Right From the Start

When a therapist explains confidentiality and its limits, they are trying to give you a realistic understanding of how therapy works. That includes what is private, what is protected, and what might require action if a serious legal or safety issue arises.

Many clients actually feel more grounded once this is explained well. Uncertainty is often harder to live with than clarity. When you know where the boundaries are, you do not have to guess. You do not have to wonder what might happen behind the scenes. You know what the relationship is built on and where the exceptions are.

Most of what clients share in therapy remains confidential.

So when therapists list these situations, they are not saying, “There are many ways your privacy could disappear.” They are saying, “Here are the specific situations where the law changes my role.” And they are saying, “This transparency, your trust, our agreement - it all matters to me for our therapeutic relationship.” Right from the start - where the foundation is laid.

The Limits

Below is a plain-language explanation of the situations that are often included in Alberta counselling consent forms.

1. Duty to report child protection concerns

If there are reasonable grounds to believe that a child is in need of protection or intervention, a therapist may be legally required to report that concern to Child and Family Services.

This can include situations where a child may be experiencing abuse, neglect, exposure to violence, serious emotional harm, or other circumstances that place their wellbeing at risk.

This duty exists to help protect children when serious concerns arise. It is not about punishment; it is about making sure that a child’s safety is not left entirely within a private conversation if intervention may be needed. And through intervention, the caregiver (usually the client) can receive attention to the problem and the help they may need to shift behaviour.

2. Requests from Child and Family Services

Sometimes Child and Family Services may already be involved with a family and may request information as part of an investigation or intervention process.

This is different from a therapist making a report based on their own concern. In this situation, the concern may have come from somewhere else, and the therapist may be asked to provide information that is legally authorized and relevant to the investigation.

This can feel unsettling for clients, especially if they did not expect outside involvement. Even so, it is part of how child protection systems sometimes operate when the law authorizes information gathering.

3. Abuse of a dependent adult

If there is a report or reasonable suspicion of abuse involving a dependent adult, a therapist may be legally required to disclose relevant information to the appropriate authorities.

A dependent adult is someone whose vulnerability, health status, disability, or reliance on others may place them at higher risk of harm or exploitation.

This may include sexual abuse, physical abuse, emotional abuse, financial abuse, or neglect. The purpose of this kind of disclosure is to protect a vulnerable person whose safety may be compromised.

4. Risk of self-harm

If a therapist believes that a client is at imminent risk of seriously harming themselves, confidentiality may need to be limited in order to support safety.

People sometimes hear this and worry that any admission of distress will automatically trigger a report or emergency response. That is not how thoughtful therapy works. Therapists understand that many people talk about despair, hopelessness, passive wishes to disappear, or dark thoughts in therapy. Those conversations are often part of healing.

What changes the situation is the level of immediacy and seriousness of the risk.

This category may include immediate and significant concern about suicide, serious bodily harm, or significant deterioration related to impaired judgment when the risk is acute enough that outside support is needed for safety.

In those moments, the purpose of disclosure is not to take power away from a client. It is to help preserve life, reduce danger, and bring in appropriate support.

5. Risk of harm to others

If a therapist reasonably believes that a client is at imminent risk of seriously harming another person, confidentiality may need to be limited to reduce that risk.

This may involve contacting authorities or, in some circumstances, warning a potential victim where it is feasible and appropriate to do so.

This does not mean that every angry thought, intrusive image, or emotionally charged statement leads to disclosure. Context matters. Therapists assess intent, credibility, immediacy, specificity, mental state, access to means, and other factors.

The goal is to respond when there is a real and serious risk, not to punish someone for being distressed, overwhelmed, or angry.

6. Public safety concerns

There are situations where a therapist may believe that a client’s actions create a clear and significant risk to public safety.

This category is broader than a threat to one specific person. It may involve conduct or statements that suggest a credible risk of serious harm to the public, a group of people, or public spaces.

This kind of disclosure is used cautiously. It is not about ordinary conflict, frustration, or strong emotions. It is about serious danger.

7. Communicable disease reporting

In some situations, Alberta law requires health professionals to disclose information related to certain communicable diseases to public health authorities.

This is different from a general public safety concern. It is tied to specific legal reporting frameworks under public health law.

The purpose is to help prevent or manage serious risks to community health. This kind of disclosure is not discretionary in the same way as a therapist’s risk assessment. It is connected to legal reporting requirements.

8. Legal subpoena or court order

If a therapist receives a valid subpoena, court order, or other legally binding direction from the court, they may be required to provide records or information.

Many clients find this category uncomfortable because it introduces the legal system into what is usually a private relationship. That discomfort makes sense.

Even so, therapists do not have unlimited power to ignore court processes. When the law requires disclosure, some information may need to be released. When possible, clients are often informed unless the law prevents that.

9. Work-related psychological injury reporting

If a client discloses or presents with a psychological injury related to the workplace, there may be legal requirements to report relevant information to the Alberta Workers’ Compensation Board.

This can feel surprising to people because they may assume that reporting only happens if they choose to start a claim. In situations in which a client presents for treatment related to work-related injury, accident, or incident, health care providers have reporting obligations connected to workplace injuries, including psychological injuries.

The purpose of this disclosure is not meant to override a person’s experience, it is part of how workplace injury systems function under Alberta law.

10. Reports of professional misconduct

If a client discloses certain kinds of misconduct by a regulated health professional, a therapist may be required to report that information to the appropriate regulatory body.

