*Note: the following information is not intended to be legal advice. The information in this blog is based on the requirements in the State of Colorado and Federal regulations as of the date of publication. This information may not be applicable outside of Colorado or outside of the United States. Please check your local laws for specific details on reporting requirements in your area. The information below was written based on the laws and ethics rules affecting licensed professional counselors in Colorado on April 4, 2024 and may have changed since then. The following information is not a substitute for therapy. Talk to your mental health professional for specific details regarding reporting requirements.

T​herapy is meant to be a safe space for you to explore your emotions, understand yourself, learn new skills to reach goals, and to resolve conflicts from the past. Because of this, it's pretty common for people to find themselves telling their therapists things that they've never told anyone else before, or would never dream of telling anyone else.

I​f you've ever had a strong bond and strong trust with your therapist, you have likely experienced a moment where you wondered if you said too much. Is there a line that you shouldn't cross when talking about yourself or your life? Is everything you say to your therapist safe? What do therapists have to report? Continue reading to understand what therapists have to report, who they have to report it to, and why.

S​uicide or self-harm*

*​If you are having suicidal thoughts, please call 988 for the National Suicide Prevention hotline or text 38255 for Colorado Crisis Services

E​very state requires therapist to report if a client is an imminent danger to themselves. "Imminent danger" means that the client has clearly stated that the will kill or harm themselves, that they have a plan to do it, and that they've decided when they will do it. If a therapist knows that a client might die or experience a significant injury before the next session, the therapist is legally obligated to report it.

D​oes that mean I should't tell my therapist if I'm suicidal?

You should absolutely tell your therapist if you are suicidal. The key words are "imminent danger." Thinking that you want to die or even thinking of ways that you could kill yourself do not put you in imminent danger. It's important to share these thoughts with your therapist so that they can help you to manage them and overcome them. You shouldn't have to suffer in silence.

If you do have a plan and intent (meaning that you want to kill yourself and have decided when and how to do it) please tell someone immediately. You can call 988 in the United States or text 38255 if you are in Colorado. For other localities, please go to your nearest crisis center. You deserve to get help because you deserve to keep living.

W​hat if my therapist fires me for being suicidal?

W​e have all heard stories of people who told their therapist that they had suicidal thoughts and the therapist sent them to work with someone else. Typically, when this happens it isn't because the therapist thinks that the person is "too crazy" or that they don't care about the person. Therapists have an ethical (and sometimes legal) obligation to only work with clients within their scope. That means that we can only work with people if we know that we have the training and experience to be able to help them. If you tell your therapist that you're having suicidal thoughts, and they send you to someone else, it doesn't mean that you're not good enough for them. It means they aren't trained to be able to meet your needs, and they want you to be able to work with someone who has the training and experience to help you.

T​hreats to others

T​herapists are legally obligated to report if someone is an imminent danger to others. Similar to suicide or self-harm, we only have to report if we believe that you post a serious and immediate threat to someone else. This is typically called a "duty to warn" and refers to our obligation to warn someone if we know that they are potentially in danger.

A​ serious and immediate threat typically means that a client has stated that they want to kill or harm someone and that they have a plan and a serious desire to do so.

I​s it okay to joke about this stuff?

O​ne of my mom's favorite jokes to make when she was annoyed was, "I'm going to ring your neck!" My mother never seriously suggested that she would actually attempt to strangle someone and was obviously joking whenever she said it. If you're the type of person who jokingly refers to violent acts ("I'm going to kill him, I swear." Or "Do it again and you're dead," etc)., that is fine. The grand majority of therapists can tell the difference between a common phrase indicating being angry and an actual threat. Your therapist has the right to choose what level of comfort they have with this type of expression and may ask you to use different wording, but they are usually not legally obligated to make a report based on this type of joke. (Local laws may be different. Check with your therapist if to ensure that jokes about harm are not reportable).

Therapists must report suspected child abuse and elder abuse

I​f a therapist becomes aware of child abuse and neglect or elder abuse and neglect - or even if they just suspect abuse is happening - the therapist is legally obligated to report it. Therapists are mandated reporters in all states and must break confidentiality to potentially protect children under 18. Many states also have laws regarding reporting elder abuse. While this can sometimes be stressful for clients who may fear repercussions from the person committing the abuse, it's ultimately the right thing to do to protect someone who may be experiencing abuse.

I​n Colorado, therapists are also obligated to report any child abuse that happened to a now-adult client if the abuser is in a position of authority over children or if the client is aware that the abuser hurt more than one child. Colorado therapists are also required to report suspected abuse or neglect of elders above the age of 70.

This can sometimes feel like a deep betrayal and it can make therapy feel unsafe for the adult client. Please know that your therapist wants to protect you as much as possible and knows that this is a difficult situation to have to reopen. You may want to stop seeing your therapist, but try to resist the urge to quit if this happens.

Understanding what has happened to you and your experiences as a child and as an adult will help your therapist develop a stronger bond with you and ultimately help you to reach your goals. I​f this happens to you, let your therapist know how you feel. You may be scared, angry, hurt, or all the above. And that's okay. You're allowed to process this with your therapist, even if they are someone you're angry with.

W​hile we are on the subject, Colorado also requires that we report if a client is planning a terrorist attack against the homeland security of the United States. Just FYI.

T​herapists must break confidentiality if a court orders them to

O​ccasionally someone will call a therapist to testify in court about a client. If a judge writes a court order stating that the therapist has to share information about a client, then the therapist is legally obligated to do so. The court order must be signed by a judge. In those cases, the therapist can work with their attorney and the judge to determine what should be shared and what can be protected.

I​f a judge does not issue a court order for a therapist to disclose confidential information, then they are legally obligated to maintain that confidentiality, even if the therapist is sitting in the courtroom.

I​nsurance companies have access to confidential information

M​ost insurance companies reserve the right to audit a client's medical records in order to ensure that the treatment meets their requirements to pay. If you choose to use insurance to cover the costs of therapy, this means that your insurance company may access confidential information. If this is a concern for you, feel free to ask your therapist if you can see their medical documentation. We are only required to describe the symptoms that you have, your diagnosis, and what we did to attempt to resolve the symptoms. We are not obligated to include private details in your medical records. Many of us adhere to this in order to ensure your confidentiality as much as we can.

W​hat do I do if my therapist reported something?

I​f your therapist made a report about something that you shared with them, talk to them about it. We are trained to receive unpleasant feedback and want to work with you to help you process your emotions about it. I've never met a therapist who enjoys breaking confidentiality. For us, it's one of the worst aspects of our job. And that's because we know that we are often hurting the therapeutic relationship we have with that client. We care very much about the therapeutic relationship and about our clients.

S​o, if you're upset that your therapist had to report something, tell them about it. Let them know how you feel. If you feel like you can't trust them, share that with them. We are trained to be able to help you through this.

W​hat if I want to stop working with a therapist who made a report?

I​f you no longer trust your therapist and want to work with a different one, you are allowed to do so. There isn't a law that says you must work with any specific therapist. Keep in mind that the new therapist will also be obligated to make a report, so you may not be able to hide it from them for very long. Also, remember that your current therapist may not have wanted to report and likely understands how upsetting it is for you. It may be more helpful to continue to work with them instead of doing all the work to find someone new and end up in the same position.

If you’re in looking for a Colorado therapist specializing in anxiety, burnout, imposter syndrome, or trauma and you want to perform better in your every day life, feel free to reach out. Stacy Andrews, LPC offers in-person therapy in Colorado Springs at her centrally located office or online therapy throughout Colorado. Click on the button below to reach out!