I hear this question all the time as a therapist, and it's no surprise, because the heart of counselling is confidentiality. You want to know how your data is sorted and that the things that you share with your therapist are precious. Ultimately, you need reassurance that your notes are protected.
For me, I would cling on to my client's therapy notes over my dead body. Nobody would be able to force them out of my clenched, fighting arms. I take my therapy notes
more seriously then a mother cradles her newborn baby.
There are certain ways in which your notes are written and a system to how your therapy notes are protected. There's a method to the notes and I'll cover it all here...
who writes therapy notes
when are they written
why are they written
what is written
how they are written
how they are stored
who gets to see them
why they might get to see them
Your therapy notes will be written by your therapist, and all therapists take notes either in the session and afterwards, or just afterwards. I am not the type of therapist who will write notes during a session, but my therapist friends tell me that if they write during the session, these notes will then be shredded or thrown into a fire - literally. Bombtastic. After the session, your therapy notes, which are taken during your session, will be disposed of.
Your therapist will absolutely 100% take notes about what was shared after the session.
And these notes are mandatory by our governing body, but also for the purposes of insurance. All insurance companies require notes to be taken. This is because one day - in the very unlikely event that a client will make a complaint or sue the therapist - the therapist needs to have some kind of record (dates, brief insight) into what happened.
The notes are not, I repeat, NOT elaborate details about what you may or may have shared. No therapist is writing down the name of your sister or how much you earn or how many pints you drank last night or how many followers you have on Instagram, even if these details matter to you. From a professional standpoint, in the therapy world cares about these details.
When notes are jotted down, we mean a few basic key words. By a few, I mean maybe maximum five to 10 words. And the words are keywords! Only the things that are key! They might be key words something like "sleep" or "food" or "parents" or "Mother's Day" - the most basic words. This means the actual connect of the therapy session, only really makes sense to the people who were in the session - you and your therapist. Nobody else reading the notes would be able to make sense of what happened or even what was actually shared. It is just a jumbled up mess of keywords.
You now may be asking, then what's really point of writing them if they're so unclear? The point of the notes is basically just to remind your therapist what was spoken about in the last
session and where we're up to. It's just a reminder. And the reminder needs to be detailed
enough so that it even if I am re-reading my notes years later, my memory is jogged.
But, know, your therapy notes will only be read by your therapist ... or ... you! If you wanted to read your notes, you're entitled to do so because the notes are about yourself. It's your data. YOu can request your notes and I would hand them cover (securely) with no questions asked - why wouldn't I want to see my boring jumbled up list of key words. So it will be either you or your therapist who reads your notes.
I have to say, there is one other individual who could read them, in the UK. The only other person who is allowed to read the therapy notes is a high court judge. Nobody else. Only the judge. Only. Let me make this super clear, even if my house was trampled by police, if the police forced my front door open and ordered me to show them my therapy notes, they can move along, thank you very much. It is completely within my rights as a therapist not to show them my confidential therapy notes. Only a judge gets to force me to show them the notes. Nobody else would be reading your notes.
Now, how are the notes stored? Because of course, you will probably be asking, how can we keep hackers and spies and burglars out of the notes? And of course these types of things, hackers and spies and burglars exist, but they can be prevented. Therapists have two ways
in which to secure therapy notes.
One is digitally/online and the other is old school pen and paper.
For me, I'm an old school pen and paper therapist, plus useless with technology. Typing and logging into Zoom is basically where my skills end. I keep my therapy notes written on a piece of paper with a pen and I store them under lock and key in my office. I literally have a safe and it is has a lock and a key. I keep the key very safely and I open this safe multiple times a day to access my client's notes. This means that even if a burglar came into my house, they would need to pick up the entire safe and then break the safe or pick the lock in order to read a bunch of keywords that make no sense to them.
The other way, of course, is for therapy notes to be kept secure is on a digital device.
Some therapists will store their therapy notes on their computers in a password protected document and on a password protected computer. So even if someone steals a therapist's computer, it's still almost impossible for people to access the notes. Besides it's incredibly unlikely that therapy notes will be hacked, because the really important thing is here, therapy notes are so anonymous, so uninteresting, so not detailed, that nobody is interested in these key words.
Your therapy notes are super, super protected. They're only read and written and read by your therapist. Only a judge is able to read them if this is demanded, and of course, yourself when you ask for them. Ask and you will receive. They will be a list of meaningless words and stored safely under a password or a lock and key.
Written by Lily Llewellyn, therapist working online based in the UK
March 27th 2025
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