“Are therapy sessions confidential?” It’s often one of the first questions new clients ask me, sometimes before we’ve even discussed what brought them to therapy in the first place. I understand why. Sex and relationship therapy asks you to speak about some of the most private parts of your life; your relationships, your intimacy, the things you might not have said out loud to anyone. Before you can do that, you need to know the room is safe.
So, let’s start with the honest answer: yes, therapy is confidential. It’s one of the cornerstones of the work I do, and of the profession as a whole. As a member of the College of Sexual and Relationship Therapists (COSRT), I work within their Code of Ethics and Practice, which sets out clearly what confidentiality means and where its boundaries sit. Confidentiality isn’t the same as secrecy, though, and it isn’t absolute. There are a small number of specific, well-defined circumstances where I may need to share information, always with the aim of keeping you, or someone else, safe.
I think the best way to build trust is through transparency, not vague reassurance. So below, I’ve broken down exactly what confidentiality in therapy looks like, where its limits sit, and why those limits exist. I hope that by the end, you’ll feel more informed about starting this work.
Is Individual Therapy Confidential?
When people ask “is individual therapy confidential?”, what they usually mean is: will you tell anyone what I say? The short answer is no, not without a very good reason, and in almost every case, not without talking to you about it first.
I still remember, early in my career, sitting across from a client who paused mid-sentence and asked, “Wait, does this stay between us?” I could see the relief on their face when I explained what confidentiality actually means in practice. That moment has stayed with me, and it’s why I now bring up the topic myself in the first session, rather than waiting to be asked.
Confidentiality is what allows therapy to work. It’s the container that makes it possible to say the things you’ve never said to anyone else; especially in a field like therapy, where shame and secrecy so often keep people stuck. But like any professional relationship involving safety and the law, it has boundaries. Here’s what those look like.
Does Clinical Supervision Affect Therapy Confidentiality?
Every COSRT-registered therapist is required to have ongoing supervision from an experienced, qualified supervisor. This isn’t optional, it’s built directly into the Code of Ethics and Practice I work under, and it exists to protect you, not to undermine your privacy.
Supervision gives me a confidential space to reflect on my work, think through difficult sessions, and make sure I’m offering you the best possible care. When I discuss a case with my supervisor, I share only what’s clinically relevant, and I limit identifying details wherever I can. My supervisor is bound by the same standards of confidentiality I am, so nothing discussed in supervision goes any further.
I like to think of supervision as a second pair of eyes, a way of making sure I’m never working in isolation with something important, particularly given how sensitive the subject matter in this field can be. In my experience, clients are often relieved to hear this, once they understand what it actually involves.
When Can Confidentiality in Therapy Be Broken?
This is the part of the conversation that matters most, so I want to be as clear as possible. Confidentiality in therapy can be set aside in a small number of situations. Under the COSRT Code, I’m required to treat everything you share as confidential unless protecting someone from harm or complying with the law means that breaking confidentiality is both necessary and justifiable given the circumstances. That’s a high bar, and I take it seriously.
1. Risk of Serious Harm (Duty of Care)
For confidentiality to be broken here, there needs to be a serious and imminent risk of harm either to you, or to someone else.
Example: credible suicidal intent with immediate risk. I want to be clear that you can, and should, talk openly about suicidal thoughts in therapy. In fact, I actively encourage it. If you share these thoughts with me, I’ll likely ask some gentle but direct questions. How often the thoughts come, how intense they are, whether there’s a plan. I would only contact an outside authority, like emergency services, if I believed you had either begun to act on a plan or were about to.
Example: a threat of violence towards someone else. There’s a real difference between a passing, human moment of frustration (such as imagining punching a difficult colleague) and a genuine, specific intent to harm someone. Part of my job is being able to tell the two apart, and I’ll ask questions to understand which one I’m hearing.
If I ever have concerns serious enough to consider involving another person or authority, I will always try to discuss this with you first. It’s only in rare situations, for instance, if you’ve contacted me outside of a session in crisis and I can’t reach you, that I would act without speaking to you beforehand. And even then, I would only ever share the minimum information necessary.
2. Safeguarding: Children and Vulnerable Adults
As a psychosexual and relationship therapist, my work is generally with adults, and COSRT’s Code specifically requires additional training, an enhanced DBS certificate, and specialist supervision for any member who works directly with under-18s or with people classified as having learning disabilities or vulnerabilities. If that’s not part of a therapist’s practice, they wouldn’t typically be seeing those clients directly.
That said, safeguarding concerns can still surface indirectly. For instance, if something a client shares raises serious concerns about the safety of a child or vulnerable adult in their life. In that situation, the same principle applies as with any risk of serious harm: I would consider, in consultation with my supervisor, whether breaking confidentiality is necessary and justifiable to protect that person, and I would aim to talk this through with you first wherever possible.
Example: if a client described a situation that gave me real cause for concern about a child’s safety, not a general worry, but something specific and serious, I would take that to supervision immediately and consider whether a referral to children’s social services was necessary to protect the child.
3. Legal Requirements and Court Orders
Confidentiality can also be overridden by law, and as a COSRT member I’m required to cooperate with any lawful investigation or inquiry relating to my therapy practice, including from a court, police, or tribunal.
