The 3 exceptions to confidentiality are imminent risk of harm to self or others, child abuse or elder abuse and court order.
Counselors, therapist, doctors etc are bound by confidentiality in which they cannot discuss a patients details to others.
However there are exceptions and doctors, therapists, counselors etc are also required by law to report any imminent risk of harm to the patients self or other people or report any cases of child abuse or possible child abuse or elder abuse.
Or if a court order requires the counselor, therapist, doctor, nurse etc to report anything and break confidentiality then they must do so.
The following things often obligate therapists or counselors or anyone else to break confidentiality and seek outside assistance.
Detailed planning of future suicide attempts.
Other concrete signs of suicidal intent.
Planned violence towards others.
Planned future child abuse.
Formerly committed child abuse.
Experiencing child abuse.
Laws also state that people such as Physicians, surgeons, coroners, dentists, dental hygienists, osteopaths, resident interns, nurses, hospital personnel, therapists, social workers, counselors, law enforcement, detectives, judges, prosecuting attorneys, daycare's, foster cares, teachers, school administrators, other school personnel and child care workers as well as attorneys are mandated reporters.
This means that these people being mandated reporters must by law report any self harm thoughts, child abuse, neglect, adult abuse, elder abuse or anything else that may cause harm to the person or other people.
The mandated reporters must contact police and or social services to report these things.