What Do Therapists Have To Report?

Therapists are professionals who help individuals to deal with emotional and mental health issues. They use various techniques and methods to assist their clients, with a focus on improving the overall quality of their lives. In their practice, therapists handle sensitive information about their clients, and there are some instances in which they may be required to report this information to third parties. But what exactly do therapists have to report, and when is it necessary to do so?

Confidentiality in Therapy

The cornerstone of therapy is confidentiality. When someone seeks help from a therapist, they expect their personal struggles and issues to be kept confidential. Therapists are not allowed to share any confidential information about their clients without the client’s explicit consent. Confidentiality is essential in building trust between therapists and clients, and it allows clients to open up freely without fear of being judged or having their secrets exposed.

However, confidentiality has limits. In some circumstances, therapists may be required to break confidentiality to protect their clients or others. The situations in which therapists have to disclose confidential information are legally mandated under certain circumstances.

Mandatory Reporting Laws

Therapists are mandated reporters in the United States, which means that they are required by law to report certain information to specific agencies or authorities. These mandatory reporters are also known as “mandated reporters” in legal terms. The most common types of mandatory reporters are doctors, nurses, teachers, and social workers, and other professionals who interact with vulnerable populations, such as children and the elderly.

The law dictates that therapists must report any suspected cases of child abuse or neglect, as well as cases of elder abuse or neglect. They also have to report if they have reason to believe that a client poses a serious threat to themselves or others, and if they have knowledge that a client has been involved in criminal activity. Failure to report mandated reporting obligations may result in legal repercussions, such as fines, loss of license or imprisonment in some cases.

Therapists and the Duty to Warn

In addition to mandatory reporting laws, some therapists have a “duty to warn or protect” that is based on their professional code of ethics. The duty to warn applies when a client presents a serious danger to others in the community or has made specific threats of harm, such as suicide or homicide. In this case, the therapist has a responsibility to warn the intended victim or take reasonable steps to ensure their safety.

The duty to warn is a controversial topic because it isn’t always clear when the duty applies. In some cases, if the therapist informs the client of the need to report a specific risk, then the client can take steps to avoid harming themselves or others. However, if the client refuses to cooperate, the therapist may need to report the risk to authorities to prevent harm.

Exceptions to Confidentiality

Therapists may need to breach confidentiality when it is necessary to provide adequate treatment to their clients. For example, therapists may need to collaborate with other healthcare providers, such as psychiatrists or primary care physicians, to ensure that their clients receive proper care. In these cases, therapists may share information with other providers to ensure coordination of care.

Another example of when confidentiality may be breached is during court proceedings. If a therapist’s client is involved in a legal case, the therapist may be asked to provide testimony or other evidence. In these cases, therapists are bound to produce the requested information to the court, and they may not have the option to refuse or request excusal from providing such evidence.


Therapists have to contend with difficult ethical issues regarding confidentiality and mandatory reporting laws. They work to balance the client’s need for privacy with the public interest in ensuring the safety of vulnerable populations. While the laws and ethical codes regarding confidentiality and mandatory reporting are complex and require careful consideration, these rules are in place to protect the clients and the community as a whole.

It is essential to understand the potential limitations and exceptions to confidentiality in therapy. Therapists are required by law to report certain situations, and they have a professional duty to protect their clients and others from harm. Whenever in doubt, therapists should consult a supervisor, professional organizations, or legal professionals to ensure they are fulfilling their responsibilities under the law.


FAQ 1: What are therapists required by law to report?

Therapists are legally required to report any suspected child abuse and neglect as well as any threats of harm to self or others. They are also expected to report if a patient has disclosed any criminal activity, including domestic violence or drug dealing.

FAQ 2: Is everything I say to my therapist confidential?

Therapists are bound by strict confidentiality rules, and everything said between a therapist and their patient is considered private. However, there are legal exceptions to this rule, such as in cases where the patient poses a threat to themselves or others, or if child abuse or neglect is suspected.

FAQ 3: What happens if my therapist reports me?

If a therapist reports suspected child abuse or neglect or threats of harm to self or others, authorities may investigate and intervene to protect those in danger. If a therapist reports suspected criminal activity, it is up to law enforcement to determine the appropriate course of action. It’s important to remember that therapists report these concerns in order to ensure the safety and well-being of those involved.


1. American Psychological Association. (2017). Record keeping guidelines. https://www.apa.org/practice/guidelines/record-keeping.

2. Koocher, G. P., & Keith-Spiegel, P. C. (2016). Ethics in psychology and the mental health professions: Professional standards and cases. Oxford University Press.

3. National Association of Social Workers. (2017). NASW code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English.