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It is important to feel we can say whatever we want to a therapist with a reasonable expectation of confidentiality. Most therapists go to extraordinary lengths to preserve their client's confidentiality, recognizing that it is essential to good care. Yet there are inroads into our privacy in all areas of life and medicine and mental health are no exception.
Therapists have a legal responsibility to notify the authorities if they have specific knowledge of child abuse or the abuse of an elderly person. They also have a "duty to warn" if someone they are treating seriously threatens their own life or the life of another. Most of us see those breaches in confidentiality as reasonable and in the service of a safer society.
If you are seeing more than one professional at St. Vincent Stress Center, or are part of a program such as the inpatient unit or intensive outpatient program, you can expect those professionals to share information which is essential to your care. Only those professionals involved in your care can have access to your records.
If you are using your insurance benefits, a diagnosis will almost certainly have to be released before the company will pay a claim. Some insurance companies that closely manage their resources will ask the therapist to give information justifying ongoing care. They may require a treatment plan before authorizing a visit or a hospitalization. The only way to prevent any information from going to your insurance company is to pay out of pocket.
It is very rare for any mental health record to get into a court setting. It happens at times in child custody cases and sometimes in difficult divorce cases. If subpoenaed, most therapists will work hard to keep such records out of the court and often may be allowed to simply talk to a judge directly instead of submitting an entire record. | 
