Unless you are using insurance, the confidentiality of the psychotherapy process is virtually absolute. The rare exceptions govern those cases where someone presents a real threat of harm to himself or herself, or to someone else.
If you are using insurance, then other factors do come into play. I discuss these factors with anyone who consults me and asks about using insurance. They involve the need to submit a psychiatric diagnosis to insurance companies, and the possibility, under some insurance plans, of having to submit more detailed information about your situation and what we discuss.