Therapist Notes: Can I View My Therapy Process Notations?

Therapist notes are records of discussions that occur during therapy sessions. These notes help therapists document their impressions and gain a comprehensive understanding of your experiences. It is understandable to be curious about these notes, but unlike other medical records, they are subject to special protections. While you can request access, your therapist may decline due to legal restrictions.

Understanding Therapy Notes

HIPAA defines psychotherapy notes as any documentation or analysis of conversations during counseling sessions. They differ from progress notes, which document treatment progress, symptoms, diagnosis, functioning, treatment plans, and prognosis. Therapy notes contain more personal information and are intended for the therapist's sole use, ensuring greater privacy and confidentiality.

Reasons for Accessing Therapy Notes

There are various reasons why you may wish to access your therapy notes:

• Changing Therapists or Moving: If you are transitioning to a new therapist or relocating, having your therapy notes can provide continuity of care.

• Concerns about Therapist Actions: If you have concerns about your therapist's conduct, reviewing your notes may shed light on the situation.

• Personal Insight: Reading your therapy notes may offer insights into your experiences and help you understand your journey.

• Improved Treatment: Some individuals believe that accessing their therapy notes can enhance their treatment outcomes and engagement in the process.

When requesting access to your notes, clearly explain your reasons to your therapist. However, if they decline, it is essential to respect their decision, as state and federal laws may prohibit access.

Patient's Rights and Limitations

Under HIPAA, you have the legal right to access most of your medical records. However, psychotherapy (process) notes taken during sessions are explicitly excluded from this right. Federal law considers process notes as the therapist's thoughts and impressions, and therapists are not legally obligated to share them with their clients.

On November 20, 2020, new federal rules mandated healthcare providers to offer patients access to their clinical notes. However, psychotherapy notes remain excluded from this requirement.

Potential Benefits of Seeing Therapy Notes

While therapy notes are primarily intended for therapist use, there is evidence suggesting that allowing clients to read these notes can be advantageous:

• Increased Involvement: Active participation in treatment can be enhanced by reviewing therapy notes.

• Enhanced Understanding: Clients may feel better heard and understood when they read their therapist's thoughts and interpretations.

• Empowerment: Accessing therapy notes can empower clients, fostering a sense of control over their treatment.

• Treatment Adherence: Reading therapy notes may improve medication and treatment adherence.

• Progress Tracking: Clients can track their progress and gain insights into their therapeutic journey.

Risks of Viewing Therapy Notes

Despite the potential benefits, there are risks associated with reading therapy notes:

• Therapist's Perspective: The therapist's thoughts and opinions may impact the client-therapist relationship.

• Uncomfortable Content: Therapy notes may contain challenging or distressing information that can be emotionally taxing for the client.

• Potential Misinterpretation: Clients may misinterpret the therapist's notes, leading to confusion or misunderstanding.

Requesting Notes from Your Therapist

If you wish to access your therapy notes, engage in a dialogue with your therapist. Explain your reasons for wanting to review them, as this can help them comprehend your request. If your therapist declines, respectfully accept their decision, refraining from arguing or becoming confrontational.