Your Privacy

So here’s where you get to breathe a huge sigh of relief: when you’re working with a licensed clinician, what you disclose to them is protected information. This is true even when it’s illegal activity, including criminalized forms of sex work and drug use, past or present - unless a victim is in a vulnerable population such as a minor or an elder.

Here are the few exceptions, when counselors are required to report what you say:

Harm to Self or Others

Each state in the US is different, but counselors most places must report risk of serious harm to self or others. This is especially true when the risk is to someone in a vulnerable population such as children, elders, and dependents.

In most states, that risk of harm must be to a specifically identified individual, and there must typically also be a plan and intention to carry it out at a specific time, and soon.

For example, telling your therapist, “I feel like punching someone” is not a risk of harm. There’s no identifiable victim and no plan. Telling them, “I’m going to go home today and steal all the money from my grandpa’s wallet, then smack him over the head with my frying pan” would make them start asking questions to see if you mean what you say, and if there is actual risk of harm.

To make sure you understand what counts as harm, your clinician will have you sign a consent form before counseling begins. This will give you details about what they have to report. If they don’t include that in their consent form, ask for clarification in your first session.

If they’re a licensed clinician and they don’t have you sign a consent form at all, RUN.

Court Orders

States also vary in what counselors are required or allowed to protect in court, if you were ever involved in a law suit. This also should be covered in their consent form or in your first session. Don’t hesitate to ask!

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You made it! That was long, but we hope it was useful. A few final things you should know before we get to that PDF:

Communicating With Your Therapist

Just like any other interaction in which you’d like privacy and security, there are ways of communicating with a therapist which are confidential and ways which aren’t.

Regulations require encrypted messaging systems for confidential communications. Phone and email are not confidential, so use discretion in what you share.

Agency Policy

Clinicians who work at agencies may be required to stay within agency policy regarding sex working and/or criminalized activity, even if they are not legally required to report. For example, they might not be allowed to treat sex working people without attempting to help them exit the profession.

If you’re looking at an agency-affiliated counselor, you might want to anonymously call the agency and ask about this.

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Now, maybe you’ve used this guide and already found a therapist for yourself, or are underway with that process. Or maybe you’re just wondering how you’re going to remember all of this (it’s a lot, we know), or how you can pass it along to a friend who can’t or shouldn’t visit this site.

So...here's that one-page handout we promised. It has all the most important points, and it's free for you to use and share anywhere you like, with anyone who needs it. The link for this article is on there, too, in case someone wants more details.

We hope it helps you, and we wish you all the best on your search. May you find comfort, safety, and kindness, and may all of your needs be met.

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