For example, some forms of sexual misconduct, abuse, or other serious professional violations may trigger mandatory reporting duties.

This kind of disclosure exists to help protect the public and to ensure that serious concerns about regulated professionals are addressed through proper oversight.

11. Coroner’s investigation

If information is required as part of a coroner’s investigation or fatality inquiry, a therapist may be legally required to disclose relevant information.

This is another example of therapy existing within a broader public and legal system. While rare, this kind of situation can arise after a death when information is needed for an official investigation.

12. Ethical complaints or legal actions involving the therapist

If a client files an ethical complaint or starts legal action against a therapist, the therapist may need to disclose relevant information to regulatory bodies, legal counsel, insurers, or others involved in responding to that complaint or legal process.

This can feel awkward to read because therapy is supposed to be private, and clients may not expect that a complaint or lawsuit changes that privacy.

However, if a therapist is required to respond to allegations, they need to be able to disclose relevant information for that purpose.

13. Regulatory audit

Psychologists and some other regulated professionals may be subject to regulatory audits by their college.

If that happens, certain parts of a client file, such as dates, notes, or documentation practices, may be reviewed by authorized auditors as part of ensuring professional standards are being met.

This is not the same as your file being casually shared. It is a regulated oversight process tied to professional accountability.

14. Threats or aggressive behaviour in the office

If a client behaves in a way that is aggressive, threatening, or dangerous while on the premises, relevant information may need to be shared with building security, property management, or law enforcement to maintain safety.

This is not about punishing emotional intensity. Therapy can include strong feelings. The issue here is behaviour that creates a safety concern in the office or building.

15. On-site emergencies

If a medical, fire, security, or other emergency happens on site, information may need to be shared with emergency responders so they can respond appropriately.

In urgent situations, safety takes priority. This kind of disclosure is usually practical and limited to what emergency personnel need in order to help.

16. Insurance coverage requirements

If therapy is being billed through an insurance company, some identifying and billing information may need to be disclosed for reimbursement.

This often includes things like session dates, times, provider information, and billing details. In some cases, insurers may request more information depending on the plan or claim requirements. (When an insurance company requires information beyond administrative as part of their agreement to cover services (e.g. assessment, disability report), a client has likely signed a consent to disclose as part of their agreement. This is one reason many therapists explain that using insurance can involve some loss of privacy compared with paying privately.)

Why Limits are Helpful

It is very common for people to read a list like this and feel a tightening inside.

Some people feel afraid.
Some feel mistrustful.
Some feel sad.
Some feel reminded of past experiences where control was taken away from them.

A list of legal limits can sound impersonal if it is not explained with care. It can feel like therapy is preparing to protect systems before protecting you.

But in practice, this is not what informed consent is trying to do.

Knowing the limits of confidentiality can help in several ways.

First, it reduces ambiguity. Many clients feel more settled when they know where the edges are. Unspoken rules tend to create more anxiety than clear ones.

Second, it creates room for real conversation. If you know there are limits, you can ask about them. You can bring in hypothetical situations. You can ask what would happen if you disclosed something specific. You can understand how your therapist thinks about risk, safety, and legal duties.

Third, it supports collaboration. When clients understand the framework, disclosure is less likely to feel sudden or mysterious if a serious issue does arise. Even when a therapist has to act, they can often explain what is happening and why.

Fourth, it reinforces that therapy is not arbitrary. Therapists are not supposed to make up their own rules based on mood, fear, or personal preference. Their decisions are guided by law, ethics, and professional standards.

And, this may be the most important part of all..

The limits of confidentiality are not there to punish people for struggling. They are not there to catch people being “bad.” They are not there to make therapy feel like surveillance.

They exist because some situations involve more than privacy alone. They involve safety, vulnerability, legal accountability, or emergency response.

When those situations arise, a therapist’s role may expand beyond listening and supporting. That does not mean the therapist has stopped caring. It means they are carrying more than one responsibility at once.

Often, the most helpful way to think about these limits is not as punishments, but as protective boundaries. Boundaries are not there because everyone is doing something wrong. They are there because, in certain conditions, extra protection matters.

And if the Therapist has to Disclose?

Even where the law allows or requires disclosure, good therapists do not treat these moments casually.

Whenever possible, they try to explain what is happening.
They try to involve clients in the process.
They try to share only what is necessary.
They try to preserve dignity in situations that can easily feel frightening or exposing.

This is part of ethical care too.

The law may define when disclosure is possible or necessary. The therapist’s humanity shapes how that disclosure is handled.

Questions you are encouraged to ask

You never need to sit quietly with uncertainty about confidentiality.

You are allowed to ask:

• What kinds of things stay private?

• What kinds of things would have to be reported?

• How do you decide whether something is a risk?

• Would you tell me if you needed to share information?

• How much information would you share?

• What happens if Child and Family Services contacts you?

• What happens if I use insurance?

• What happens if I talk about suicidal thoughts?

• What happens if I talk about violent thoughts that I do not want to act on?

These are not difficult questions. They are part of informed consent, and many therapists welcome them.

You deserve to know how counselling works before you begin.
You deserve to understand what is private and what is not.
And you deserve a therapist who can explain all of this in a way that feels respectful, clear, and human.

If you are starting therapy and feel unsure about confidentiality, bring that question into the room. It belongs there.

This article was authored by Penelope Waller Ulmer, a verified therapist in our network. Learn more about their expertise and approach below.

Penelope Waller Ulmer

Registered Psychologist (AB)Registered Psychologist (YK)MACP, BA

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