In my clinical work, it is my aim and promise to protect your confidentiality as fully as the law allows. Confidentiality is essential to psychiatric care, and my concern for your confidentiality is one reason I am not on managed care insurance panels.

I will not release information about you to anyone without informing you first, and in almost all cases only after you give me clear permission. There are a few circumstances where the law requires me to disclose information even without your permission. Child or dependent-elder abuse must be reported. A valid subpeona by the court may force me to release records or testify about your case. Immediate risk of self-harm (suicide), inability to care for yourself, or clear intent to hurt others forces me to breach your confidentiality to maintain the physical safety of yourself or others. Please note that suicidal or violent feelings— feelings about anything really — are not reportable in themselves, and that talking about such feelings in confidence can be the best way to defuse them.

Occasionally I use a clinical example from my practice in my writing or teaching. I always disguise personal details or leave the description so vague that the person cannot be identified. But if the possibility still troubles you, please let me know and I promise I will never refer to your situation at all, even in highly disguised or derivative ways.