Confidentiality, record-keeping, and release of information under Maryland law
Confidentiality, records, and release
This domain tests the psychotherapist-client privilege, Maryland confidentiality statutes, and practical record rules. Confidentiality is broader than privilege: privilege governs court testimony, while confidentiality governs everyday disclosure.
Core rules
- Mental health information is confidential and may be released only with a valid written authorization or a statutory exception.
- Exceptions include suspected abuse or neglect, court orders, emergency disclosure to prevent serious harm, and certain treatment or payment operations. A subpoena alone may not override privilege; a court order or client authorization is usually needed.
- Records must be accurate, secure, and retained under Board rules, generally at least seven years after the last service, with special rules for minors.
- Clients have rights to inspect and amend records, subject to exceptions for harm or third-party information.
Worked example
An attorney subpoenas a psychologist's file without the client's consent. The psychologist should not automatically release the file. The psychologist should notify the client, assert privilege, and seek a court order or valid authorization. If the court orders limited disclosure, release only what is ordered.
Traps
Do not treat a subpoena as consent. Do not release the entire record when a summary or redacted copy satisfies the request. Do not discuss a client's care with a spouse or employer without a valid authorization, even if the client is a family friend.