Therapy is a place where everything you reveal is always kept completely safe and secret, right? Wrong. Although therapists work under codes of ethics and the law, there are times, such as we saw in the Johnny Depp/Amber Heard lawsuit trial, when telling all is permissible. Before you decide to tell all, perhaps a bit of a refresher would be helpful for you.

The first time you go to a psychotherapy session your therapist must tell you about the limits of confidentiality in psychotherapy. Everything will be kept confidential except under certain conditions where a therapist must break confidentiality or seek other assistance, and these  include:

• Detailed planning of future suicide attempts
• Other concrete signs of suicidal intent
• Planned violence towards others
• Planned future child abuse
• Current evidence of elder abuse
• Formerly committed child abuse
• Experiencing child abuse
• Money laundering, terrorism, drug trafficking or potential future criminal actions

Court orders may attempt to pry the information from a therapist's notes, but a court order doesn't mean the therapist must release the information. That's not always the case.

Laws differ between states and it is in both the therapist and the patient's interest to gain information regarding how their state details matters of confidentiality. The therapist may resist and go to jail for their lack of cooperation. But the therapist may also appeal to the patient to release them in order to comply with the court order. This is called asking the patient to exercise their "privilege" and permit the therapist to reveal what they know.

Marriage counseling presents another aspect of the issue of both confidentiality and privilege. If both partners are in the therapy sessions, one may agree to wave privilege and permit the therapist to disclose whatever has been discussed. In the Johnny Depp/Amber Heard lawsuit, there appears to have been a release of several therapists from the constraints of both confidentiality and privilege. Therapists have appeared at the court sessions and discussed, at length, issues related to the marital relationship as well as the results of psychological testing taken by Amber Heard.

Anyone wishing to acquaint themselves with the various state laws regarding confidentiality and therapy can go to a website which contains information on state legislatures and a mental health professional's obligations, specifically the duty to warn. It should be remembered that the duty to warn may mean informing someone of a patient's intention or thoughts of hurting that individual. In some instances, this is also regarded as the duty to protect imperative.

Lawmakers included specific indications regarding the duty to warn after a highly-publicized murder case in California where a young woman, Tatiana Tarasoff, was killed by a college student she had dated previously. The student had informed the university therapist of his thoughts of hurting her and the courts found the university had provided inadequate protection for Ms. Tarasoff who was then murdered as a result. The case is detailed in Tarasoff v. Regents of the University of California (1976).

Both psychotherapists and patients would be wise to be fully informed regarding both confidentiality and privilege in all their aspects relative to the information contained in therapy sessions or via psychological testing.