Most people believe that going to therapy is a process earmarked by privacy. And it is, sort of, if you don’t use your insurance. I have worked in therapy both as a therapist and as a medical biller for a therapy agency, so I know both sides of this fence intimately. When you see your therapist, the therapist, by law, generates an intake, a treatment plan, and notes. They likely also diagnose you with one or more conditions, which may be transient or permanent, depending on the client.

If you use your insurance, this information is all available to the insurance company, and is part of the contract either your therapist or their agency signs when agreeing to be paid by the insurance company. The insurance company can reject payment if they do not have “justification” that your problem is significant enough, which can result in a therapist making an addendum to the note to state you are worse off then you are, or that they require more information about your case; this results in the therapist sending more information from your file (extra copies of notes or additional notes or summaries) stating your problem, when it began, problems with treatment (perhaps you missed an appointment, were late, or did not do a homework assignment), or additional facts about your case that were not initially captured in the session note. While, ethically, all of this information should be factual, it is also private and is not the business of the insurance company.

If you are seeking treatment for substance abuse, for example, it needs to be cited what drugs you were taking, but what means, in what amounts, for how long, and what previous steps you have taken to try and quit. If you have not tried unsuccessfully to quit on your own, most insurance companies will not cover your inpatient services. If you have tried to quit several times through inpatient and outpatient services, they may deny you as too big of a risk for failure. The insurance company is not on your side in these matters, but looks at you as part of risk-analysis.

I believe the client-therapist relationship is one based on honesty, privacy, ethics, and rapport. I want my clients to know that their information stays with me and no one else. I do not believe that most people understand how their information will be used and to whom and how it will be disclosed. Now you know. Feel free to share this.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.