Can Therapists Share Information With Other Therapists?

Yes, therapists can share information with other therapists, but only in defined situations: when you sign a written authorization allowing it, when the sharing is part of coordinating your treatment under HIPAA, or when a narrow legal exception like a safety emergency, a mandatory reporting duty, or a court order applies. Outside those situations, what you say in therapy stays between you and your therapist.

Sharing to Coordinate Your Care

The most common reason a therapist exchanges information with another clinician is to coordinate treatment. If you see a psychotherapist for talk therapy and a psychiatrist for medication, the two need to communicate about your symptoms, progress, and side effects. The same applies when your therapist consults with your primary care doctor so mental health care lines up with your physical health care.

Under HIPAA, your therapist can share general medical record information with other providers involved in your treatment without getting a separate written authorization for each disclosure. This treatment exception also covers payment activities like billing your insurance and certain administrative functions such as quality improvement and care coordination.¹

HIPAA’s minimum necessary standard, which usually limits disclosures to only what is needed for a specific purpose, does not apply when the disclosure is for treatment. Providers treating you can exchange the clinical information that is relevant to your care without having to parse out exactly which details are strictly necessary.² Billing insurance is different. Only the information needed to process the claim should go to the insurer, which is typically your diagnosis, dates of service, and type of treatment, not the content of your sessions.

When You Authorize a Broader Release

You control whether your therapist shares information beyond routine care coordination. The standard way to grant permission is a written authorization, often called a Release of Information form. To be legally valid under federal rules, the form has to include a clear description of what will be shared, who is authorized to release it, who will receive it, the purpose of the disclosure, an expiration date, and your signature with the date you signed.³

You can make the release broad or narrow. You might authorize your entire file, or you might limit it to a treatment summary or diagnostic information. You can also revoke the authorization in writing at any time, which stops future sharing but cannot undo disclosures that already happened.³

Psychotherapy Notes Get Their Own Consent

Federal law draws a sharp line between your general medical record and your therapist’s psychotherapy notes. Psychotherapy notes are the therapist’s private observations and analysis recorded during or after a session, kept separate from the rest of your file. They do not include your diagnosis, treatment plan, medication information, session dates, or progress summaries, all of which live in your standard medical record.⁴

Because these notes contain uniquely sensitive material, they require a separate, specific written authorization before a therapist can share them with anyone, including another therapist treating you. A general medical records authorization is not enough, and the authorization for psychotherapy notes cannot be bundled into the same form as an authorization for other records.⁵

Two narrow exceptions exist. The therapist who created the notes can use them for their own treatment of you without your authorization. And a covered entity can use psychotherapy notes in its own training programs where mental health students or trainees learn under supervision, which is the legal basis for clinical supervision discussions.⁵

Substance Use Disorder Records

If you receive treatment for a substance use disorder at a federally assisted program, your records get an extra layer of protection under 42 CFR Part 2. Historically these rules required specific written consent before any disclosure, even to other treating providers, and were significantly stricter than standard HIPAA.

A major change took effect on February 16, 2026. Under an updated final rule, patients can sign a single consent form authorizing all future disclosures for treatment, payment, and healthcare operations, bringing Part 2 closer to how HIPAA handles general medical records. Once you sign that consent, providers who receive your records can redisclose them under HIPAA’s regular rules.⁶

One protection survived the update: your substance use disorder records still cannot be used against you in criminal, civil, or administrative proceedings without a separate, specific consent. A provider or insurer who receives your records under a general treatment consent cannot turn around and share them with law enforcement or use them in litigation against you.⁷ Substance use disorder counseling notes, similar to psychotherapy notes under HIPAA, also require their own separate consent form.⁶

When a Therapist Can Share Without Your Permission

Some situations let a therapist disclose information without your consent. These exceptions are narrowly drawn, and a therapist who oversteps them faces legal liability.

