Most people preparing for a first therapy session think about what they will say. Far fewer think about what happens to it afterwards — and yet, from the moment you fill in an intake form, you are creating a record. That record holds some of the most sensitive information that exists about you.
This guide explains what actually happens to your information when you start therapy in Nepal: where it goes, who can open it, how long it is kept, and what you are entitled to ask. It is written so you can hold any practice to it, including ours.
Your information starts before the first session
The record begins earlier than most people expect. By the time you sit down for session one, a practice may already hold your name and phone number, the reason you got in touch, an intake form covering history and symptoms, and any messages you sent while booking.
This matters because these early pieces are often handled the most casually. A first message may sit in a personal inbox; an intake answer may live in a general form tool that was never built for health information. The care taken at this stage tells you a lot about the care taken later.
Where clinical records are supposed to live
A clinical record is not simply a document. It should sit inside a system designed for health information, which means a few specific things:
- Encryption in transit and at rest — protected both while moving across the internet and while stored
- Access control — only the people involved in your care can open your file, through their own named accounts rather than one shared login
- An audit trail — a log recording each time your record is opened, and by whom
- Separation — one practice's records held apart from any other practice's
- Backups — so records survive a lost laptop or a failed server
The distinction that matters is not encrypted versus unencrypted. It is whether clinical information stays inside clinical systems at all, or drifts into ordinary tools — an inbox, a spreadsheet, a chat thread — because that was quicker on a busy day.
What your therapist writes down
Clinicians keep notes because good care requires continuity. A note is a working clinical document — what was discussed, how you presented, what was agreed, what to follow up. It is not a transcript, and it is not a verbatim account of everything you said.
You are allowed to ask what goes into your notes. A reasonable practice will tell you plainly, and many clients find that the answer is less alarming than they imagined.
Recording, transcription, and AI
This is newer ground, and worth asking about directly. Some practices record sessions. Some use automatic transcription. Some use AI tools to help draft notes. None of these is automatically wrong — but each creates a second copy of your session, and you are entitled to know whether that copy exists and where it lives.
- Is the session recorded, in audio or video?
- Is it transcribed automatically by software?
- Is any part of it passed to an AI tool to help write notes?
- If yes to any of these, where is that stored, who can access it, and for how long?
A practice that has thought this through will answer quickly and specifically. Hesitation, or an answer that stays vague, is itself informative.
Who else can see your file
Inside a practice, access should follow the principle of minimum necessary: the people involved in your care, and no one else. In a small clinic it is easy for everyone to end up able to open everything, simply because there is one login and nobody set up anything more careful.
The question worth asking is not only who can see your file, but whether there is any record of who did. An audit trail changes the situation, because access stops being invisible.
How long records are kept
Clinical records are generally retained for a period after therapy ends rather than deleted immediately. This is normal and protective: if you return to therapy years later, or need documentation of the care you received, the record needs to exist.
What retention should never mean is that your information gets repurposed — used for marketing, shared with advertisers, or sold. Those are different things, and it is fair to ask a practice to distinguish them for you.
Where confidentiality genuinely ends
No practice can offer absolute confidentiality, and one that promises it is telling you something inaccurate. The limits are narrow, and a clinician should explain them before ongoing work begins:
- Serious risk of harm to you or to another person
- Where disclosure is required by law or a valid legal order
- Care coordination you have specifically agreed to — such as a psychiatrist you ask your therapist to speak with
Hearing these limits stated openly is a good sign rather than a worrying one. It means the boundaries have been thought about, and that you will not discover them at the worst possible moment.
Also read: How we protect your information →
What you can ask for
You can ask what information a practice holds about you, ask for factual corrections, ask how any part of the process works, and ask what would happen to your file if you stopped therapy. These are ordinary requests, not confrontational ones.
A short checklist before your first session
- Where are my records stored, and who else can open them?
- Is my intake form going into a clinical system, or a general form tool?
- Are sessions recorded or transcribed?
- Is any of my information sent to an AI tool?
- Is there a log of who opened my file?
- What exactly would make you break confidentiality?
- If I stop therapy, what happens to my file?
You are not being difficult by asking. You are doing what anyone would do before handing over something valuable — and the answers will tell you a great deal about how a practice works.