By law, therapists are required to protect your confidentiality, and a breach of this responsibility can lead to a therapist loosing their license.  The exceptions to this are related to child or elder abuse, a threat to harm another person or if you are in danger of self harm. If you want to use a third party payer to pay for therapy it will be necessary to provide the information required by your insurance company which will likely include a diagnosis.  Your therapist will discuss with you exactly what information will be confidential and when information will need to be shared.