Safety Emergencies

If your therapist has a good-faith belief that you pose a serious and imminent threat to yourself or another person, HIPAA permits them to share information with anyone reasonably able to prevent or reduce that threat, including other healthcare providers, family members, or law enforcement.⁸ The disclosure has to be limited to information necessary to address the danger.

Beyond this HIPAA permission, most states impose their own duty-to-warn or duty-to-protect obligations on mental health professionals. Roughly half the states make warning an identified potential victim mandatory, others leave it to the therapist’s discretion, and a small number provide no specific guidance. The details vary, but the practical point is the same: if your therapist believes someone’s life is in danger, confidentiality gives way to safety.

Mandatory Reports of Abuse

Every state requires therapists to report suspected child abuse or neglect to authorities. This obligation runs under state law, with the federal Child Abuse Prevention and Treatment Act conditioning federal grant money on states maintaining mandatory reporting systems.⁹ The therapist does not need your permission to make a report and in most states is not required to tell you before or after doing so. Most states also require reporting of suspected abuse or neglect of elderly adults and people with disabilities.

Court Orders and Subpoenas

A court order can compel your therapist to release your records. Under HIPAA, the therapist may only disclose the specific information described in the order, nothing more.¹⁰

Subpoenas work differently. A subpoena alone, without a court order, does not automatically entitle the requesting party to your records. Before your therapist can respond, the person who issued it must show they either notified you and gave you a chance to object, or sought a protective order from the court to limit how the information will be used.⁸ If you receive notice that your therapy records have been subpoenaed, you have the right to file an objection with the court before anything is disclosed.

Clinical Supervision

Therapists in training or early in their careers typically work under the supervision of a more experienced clinician. Federal rules allow psychotherapy notes to be used in training programs where students and trainees learn under supervision, without requiring individual patient authorization.⁵ The supervisor is bound by the same confidentiality obligations as the therapist. Good practice is for your therapist to tell you at the start of treatment if supervision is part of their arrangement.

Where State Law Adds Extra Protection

The HIPAA Privacy Rule sets the federal floor for how your health information is handled by most therapists and mental health practices. States can and often do go further, and many impose stricter rules on mental health records than HIPAA requires. When federal and state law conflict, the law providing greater privacy protection to the patient wins.¹¹ What your therapist can share, and under what conditions, may depend on where you live and the type of record involved.

If You Believe Your Information Was Shared Improperly

Two complaint routes are open to you, and they are independent, so you can pursue both. You can file a written complaint with the U.S. Department of Health and Human Services Office for Civil Rights, which enforces HIPAA. You generally need to file within 180 days of when you learned about the violation.¹²

You can also file a complaint with the state licensing board that oversees your therapist’s profession. Every state has boards that license psychologists, clinical social workers, marriage and family therapists, and professional counselors. These boards can investigate misconduct and impose discipline ranging from a reprimand to license revocation.

1
U.S. Department of Health & Human Services. Uses and Disclosures for Treatment, Payment, and Health Care Operations
2
U.S. Department of Health & Human Services. Minimum Necessary Requirement
3
U.S. Department of Health & Human Services. Disclosures for Emergency Preparedness – A Decision Tool: Authorization
4
U.S. Department of Health & Human Services. HIPAA Privacy Rule and Sharing Information Related to Mental Health
5
eCFR. 45 CFR 164.508 – Uses and Disclosures for Which an Authorization Is Required
6
U.S. Department of Health & Human Services. Fact Sheet 42 CFR Part 2 Final Rule
7
eCFR. 42 CFR Part 2 – Confidentiality of Substance Use Disorder Patient Records
8
eCFR. 45 CFR 164.512 – Uses and Disclosures for Which an Authorization or Opportunity to Agree or Object Is Not Required
9
Administration for Children and Families. Child Abuse Prevention and Treatment Act
10
U.S. Department of Health & Human Services. Court Orders and Subpoenas
11
U.S. Department of Health & Human Services. HIPAA Privacy Laws and Regulations
12
U.S. Department of Health & Human Services. HIPAA What to Expect