Confidentiality in Therapy: What You Should Know

One of the most common concerns people have before starting therapy is privacy. What happens to what you say in a session? Who can access your records? What if someone finds out you are seeing a psychologist?

These are reasonable questions, and they deserve clear answers.

The basic principle

Confidentiality is a foundational element of the therapeutic relationship. Without it, the kind of honest and open conversation that makes therapy useful would not be possible. A registered psychologist is bound by professional and legal obligations to protect the privacy of their clients — obligations that are taken seriously and enforced by the College of Alberta Psychologists.

In practical terms, this means that what you share in therapy is not disclosed to anyone without your written consent. Your employer does not find out. Your family members do not find out unless you choose to tell them. The fact that you are attending therapy is itself private information.

What confidentiality does not cover

Confidentiality is not absolute. There are specific, legally defined circumstances in which a psychologist is required or permitted to disclose information without a client's consent. These exceptions exist to protect safety and are not unique to psychology — they apply across health professions in Alberta.

The most significant exception involves situations where there is a serious and imminent risk of harm — to the client or to an identifiable other person. If a psychologist has reasonable grounds to believe that someone is in immediate danger, they are required to take steps to protect that person, which may involve disclosing information to emergency services or other relevant parties.

There are also obligations related to mandatory reporting. In Alberta, psychologists are required to report reasonable suspicion of child abuse or neglect to the appropriate authorities. This obligation exists regardless of the wishes of the client.

Additionally, there are circumstances in which records may be subject to legal processes, such as a court order. While psychologists are required to take steps to protect client confidentiality in legal proceedings, there are situations in which disclosure becomes legally compelled.

When confidentiality is explained to you

A registered psychologist in Alberta is required to explain the limits of confidentiality to clients at the outset of the therapeutic relationship. This is not a formality — it is an important part of establishing informed consent, and it gives you the opportunity to ask questions before you begin sharing.

If a situation arises during the course of therapy that requires a disclosure, a responsible psychologist will, where it is safe and appropriate to do so, discuss this with you before acting. Transparency in these situations is both an ethical obligation and a matter of respect for the therapeutic relationship.

Your records

Your clinical records are maintained securely and are accessible only to those with a professional need and legal basis for access. In most circumstances, this means your psychologist and, where applicable, their supervising psychologist.

You have the right to request access to your own records, subject to certain limitations outlined in Alberta's health information legislation. If you have questions about how your records are stored, retained, or accessed, you are entitled to ask your psychologist directly.

What this means in practice

For most people, in most sessions, confidentiality functions exactly as they hope it will. The conversation stays in the room. The records stay secure. The relationship remains private.

The limits described in this post are real and important to understand — but they are not the norm. They describe edge cases in which a higher obligation to safety overrides the general principle of confidentiality. Understanding them in advance helps you enter the therapeutic relationship with accurate expectations rather than assumptions that could lead to uncertainty later.

Disclaimer

Privacy legislation and professional obligations related to confidentiality may vary across provinces and territories in Canada. The information in this post refers specifically to the regulatory and legislative context in Alberta. If you have specific concerns about confidentiality, discussing them directly with your psychologist before beginning therapy is always the most appropriate step.

Heartwill Elewosi is a Registered Provisional Psychologist with the College of Alberta Psychologists. This article is for informational purposes only and does not constitute psychological advice or establish a therapeutic relationship.