Confidentiality, Privacy & Rights

Private Mental Health Information

In accordance with the Illinois Student Optional Disclosure of Private Mental Health Act (the “Act”, P.A. 99-278), a student’s mental health information is considered private and will not be released to a third party without that student’s prior written consent, unless otherwise provided by other state or federal laws. Please read the Administrative Procedure in its entirety.

Student Optional Disclosure of Private Mental Health Information

Disclosure Form

Student Rights & Confidentiality

If you have any questions about confidentiality, I will gladly discuss them with you. The purpose of this confidentiality statement is to enhance the therapeutic relationship by ensuring and allowing you to understand the boundaries of information that you can comfortably and confidentially share in therapy.

Student and client will be sued interchangeably in this document and has the same meaning, "an enrolled student that is receiving or received in the past, any form of counseling provided by a licensed counselor located in CSU Counseling center. means that I have a responsibility to safeguard the information obtained during counseling. All identifying information about your assessment and treatment is kept confidential, except as mandated by law. You must sign a release of information before any information about you is given to anyone, except as mandated by law, which is outlined further below. Any communication or discussion between us is confidential. This means that I will not discuss your case orally or in writing without your expressed written permission.

All interactions which take place in the setting of counseling are considered confidential. This includes requests by telephone, all interactions with me, any scheduling or appointment notes, all session content records and any progress notes that I take during your sessions.

I will not verify that you are a student receiving counseling services from the CSU Counseling Center. I prefer not to leave messages on my client’s voicemail. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate. The law protects the privacy of communication between us. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPPA.

I may occasionally find it helpful to consult with other health and mental health professionals about a case. During such consultation, I make every effort to avoid revealing the identity of you, the client. The other professionals are also legally bound to keep any information shared confidential. I work with other mental health professionals in the counseling center, and I may eventually employ administrative staff.

I may need to share protected information with individuals for clinical purposes. All mental health professionals are bound by the same rules of confidentiality, and we are all responsible for practicing professional codes of ethics. All counseling team members have been given training about protecting your privacy and have agreed not to release any information outside of the practice without the permission of a professional staff member.

Limits of Confidentiality

Confidentiality is extremely important to our counseling relationship. What we discuss in therapy will not be passed on. However, there are circumstances in which I have an ethical and legal obligation to break confidentiality. These circumstances include if:

There is a reason to believe there is an occurrence of child, elder, or dependent adult abuse or neglect, including being impaired while caring for a child or vulnerable adult.
There is reason to believe that you have serious intent to end your life, and/or if you intend to harm yourself, someone else, or property by a violent act you may commit.
You introduce your emotional condition into a legal proceeding.