Therapists Treating Therapists: Legal and Ethical Considerations

How can a psychotherapist navigate the potential ethical dilemmas of treating (or being treated by) another licensed mental health professional?

Two people in a therapy session.

Psychotherapists, just like anyone else, need an outlet to discuss their personal and professional lives. Attending to others’ emotional struggles and personal traumas as a full-time job can affect their own mental health. Fortunately, professional norms strongly encourage mental health professionals to seek therapy.

However, questions regarding confidentiality, ethics, and boundaries naturally arise when a psychotherapist provides therapy to or receives therapy from a professional peer. This article touches on these dilemmas and discusses approaches.  


Keeping clients’ communications private builds trust between the therapist and the client and allows for therapy to be effective. Violating privacy requirements can place a therapist in jeopardy with their ethics board and potentially violate state and federal law. 

Unsurprisingly, the ethical obligation to maintain client confidentiality lies at the heart of many dilemmas that arise from therapists treating fellow therapists. How does a therapist-client balance confidentiality with the need to express themselves freely in their therapy session? 

The therapist-client will likely want to discuss how working with their own clients affects their well-being. In this situation, the therapist-client should always protect their patients’ privacy. Ideally, therapist-clients should speak about their clients in only the most general terms.  At a minimum, the therapist-client must refrain from disclosing any information that could identify a specific individual.

Naturally, the therapist providing treatment is ethically obligated to keep the contents of the session confidential. However, the therapist-client receiving treatment should still mind the details that they divulge and not rely on the treating therapist’s ethical responsibility to maintain confidentiality. 


If you’re a therapist and had a positive experience receiving care or treating another therapist, you may be tempted to refer others to them for care. Is this allowed? 

No specific law bars a therapist from referring clients to their own therapist or to a therapist-client. However, you should proceed with caution. Only refer clients to a therapist if, in your professional opinion, you believe the therapist can benefit that client for a reason based on their own specialty or experience. Otherwise, referring prospective clients to a clinician with whom you have a therapeutic relationship can lead to ethical and legal quandaries. 

For instance, say that you refer a client to a therapist with whom you are friendly, knowing that the therapist’s pay will increase with each additional client. This is ethically questionable at best. Instead, consider the client’s various needs before making such a referral. Additionally, you should never form any sort of agreement with your therapist (or therapist-client) to receive a personal or financial benefit for referring clients to one another. Doing so could violate state or federal law.

Professional Boundaries 

If you watch television, you probably love it when your favorite show does a crossover episode with another series. However, it’s often less enjoyable when your own life feels like a crossover episode. This can happen at conferences or other professional events where therapists may bump into their therapist-clients. Such encounters can make it difficult to maintain confidentiality and keep your professional and personal lives separate.

Professional events are not the only context in which professional boundaries can become difficult. For instance, say you have a new client who came to you after a negative experience with your therapist-client. If the new client brings up their struggles with their former therapist, the situation can become uncomfortable. 

When situations like these challenge professional boundaries, remind yourself to maintain “CPR” – Confidentiality, Professionalism, and Record. 

  • Maintain client confidentiality in a way that is consistent with your specific licensure’s ethical obligations; 
  • Maintain professionalism in a way that still allows all parties involved to feel comfortable and respected; and
  • Keep a record of any client exchanges where professional boundaries came into play so that you can refer back to your notes for future reference.

Make a Plan

When working with therapist-clients, it’s vital to make a plan and set expectations. During the first meeting with the therapist-client, you should discuss how you will keep client information confidential and your policy for referring patients to one another. Clear communication from the outset can help prevent conflicts of interest or violations of professional ethics as the relationship evolves. 

Get Legal Help

The attorneys at Jackson LLP work with therapists navigating ethical boundaries and internal practice policy questions. We are in the business of helping prevent ethical dilemmas before they arise. If you operate in any of the states where we have licensed attorneys, contact us for a free consultation to find out if we fit your needs.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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