Which statement about psychotherapy notes under the Privacy Rule is accurate?

• A. They are part of the medical chart
• B. They are always kept with the patient record
• C. They are kept separately and may contain the clinician's personal thoughts about the session
• D. They may include treatment plans and prognosis

Answer: (C)

Psychotherapy notes are protected and kept separate from the standard medical record to safeguard sensitive clinical information. They’re often where a clinician records impressions, reflections, and other thoughts from a session, which is why they aren’t part of the usual patient chart. Because of this separation, releasing them typically requires explicit patient authorization and they aren’t routinely included in disclosures. Treatment plans and prognosis are usually documented in the medical record rather than in psychotherapy notes, so the statement that psychotherapy notes are kept separately and may contain the clinician’s personal thoughts about the session is the most accurate.