Do I Have a Right to My Therapy Notes?

With the laws in place, the answer may surprise you.

Councillor looking at couple on the sofa. Credit: Peter Cade

Question: Requesting Therapy Notes

I recently changed therapists and my new therapist asked that my old one forward all of my treatment notes to her. I asked my old therapist for the notes but she said she would prefer to forward my notes directly to my new therapist rather than give them to me. Even when I insisted on getting the notes, she refused. I don’t understand; aren't the notes my medical records? Don’t I have a right to see them? What are the rules about requesting my therapy notes?

Answer:

In the United States, you do have a legal right to see most of your medical records. However, according to the U.S. Department of Health and Human Services, therapy notes are an exception. You do not have a right to your therapist's psychotherapy notes about you during your sessions and treatments. 

Psychotherapy notes are considered completely separate from your medical records which list things like when you got your last tetanus shot or had surgery. The notes are thoughts your therapist jotted down about you and your experiences with borderline personality disorder while in sessions with you, so they are not included in your record.

Because of these rules, whether or not you get to see your therapist's notes are completely up to your healthcare provider. If she believes that something written in her records may harm you in some way, she has every right to deny you access to them.

She can't hold them back due to other reasons, such as a late payment, but she can withhold them in order to protect you.  

While this may seem very unfair, these guidelines were created with your health and safety in mind. Mental health records are extremely sensitive. Therapists write notes very quickly to keep up with the conversation and can't take the time to think through the right words or tone.

If you saw her raw notes, you may misinterpret something she wrote or be offended by something she commented on during a session.Therapists often use jargon or professional language that just isn't geared toward patients; they generally write for other treatment providers.

If you want to see your notes, explain your reasoning to your therapist. Tell her that you feel it's important for your progress or that you're just curious. She may decide that she can share them with you. Even if there is nothing in the notes that is deemed by your therapist to be potentially harmful, your therapist may wish to review your notes with you to make sure you understand what is written in them. This way, she can explain what is in the notes, clear up any confusion and make sure that you understand why she recorded the information the way she did.

Keep in mind though that she has no obligation to share those notes with you. It is completely at her discretion whether or not you see them. If you've had a good relationship with your therapist, try to understand that she has your best interests in mind and is trying to do what is best for your ongoing treatment and recovery.

Your feelings on this and your concerns are something you can certainly bring up with your next therapist as well to help you feel more comfortable about the situation. 

Sources:

American Psychological Association. Ethical Principles of Psychologists and Code of Conduct, American Psychological Association, 2010.

U.S. Department of Health & Human Services. "Your Medical Records". 2014. 

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