrative issues. CAPS therapists will not use any electronic means for personal counseling. Secure message exchanges are also considered part of your medical record and may be accessed by Vaden clinicians involved in your care when considered appropriate.

You Determine What Is Disclosed

If you decide that you want to authorize CAPS to disclose information contained in your record, you can determine what information is disclosed. You can

• Designate to whom the disclosure is to be made
• Specify the purpose or need
• Expressly limit what information you authorize released
• Revoke the authorization at any time
• Indicate when the authorization expires

Common Reasons for Disclosure

Additional testing or treatment by another professional outside CAPS—For example, for specialized psychological testing a CAPS therapist will need to talk to someone or write a brief summary about what is hoped to be achieved by the testing.

To support academic accommodations—You may want to authorize disclosure if you are requesting academic accommodations from the university due to psychological conditions. For example, you may request that your therapist provide certain information contained in your CAPS record to the Stanford Office of Accessible Education. This information typically includes an evaluation, specific diagnosis, historical information, diagnostic interview, and/or psychological assessment, and a rationale for the requested accommodations.