Confidentiality, Privileged Communication, and Mandatory Reporting
Separate two ideas. Confidentiality is the professional and statutory duty not to disclose information learned in the professional relationship; it arises from the Practice Act, Board rules, and federal privacy law. Privilege is an evidentiary rule that protects the client from compelled testimony in legal proceedings, is held by the client, and can be claimed or waived by the client or the client's representative. A subpoena tests privilege; it does not by itself create authority to disclose, and a subpoena served without a court order or client authorization requires verification, client notification, and often legal consultation.
Both duties yield to recognized exceptions: valid written authorization (limited in scope, purpose, and duration, revocable); a court order; imminent risk of serious harm to self or others; reporting of suspected child abuse or neglect to the Children, Youth and Families Department's statewide intake line; reporting abuse, neglect, or exploitation of a vulnerable adult through adult protective services; commitment proceedings; and limited disclosures necessary for payment or oversight under federal privacy rules. Confidentiality generally survives the client's death.
Reporting duties attach to reasonable suspicion, not proof, and the report must go to the designated agency, not merely to a supervisor or an internal committee. Federal privacy rules permit these reports; they do not forbid them.
Traps: treating every disclosure of domestic violence between competent adults as a mandatory report (generally it is not, absent a specific rule, injury pattern, or incapacity); conflating confidentiality with privilege; assuming a client's verbal permission suffices where written authorization is required; and believing that telling a supervisor satisfies a statutory reporting duty.
Rule of thumb: disclose the minimum necessary to meet the specific exception, document the legal basis and your reasoning, and keep the reporting obligation moving while you seek consultation.