Therapy Privacy in Washington: 5 Essential Rights

What therapists can and cannot share about you—and how Washington’s new privacy laws protect your mental health information

If you’re considering therapy, one of your first questions might be: “Is therapy actually confidential?” You might wonder if your employer could find out, if your therapist could tell your family, or if your sessions could be shared with insurance companies.

The short answer is yes, therapy is confidential—but the full answer is more nuanced. This guide will explain exactly what’s protected, what exceptions exist, and how Washington state’s new privacy laws give you even stronger protections starting in 2026.

Why Therapy Confidentiality Matters

Confidentiality isn’t just a nice feature of therapy—it’s essential for healing. Without the assurance of privacy, you might:

• Hold back important details
• Avoid discussing difficult topics
• Feel unable to be fully honest
• Worry about judgment or consequences

Therapy works best when you can speak freely. That’s why confidentiality protections exist—to create a safe space where you can address your concerns openly.

Federal Protection: HIPAA and Therapy

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects your health information, including mental health records and therapy notes.

What HIPAA Protects

Under HIPAA, therapists and mental health providers must keep confidential:

• What you discuss in sessions – the content of your therapy
• Your diagnosis – any mental health conditions identified
• Treatment plans – therapeutic approaches and goals
• Progress notes – documentation of your sessions
• Payment information – billing and insurance details
• The fact that you’re in therapy – even your attendance is protected

Who Cannot Access Your Therapy Records

Without your written permission, therapists cannot share your information with:

• Your employer
• Your family members (including spouses or parents, unless you’re a minor)
• Friends or other therapists
• Schools or universities
• Law enforcement (with limited exceptions)
• Anyone else

Even if someone calls claiming to be your parent, partner, or doctor, your therapist cannot confirm or deny that you’re a client without your explicit written consent.

Washington State Protection: My Health My Data Act

Washington state has gone even further to protect your privacy. The My Health My Data Act (MHMD), which took full effect in 2024 and continues to strengthen in 2026, provides additional protections specifically for consumer health data, including mental health information.

What Makes Washington’s Law Different

While HIPAA protects traditional healthcare providers, Washington’s My Health My Data Act extends protections to:

• Digital health platforms – therapy apps and telehealth services
• Mental health data – searches, browsing, and online behavior related to mental health
• Health-related communications – messages and emails about therapy
• Geolocation data – preventing tracking to/from therapy appointments

Your Rights Under Washington Law

Under the My Health My Data Act, you have the right to:

What Information Is Protected in Therapy?

When you’re in therapy, virtually everything is confidential. This includes:

Session Content

• Everything you say during sessions
• Topics you discuss
• Feelings and thoughts you express
• Past experiences you share

Clinical Information

• Your diagnosis (if given)
• Treatment approaches used
• Medications discussed
• Progress assessments
• Therapeutic goals

Administrative Details

• The fact that you attend therapy
• Your appointment times
• Payment information
• Insurance claims (though insurance companies see limited information)

What About Psychotherapy Notes?

Therapists keep two types of notes:

• Clinical records – basic documentation of sessions, diagnosis, treatment plan
• Psychotherapy notes – personal notes about impressions, not part of your medical record

Psychotherapy notes have extra protections. Even with your consent, these notes typically aren’t shared—they’re for the therapist’s use only.

When Therapists Must Break Confidentiality

While confidentiality is the rule, there are specific situations where therapists are legally required to share information. These exceptions exist to protect safety.

Mandated Reporting Situations

Important Clarifications

Discussing suicidal thoughts is NOT the same as planning suicide. You can talk about depression, hopelessness, or even passive suicidal thoughts without triggering a mandated report. Therapists only break confidentiality when there’s an imminent, serious risk with a specific plan.

Past abuse doesn’t require reporting if the child is now an adult and no longer at risk. Therapists report ongoing or current risk to children.

General anger or frustration doesn’t trigger reporting. It’s specific, credible threats to identifiable individuals that require action.

Your Rights as a Therapy Client

Under both HIPAA and Washington state law, you have specific rights regarding your therapy records and privacy:

Access Your Records

You have the right to:

• Request copies of your therapy records
• Review your clinical documentation
• Request corrections to inaccurate information

Note: Psychotherapy notes are not included in records you can access.

