Ask the Doc - Will my professors know I've been to the counseling center?

I just got this question in my email, and it's one of those basic questions that a lot of people ask. It's about a really important question that is at the heart of the therapist/client relationship - confidentiality.

Q. If a student goes to a counselor/psychologist ON STAFF at the college, does it get put into their academic file? I guess what I am asking is, can it be held against them? I think we have a counselor at my college and I've been thinking about it but what if my professors decided it meant I am not a good candidate to work in my chosen profession? I can't risk that.

A. The good news is that you don't HAVE to risk that. On your first visit to your counseling center (and to just about any other place you'll go for therapy) they'll take a few minutes to explain your rights of confidentiality. In short, they won't let anyone, even a family member, know anything about your time there - not even whether or not you've ever been seen. When someone calls my clinic and asks about a client, we say, "I'm sorry, I'm not allowed to confirm or deny whether that person is our client."

So, if your professor, your dean, or your mom calls the counseling center to ask about you, they won't get an answer unless you've signed a specific release that expressly permits the center to give out information about you. Those releases are very specific for a reason. It could be that you want your mother, but not your father to have information. Or it could be that you'd like it shared with a professor that you've attended counseling, but nothing beyond that.

As for your records, the same thing applies. Without your written permission, no one but counseling center staff can look at your file. At our counseling center, the medical staff isn't allowed to look at your records without a release of information. This varies from clinic to clinic, so be sure to ask. Your therapy records will never be combined with your academic records. In addition, colleges have FERPA rules that cover confidentiality of academic records. Ask your registrar about these rules.

There are exceptions to the confidentiality rules, and those will be explained to you as well. The short version is that if you are imminently at risk of suicide, or have identified someone you plan to hurt, confidentiality may be breached. In some cases, abuse of an elderly person or a minor may be reported as well.

It is important to note that just talking about suicidal thoughts will NOT trigger this breach of confidentiality. It is important to us as clinicians that you can be as honest as you need to be about how you are feeling. Only if we feel you may complete suicide if you walk out of your session will we break confidentiality. Even then, we do everything we can to stop short of that. Confidentiality is one of the most important things about our relationship with our clients, and we'll do everything in our power to maintain your privacy and security.