Mental health

What are psychotherapy notes, and can you get a copy?

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Psychotherapy notes are your therapist's private process notes, kept separate from your medical record and given extra HIPAA protection. You may not have an automatic right to those specific notes, but you do have a right to the rest of your mental-health record, usually within 30 days [1][2].

Last updated: July 2026

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What exactly are psychotherapy notes?

Psychotherapy notes are a specific, narrow category under federal privacy law. They are the notes your therapist keeps for their own use — working through what a session meant, testing ideas, and planning — and they live apart from the shared record. That is different from the clinical documentation that belongs in your chart, such as your diagnosis, symptoms, medications, test results, treatment plan, and session start and stop times. The American Psychological Association explains that confidentiality is the foundation of therapy, with only limited exceptions 1. Because psychotherapy notes are set aside from the rest of the record, they are handled under stricter rules than ordinary chart entries. Our guide to how to request your therapy notes walks through what usually is and isn't included.

Are they protected differently from the rest of your record?

Yes, psychotherapy notes sit under a higher level of protection than most health information. HIPAA generally requires a provider to obtain your separate, specific authorization before disclosing these notes, even to an insurer, and a blanket release for your other records does not automatically cover them. Your broader health information is protected too, but it moves more freely for treatment, payment, and health-care operations. The U.S. Department of Health and Human Services describes the individual rights HIPAA grants over your protected health information, including access and corrections 3. Knowing the distinction helps you ask the right question, because what your therapist can and can't keep private depends on which category the information falls into.

Can you get a copy of your notes?

You have a broad right to your medical record, but psychotherapy notes are the main exception. Under the HIPAA right of access, a provider must give you a copy of the information in your designated record set, usually within 30 days, and any fee has to be reasonable and cost-based 2. Your therapist's private process notes generally fall outside that right, so a provider can decline to release them — though many will still discuss their contents with you or share them voluntarily. Everything else in your mental-health chart is typically obtainable, increasingly through online portals. Our overview of reading your records through a portal and the 30-day rule explains the timelines.

What can you do if access is denied?

A denial is not always the end of the road, and you have options. Federal rules increasingly discourage unnecessary blocking of your electronic health information: the 21st Century Cures Act defines information blocking as a practice that interferes with access to your records, with specific exceptions, and federal agencies oversee it 4. If you believe your right of access was wrongly denied, you can ask the practice for its reason in writing, request a review, or file a complaint with the HHS Office for Civil Rights. Psychotherapy notes remain a legitimate exception, so a refusal there may be proper. For the rest of your record, our guide to filing a HIPAA complaint over denied records lays out the steps.

When it helps to ask your provider

Asking your therapist directly is often the simplest path, and the conversation itself can be useful. A brief request lets you learn what is documented, correct anything inaccurate, and understand what will and will not be shared with an insurer or a new clinician. Providers are used to these questions, and being clear about why you want the information — continuity of care, a second opinion, or your own understanding — usually smooths the process. If the notes are being withheld, you can still access the substantive parts of your record and ask for a summary. Gale can help you make a records request and point you to the right form, so your history follows you when you change providers.

Common questions

Psychotherapy notes are your therapist's private process notes, kept separate and given extra HIPAA protection. Your therapy record — diagnoses, medications, treatment plans, and session times — is part of your chart and is generally accessible to you 12.

Not automatically. These specific notes are the main exception to the HIPAA right of access, so a provider can decline to release them, though many will discuss them with you. The rest of your record is usually obtainable within 30 days 2.

Generally not without your separate, specific written authorization. HIPAA gives psychotherapy notes stronger protection than ordinary records, so a routine release does not automatically cover them 3.

You can ask for the reason in writing, request a review, or file a complaint with the HHS Office for Civil Rights. Federal information-blocking rules also discourage unnecessary interference with your electronic records 4.

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Good to know about your records and privacy

  • —A provider refuses to explain in writing why records were withheld
  • —You spot an error in your chart that could affect your care
  • —You need records transferred quickly for a new clinician or a second opinion

This article explains general HIPAA rights and isn't legal advice; rules can vary by state and by situation.

References

  1. 1.American Psychological Association (2024). Protecting your privacy: Understanding confidentiality in psychotherapy. American Psychological Association. link ✓therapist-confidentiality
  2. 2.U.S. Department of Health and Human Services (2023). Individuals' Right under HIPAA to Access their Health Information — 45 CFR § 164.524. HHS.gov. link ✓Patients have a right of access to their designated record set under 45 CFR 164.524; psychotherapy notes (private notes separate from the clinical record) are excluded from this right; providers have 30 days to respond with one 30-day extension permitted
  3. 3.U.S. Department of Health and Human Services (2022). HIPAA Privacy Rule and Sharing Information Related to Mental Health. HHS.gov. link ✓Guidance on HIPAA rules specific to mental health information, including the psychotherapy notes exception and situations where state law provides stronger protections
  4. 4.Office of the National Coordinator for Health Information Technology (ONC/ASTP) (2024). Information Blocking. HealthIT.gov (ONC). link ✓hipaa-right-of-accessinformation-blocking

4 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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