Control Who Sees Your Information

You decide:

• Who can receive your therapy records
• Whether to sign releases for other providers
• What information insurance companies receive
• If your therapist can discuss your care with family

Request Privacy Measures

You can ask your therapist to:

• Use a specific phone number for contact
• Avoid leaving voicemails
• Send mail to an alternate address
• Communicate via secure messaging only

File a Complaint

If you believe your privacy rights have been violated:

• File a complaint with your therapist’s licensing board
• Contact the U.S. Department of Health and Human Services
• Report violations of Washington’s My Health My Data Act to the state Attorney General

How Seattle Wellness Center Protects Your Privacy

We take multiple steps to ensure your information remains confidential:

Secure Systems

• Encrypted electronic health records – all digital records are encrypted and password-protected
• HIPAA-compliant telehealth platform – secure video sessions with encryption
• Secure messaging – encrypted communication for appointment reminders and updates
• Locked physical files – any paper records are stored in locked cabinets

Staff Training

• All staff receive annual HIPAA training
• Washington My Health My Data Act compliance training
• Strict protocols for discussing client information

Private Spaces

• Soundproof therapy rooms
• Private waiting areas
• Discreet check-in procedures
• No identifying information visible to other clients

Limited Information Sharing

• We only share information with your written authorization
• Insurance companies receive only the minimum necessary information
• We never sell or share your data for marketing purposes
• We comply with all “Do Not Sell” requests under Washington law

Common Privacy Concerns Answered

Will my employer find out I’m in therapy?

No. Even if you use employer-provided insurance, your employer cannot access your therapy records or even know that you’re attending therapy. They may see a general claim for “mental health services” on aggregate reports, but with no identifying information.

Can my spouse access my therapy records?

No. Marriage doesn’t give automatic access to therapy records. Your therapist cannot confirm you’re a client or share any information without your written consent—even if your spouse is paying for sessions.

What if I’m in couples therapy?

In couples or family therapy, confidentiality works differently. Your therapist will explain the specific confidentiality arrangement—typically, information shared in joint sessions is not kept confidential from the other participants, but information shared in individual sessions may be.

Are telehealth sessions as private as in-person?

Yes. When you use a HIPAA-compliant telehealth platform (like Seattle Wellness Center does), your video sessions are encrypted and just as confidential as in-person sessions. Make sure you’re in a private location during your session.

Will therapy show up on my insurance explanation of benefits?

If you use insurance, yes—your explanation of benefits (EOB) will show claims for mental health services, typically with dates and amounts. The EOB won’t include details of what you discussed, but it will show you attended. If this is a concern, you can pay out-of-pocket to avoid insurance billing entirely.

Frequently Asked Questions

Is therapy confidential in Washington state?

Yes. Therapy is confidential under both federal HIPAA law and Washington’s My Health My Data Act. Therapists cannot share your information without your written consent, except in specific legally mandated situations involving imminent safety risks.

What is Washington’s My Health My Data Act?

The My Health My Data Act (MHMD) is a Washington state privacy law that protects consumer health data, including mental health information. It gives you rights to know what data is collected, control how it’s used, and request deletion. It provides stronger protections than federal law alone.

When can a therapist break confidentiality?

Therapists must break confidentiality when there’s imminent risk of harm to yourself or others, suspected child or elder abuse, or a court order. These exceptions exist to protect safety and are required by law.

How does HIPAA protect therapy records?

HIPAA (Health Insurance Portability and Accountability Act) is a federal law requiring healthcare providers to keep your health information private. This includes therapy session content, diagnoses, treatment plans, and even the fact that you’re receiving therapy.

Can I request my therapy records?

Yes. Under HIPAA, you have the right to access and request copies of your clinical therapy records. Note that personal psychotherapy notes kept by your therapist for their own use are not included in records you can access.

Does insurance compromise my therapy privacy?

Insurance companies do receive limited information—typically your diagnosis and dates of service—but they don’t get session content or detailed notes. If you prefer complete privacy, you can pay out-of-pocket and not involve insurance at all.

Get Started with Confidential Care

Now that you understand how therapy privacy works, you can feel confident taking the next step. At Seattle Wellness Center, we’re committed to protecting your privacy while providing excellent mental health care.

• ✅ Full HIPAA compliance
• ✅ Washington My Health My Data Act compliant
• ✅ Encrypted electronic records and secure telehealth
• ✅ Private, soundproof therapy rooms
• ✅ Experienced, licensed therapists
• ✅ In-person and telehealth options

Ready to Begin?

Call: (206) 636-1982

Visit:
Seattle Wellness Center
155 NE 100th St, Suite 125
Seattle, WA 98125

Your privacy is protected by law—and by our commitment to confidential, compassionate care.

Related Resources

• Seattle Wellness Center Privacy Policy
• What to Expect in Therapy
• Telehealth Therapy Options
• Insurance and Payment Options
• How to Find a Therapist in North Seattle

About This Article: Written by Seattle Wellness Center to help clients understand their privacy rights under federal and Washington state law.

Last Updated: February 2026 | Complies with HIPAA and Washington My Health My Data Act