You, Confidentiality, & Health Insurance Portability & Accountability Act (HIPAA)

A label that says Your privacy & confidentiality are important

Page updated 05-04-2018. By Lucrezia Mangione, LCPC, NCC, BC-TMH,, DCEP.

Confidentiality is vital to the practice of counseling and psychotherapy.  Safe places are needed when what you say is private between you and your counselor and/or psychotherapist.  Without safety, the environment in which you share your thoughts and feelings to process and work through the challenges you face is compromised.

Under very specific circumstances, sometimes there will be exceptions. In general, who you are, your name and your demographics and all data associated with your past, present and future health PLUS more is protected by law. What is not protected are certain exceptions which is also written in the same law. Read on for more basic information about HIPAA.

Your protected health information and the exceptions to it are clearly established at the state and federal level under what’s called the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.  All healthcare providers are subject to it, not just your counselor and/or psychotherapist.  It is very detailed info.

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Emergency Numbers

If you are experiencing an emergency, please call:

  • 911
  • 240-777-4000: Crisis Hotline, Montgomery County, MD
  • 800-422-0009: Maryland state-wide Crisis Hotline
  • Suicide Prevention Lifeline website

You can read about it directly from state and federal sources. Here are the links:

State of Maryland:

Department of Health and Human Services:

What’s written on this website is for general informational purposes only. The content on this page is not meant to replace the information found at the State of Maryland and Department of Health and Human Services (DHHS). Consequently the information on this page may not be complete.  It's also not meant to replace medical or psychological advice or treatment.  For that you'll need to seek services by contacting and meeting with a licensed professional. See the disclaimers here and here.

Keep in mind that if you decide to enter into counseling and therapy,  you will be given detailed information concerning the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the topic of confidentiality by your counselor and/or psychotherapist. 

Folder with word HIPAA law & you

In brief, here are the exceptions to your confidential information:

  • when a client in writing asks their counselor and/or psychotherapist to share information from a session or sessions.  A release form is signed by the client authorizing any communication between the counselor and the client.
  • when a client shares information that there is a threat to harm themselves.
  • when a client shares information that there is a threat to harm another person whether that be an adult, child, elder or vulnerable person
  • when a court of law orders it
  • when you share your own therapy information to a medical provider in a medical emergency
  • when involved in research, audit or an evaluation of a program

There’s a lot more information about this topic. This is not meant to be comprehensive and as a result may be incomplete.  It is important for you to know your rights as a client and/or patient when it comes to your health and the healthcare providers that you work.  Knowledge is vital and empowering. Kindly read this information directly from the State of Maryland and Department of Health and Human Services (DHHS) websites for the most up-to-date information.  There you’ll find resources and detailed info to help you understand your rights as a client and/or patient.

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Lucrezia Mangione is in private practice. She is a board certified licensed professional counselor, board certified telemental health provider, counselor supervisor and educator, and nurse wellness education consultant. View her profile.