Example: a subpoena during criminal proceedings. If a client was involved in a criminal case and a court issued a legal order requiring my notes or testimony, I would be obligated to provide the information specified, even without the client’s consent. This is rare in practice, but it’s important you know it’s possible from the outset.
In every case like this, I would tell you what’s being disclosed and why, unless I’m specifically prohibited by law from doing so.
4. Terrorism Act 2000
This is one piece of legislation that applies to everyone in the UK, regardless of profession, including me, as a private practitioner. Under Section 38B of the Terrorism Act 2000, if I came to know or believe that information I held might help prevent an act of terrorism, or help bring someone to justice for one, I would be legally required to disclose it to the police. I personally have not experienced this nor heard of any examples of this occurring from a colleague, but it’s part of being transparent about the very outer edges of confidentiality.
5. Professional Standards: My Obligations to COSRT
As a COSRT-registered therapist, I have my own professional obligations that sit alongside client confidentiality. These are less about disclosing what a client tells me, and more about the standards I’m held to as a practitioner.
Example: concerns about a colleague’s fitness to practise. If I had serious concerns that another therapist wasn’t fit to practise, for instance, due to their own wellbeing or conduct, I would be required under the COSRT Code to take reasonable steps to protect the people affected, which could include reporting this to COSRT, an employer, or another relevant body.
Example: an investigation into my own practice. If a regulator, the police, or a court were ever investigating an allegation against me, I would be required to inform COSRT within 14 days. This is a duty of transparency I hold toward my professional body, not something that affects the confidentiality of what you and I discuss.
Is couples therapy confidential?: The “No Secrets” Policy
Given that so much of my work involves couples and relationships, this next point matters more here than almost anywhere else. Couples’ therapy sessions are just as confidential as individual sessions. The one point where they may differ is where I’m working with two people, as partners, or within a relationship dynamic, I work with a “no secrets policy.” This isn’t a legal requirement; it’s a clinical agreement we make together at the start of the work. You can learn more about what to expect from couples therapy here.
In practice, it means that anything shared with me individually may come up in joint sessions if it’s directly relevant to the relationship work. This is about protecting the honesty and integrity of the therapeutic process itself.
Example: an individual session that touches on the couple’s work. If I meet one partner alone and something comes up that’s directly relevant to what we’re working on together, such as a boundary that’s been crossed or a decision one partner is weighing that will affect the other. I wouldn’t sit on that as a private secret sealed off from the joint therapy. I’d usually encourage the client to raise it themselves in a joint session, or ask their permission to bring it in myself. I wouldn’t disclose anything to the other partner without that permission. But if I were asked to keep a secret that could genuinely disrupt the therapeutic alliance, and we couldn’t agree on a way to share it within a joint session, I may have no choice but to end the couples therapy.
I always explain this policy clearly before couples or relationship work begins, so both partners can decide what they do and don’t want to share individually, with full knowledge of how that information will be treated.
The Principle Behind It All
Whenever confidentiality does need to give way to something else, the COSRT Code requires me to make sure that breaking it is both necessary and justifiable in the circumstances. In practice, that means I try to hold to three principles:
- Share the minimum information necessary, and nothing more
- Prioritise safety above all else
- Tell you what’s happening and why, before I act, wherever that’s possible
So, is therapy confidential? Yes, overwhelmingly so. The exceptions exist for good reason, and they’re rare, particularly in the kind of one-to-one and couples work I do. In my experience, understanding them upfront doesn’t make people more hesitant to begin therapy; it tends to make them feel more secure.
If you have any questions about confidentiality before starting therapy, please don’t hesitate to contact us. I’d always rather you feel fully informed from the very first conversation.
FAQs
Can a therapist tell someone what I say?
No, not without a very good reason, and in almost every case, not without discussing it with you first. Confidentiality is the foundation of therapy, but it isn’t absolute. It can be set aside only in specific, narrow circumstances, such as a serious and imminent risk of harm, safeguarding concerns, or a legal requirement.
Can a therapist be ordered to share my therapy notes?
Yes, in rare cases. If a court, police, or tribunal issues a lawful order (such as a subpoena) as part of an investigation, a therapist is required to comply, even without your consent. Where possible, they should tell you what’s being disclosed and why, unless the law specifically prohibits this.
Can I ask my therapist about confidentiality before starting therapy?
Absolutely, and it’s encouraged. Most therapists would rather you raise questions about confidentiality upfront than begin sessions with any uncertainty about how your information will be handled.
Does confidentiality apply to everything I say in therapy?
Broadly, yes, with the same limited exceptions that apply throughout: risk of serious harm, safeguarding of children or vulnerable adults, legal obligations, and counter-terrorism law. Outside of these situations, what you share stays private.
Will my therapist tell my partner what I say in an individual session?
Not without your permission, but in couples therapy, a “no secrets” policy usually applies. If something raised in an individual session is directly relevant to the joint work, your therapist would typically encourage you to share it yourself, or ask your permission to raise it. If a disclosure would seriously disrupt the therapeutic process and can’t be resolved, it may mean the couple’s work can’t continue.
