How does a therapist handle confidentiality in cases in which the client expresses thoughts of self harm?

If the client wants to confide in secret what are types of things will you have to tell her that you cannot keep secret?How does a therapist handle confidentiality in cases in which the client expresses thoughts of self harm?
Well, I can answer your question using personal experiences. About a year and a half ago I went to see a therapist, and I talked with her for about two months. Then, she broke the confidentiality agreement that she had with me and called my dad (even though at the time I was 19 -- not a minor), and told him that I was suicidal, when he didn't even know that I was seeing a therapist.





Since then I've seen two more therapists (though I'm not seeing one now), and I was always careful to ask what I was able to confidentially say. Here's what I've gathered:





If you have passive thoughts of suicide (e.g. you have thoughts of suicide, but no intention or plan to actually go through with it, and you don't have the means to go through with it if your thoughts were to get worse) then they would NOT break a confidentiality agreement. They would monitor your thoughts carefully, but it seems to me that you can talk about passive thoughts.





If you have active thoughts of suicide then they would break the confidentiality agreement. If you say that you have a plan to commit suicide, or if you have the means to commit suicide and you can't guarantee that you'll be safe, etc. then they will report it.





Before they break confidentiality they may give you a number for a suicide hotline, etc. and that may be sufficient so long as you guarantee that you'd call it if you thought you were going to make an attempt to kill yourself. If you take the number but say you can't guarantee that you'd call it, then they could break confidentiality.





It seems to me that the main point is if they are unsure that you will be safe then they will break confidentiality. If they are unsure that other people will not be safe as a result of you being in public (if you're having thoughts of hurting other people), then they will break confidentiality.





Safety is what it boils down to. If they have any doubts that you won't be safe, then they will try to do whatever is necessary in order to guarantee that you will be safe. If you go to see a therapist ask them what you're able to say, and under what circumstances they would break confidentiality and they'll tell you. If you don't understand something they say ask them for clarification.





Having confidentiality broken is a terrible experience. I wish you the best. If I wasn't clear with something I said, or if you'd like me to clarify something feel free to email me.





Good luck!How does a therapist handle confidentiality in cases in which the client expresses thoughts of self harm?
you can tell your therapist any ';thoughts'; you have, it's doing it that they have to do something about.


For instance it you went in and said I just took 100 pills a 1/2 hour ago, that they would have to report.





Or if you were planing on hurtng someone else and had a plan all worked out and the date, that they would have to report, all else is confidential.
if your or someone else's life is at risk, they have to report it, for example:


if you talk about planning a suicide (thoughts are ok, plans to kill yourself are not)


if you talk about seriously hurting/killing someone else


if you talk about any kind of abuse- sexual or physical- they will report it because you are in danger





so, if you tell your therapist about cutting or any other kind of self harm, as long as it is not a suicide attempt/you are not having thoughts of using self harm to kill yourself, they will not tell anyone or report it- they'll probably try to talk about some coping skills you can use to avoid self harm and try to come up with a plan in case you do start to feel suicidal.
Expressing thoughts is different than actually having a plan. If you have a plan then the therapist could get others involved to protect you from yourself.