Running a practice
When can a therapist break confidentiality, as mandated reporters?
While therapists have an essential responsibility as mandated reporters, it’s challenging to navigate. Learn when a therapist can and must break confidentiality.
August 19, 2024 • Updated on August 29, 2025
4 min read
Confidentiality is one of the core values that creates a safe, trusting therapeutic relationship. When your clients feel confident that what they share stays between the two of you, they’ll be more likely to share their thoughts and feelings authentically, leading to more productive therapy. That said: In rare and serious cases, you may have an ethical and legal obligation to break client confidentiality.
Mandatory reporting laws, or mandated reporting, require therapists to report to authorities when a person is being harmed or is in danger of being harmed. While you as a therapist have an essential responsibility as a mandated reporter, the process can be challenging to navigate.
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Situations that require mandated reporting and breaking confidentiality
In general, mandated reporting laws exist to protect individuals — and specifically vulnerable persons including elderly people, children, or those living with disabilities, for example — who often cannot protect themselves from harm. Each state in the U.S. has its own mandated reporting requirements for therapists, with guidance about which situations are mandatory to report and how they should be reported.
The most common mandated reporting situations include:
- Physical harm can be any form of bodily harm against another person, such as beating, hitting, kicking, biting, or choking. In some states, this also includes spanking.
- Sexual harm involves any form of sexual abuse. According to the National Sexual Violence Resource Center, sexual abuse takes place when “a person knowingly causes another person to engage in a sex act by threatening or placing the other person in fear, or if someone engages in a sexual act with a person who is incapable of appraising the nature of the act or unable to give consent.”
- Neglect entails ignoring a vulnerable person’s emotional, educational, medical, or physical needs.
Some mandated reporting situations can be murkier, such as the circumstances surrounding a client disclosing intent to harm or kill another individual; your state may have a law about the circumstances under which you are allowed to tell the individual your client plans to harm. That’s why it’s so important to be aware of your state’s individual laws, and your responsibilities within them.
How to report
In order to report, you need specific information. For example, you typically would not report if a client tells you they’re having intrusive thoughts about harming a child. However, if the client admits they harmed a child in some way, or if they reveal a plan and intent, you would be mandated to file a report.
Where you report depends on the information you’ve received. If a child is being harmed, then you’d contact your area’s Child Protective Services. If an elderly individual is being harmed, then you’d contact Adult Protective Services. Call the police if someone is homicidal, and the suicide hotline (988 or your state’s designated number) if someone is considering self-harm or suicide. In any case, always defer to your state’s laws when it comes to mandated reporting.
Please always consult your state licensing and reporting laws for understanding your client’s specific situation and any obligations that may arise.
How to discuss this with your clients
Discussing mandated reporting requirements with your clients may feel awkward, but it’s essential to do so proactively. For many people, it takes a great deal of trust and vulnerability to confide in a therapist. If therapeutic conversations do not stay private, clients may feel betrayed or blindsided — particularly if they were not previously aware of your responsibilities as a mandatory reporter.
The American Psychological Association’s code of conduct says that psychologists should discuss the limits of confidentiality at the beginning of a new therapeutic relationship. Providers should inform their clients directly, as well as their clients’ legal guardians or representatives, if necessary.
Your informed consent paperwork, which a client receives at the start of therapy, should also include all the information they need to know about their confidentiality rights and your responsibility as a mandated reporter.
Also be aware that some states require therapists to notify clients and/or their families when they file a report. These conversations are never easy, but they will likely go a bit more smoothly if clients and their families already know about your legal requirements to report.
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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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