In today’s fast-paced, tech-driven world, texting is one of the most common ways people communicate. For mental health professionals, it can feel natural to use text messages for scheduling, reminders, or brief check-ins with clients. But what’s actually allowed when it comes to texting clients—and how can you stay compliant with privacy laws like HIPAA? Let’s break it down.

When Texting Is Permissible

Texting can be appropriate in limited, well-defined circumstances—mainly for administrative purposes. This includes scheduling or confirming appointments, sharing location details for sessions, or notifying clients of office closures or emergencies. Texting should not be used for therapeutic communication or discussions involving sensitive client information. Even simple exchanges can unintentionally reveal private details or create blurred boundaries between professional and personal roles.

Before sending any text, always ask:

• Is this message necessary for administrative reasons?
  
• Could this communication be misinterpreted or compromise confidentiality?

If the answer is unclear, it’s best to use a secure, documented communication method instead.

Using HIPAA-Compliant Platforms

Not all texting tools are created equal. Standard SMS text messages are not HIPAA compliant because they can’t guarantee encryption or secure storage. If your practice communicates electronically, make sure you’re using a HIPAA-compliant messaging platform that provides end-to-end encryption, secure user authentication, audit trails, and Business Associate Agreements. Some examples include Spruce Health, OhMD, or Updox, which are designed specifically for healthcare communication and documentation.

Documenting Client Communication

Even if a text exchange is brief, it’s still part of the client record. Proper documentation protects both you and your client. Best practices include summarizing all client-related texts in the clinical record, noting the date, time, and purpose of the communication, and saving or screenshotting messages if they are relevant to care decisions. Having a clear documentation process ensures transparency, supports ethical practice, and helps maintain compliance in the event of an audit or dispute.

Respecting Privacy and Consent

Before engaging in any form of electronic communication, always obtain written consent from clients. Explain what types of communication are permitted (e.g., scheduling vs. therapeutic discussion), what platforms are used and how they’re secured, and the risks of electronic communication, including potential breaches. This consent should be part of your intake paperwork and revisited periodically, especially if your policies or platforms change.

While texting can make communication more convenient, it must be handled with care. Staying mindful of HIPAA standards, maintaining clear documentation, and respecting client privacy are essential for building trust and maintaining professional integrity.

Have a Question about Digital Boundaries?

We’re building this series based on your real-world challenges. What questions do you have about navigating professional communication in the digital age? Send us your questions and we may feature them in next month’s blog!