Mandatory Reporting, Confidentiality, and Privileged Communication
Confidentiality and privilege are not the same
Confidentiality is the professional and statutory duty not to disclose client information. Privilege is an evidentiary rule that lets the client prevent compelled disclosure in legal proceedings. Colorado's psychotherapist-client privilege is in C.R.S. 13-90-107(1)(g). The client holds the privilege; the LMFT asserts it on the client's behalf unless the client waives it. Privilege is not absolute: waiver, court order, mandatory reporting, involuntary commitment proceedings, and other statutory exceptions can alter the analysis.
Mandatory reporting
Under C.R.S. 19-3-304, any person who has reasonable cause to know or suspect that a child has been abused or neglected must report to the county department of human services or local law enforcement. The standard is reasonable cause, not proof, and the therapist should not investigate. For at-risk elders and at-risk adults with intellectual and developmental disabilities, C.R.S. 18-6.5-108 imposes a similar mandatory report to county adult protective services or law enforcement. Document the disclosure, the report, and the agency contacted.
Worked example
An adult client reports leaving her 7-year-old child alone overnight while she works. The therapist suspects neglect and feels torn because the client is the identified patient. The therapist must report: reasonable cause of child abuse or neglect triggers the statute, and confidentiality does not block a mandatory report. The therapist should tell the client, in advance if possible, what must be reported and why, and should not promise secrecy.
Traps that cost marks
Do not wait for proof or corroboration. Do not report suspected child abuse only to the Board or to a supervisor. Do not assume a parent's consent makes disclosure unnecessary. Do not assume privilege bars a mandatory report. Do not forget at-risk adult reporting. Do not release records on an informal request or subpoena without checking authorization or a court order.