this post was submitted on 17 Sep 2025
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privacy
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Aren't the ethics rules that notes are only for the therapist?
Not even clients get to see their own notes.
That said, I dated a therapist once. And she was glad to share with me the notes on her patients. Lots of unethical therapists out there.
Law now says clients have to be given access to their notes, you can probably access them through a web portal or by asking. That said I do not encourage people to do so regularly because it creates the wrong kind of feedback loop where you're trying to influence the notes instead of following your therapist's (hopefully) guidance.
But HIPAA rules apply to notes, for instance the therapists I support have 365 HIPAA or better (self hosting has its own problems and most therapists aren't scaled for it).
So I suppose I'd have no hope of finding a therapist where notes are local-only on airgapped (eg. no nic, never online) devices and remote sessions, if offered, are over Signal?
Signal is not HIPAA compliant
HIPAA affects the technical implementation because the law requires certain features that signal lacks. Without those features, signal cannot be used for healthcare in the US.
https://www.hipaajournal.com/is-signal-hipaa-compliant/
Mine simply doesn't take notes. We just walk and talk.