Confidentiality in Online Therapy

Ensure That Your Right to Confidentiality Is Protected in Online Therapy

Therapist with confidential information
Confidentiality is an important issue in online therapy. JPM / Image Source / Getty Images

Confidentiality, or the protection of client information, is one of the most pressing concerns in online therapy. The use of electronic communications presents a threat to patient confidentiality if proper precautions are not taken. For example, one health care organization in Michigan accidentally posted the medical records of thousands of patients to the Internet.

What Exactly Is Confidentiality?

Confidentiality is an important part of any therapeutic relationships, both in traditional settings and online.

Keeping client information strictly confidential is a key part of a psychologist's code of ethics. In order to be able to share information freely with a therapist, particularly sensitive and potentially revealing information, clients need to feel that their personal details are going to remain private.

Confidentiality is not just an ethical principle. There are also a number of laws in place designed to protect health consumers. The Health Insurance Portability and Accountability Act (HIPAA) established a national privacy rule that protects health information and medical records including information about mental health and psychotherapy services.

Psychotherapists are allowed to disclose confidential information without written consent from a client in a few different situations.

  • A therapist might be required to disclose information due to a court order.
  • A therapist is required to report issues related to domestic violence, child abuse and neglect, or situations where an elder or disabled person is being abused or neglected.
  • Therapists have a legal duty to warn if they feel a client poses a danger to themselves or to other individuals.

Concerns About Confidentiality in Online Therapy

Confidentiality is just as important in online therapy as it is in regular offline psychotherapy, but the nature of the delivery creates a number of special concerns.

Communicating over the Internet opens up the possibility of security breaches, both accidental and intentional. Email is rarely 100 percent secure and mistakes sometimes happen such as sending a message meant for your therapist to someone else in your address book.

In order to minimize potential confidentiality slips, some online therapists utilize secure messaging systems rather than standard email. These systems require you to log-in with a username and password and send messages in a more secure manner, similar to the security protocols used by banks to protect financial information.

Before you consider trying online therapy, you should first consider the privacy of your personal information. Does your potential online therapist utilize a secure site to protect your privacy? Discuss the issue of privacy with any potential therapist and inquire about what precautions he or she takes to ensure the confidentiality of your personal information.

5 Steps You Can Take to Protect Yourself

  1. Do not access therapy e-mails or chats at work. Ideally, online therapy should occur on a private computer that is not shared with other users.
  2. If you must use a shared computer, always close the browser when you have finished your session.
  1. Do not share your computer or e-mail passwords with others.
  2. Double-check all communications between you and your therapist to be sure they are properly addressed. Confidentiality breaches often occur when client or therapists click the wrong name in their address book.
  3. Choose an online therapist who uses a secure website to conduct therapy sessions and transmit private communications.

More About E-Therapy: Is Online Therapy the Right Choice For You?


American Psychological Association. (). Protecting your privacy: Understanding confidentiality. Retrieved from

Luepker, E. (2003) Record Keeping in Psychotherapy and Counseling. New York: Brunner-Routledge

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