Security Clearance & Mental Health Therapy: What You Need to Know
Quick Answer
In general, therapy and a security clearance can coexist; the key is truthful, concise reporting aligned with current SF-86 and agency guidance.
What matters most: adjudicators weigh reliability, judgment, and coercion risk—not the mere fact of seeking care.
How to report: if therapy is included, keep it brief and factual (status, stability, adherence) and follow your agency’s instructions.
Privacy-forward logistics: consider private-pay telehealth and minimal-disclosure scheduling.
Who this helps: clearance holders/applicants seeking clinically sound care with careful documentation.
Do this next: schedule a 15-minute consult.
Many federal employees and high-clearance professionals struggle silently with anxiety, depression, or trauma, fearing that seeking help might cost them their security clearance. I understand this concern deeply – I’m Dr. Sheila Vidal, a clinical psychologist who works with clearance holders in California and Virginia. Let me reassure you: according to official DCSA guidelines, getting mental health treatment does not, by itself, disqualify you from holding a clearance (DCSA, 2024). In fact, seeking counseling is seen as a sign of good judgment, not a liability (Priester, 2025). Simply put, therapy itself is not a reason to deny or revoke a clearance – and avoiding needed care can actually be more problematic.
“Seeking mental health counseling or therapy is viewed as a positive course of action and does not by itself negatively impact security clearance.”
– Defense Counterintelligence and Security Agency (DCSA, 2024)
This myth-busting stance comes straight from the Defense Department. The DCSA (which oversees clearance investigations) explicitly encourages proactive mental health care, noting that getting help demonstrates responsibility and integrity rather than instability (DCSA, 2024; Aker, 2024). As a therapist, I want you to know that prioritizing your well-being aligns with what clearance adjudicators want to see: honesty, stability, and commitment to taking care of issues appropriately (Aker, 2024). If you need support, don’t let fear keep you from getting help.
Important: This article is for education only and is not legal, agency, or security-adjudication advice. Policies can change—always review the current SF-86 Section 21 and follow your agency’s guidance. Answer all questions truthfully; if you’re unsure, consult your Facility Security Officer (FSO) or legal counsel. (Last reviewed: September 20, 2025.)
When Might You Need to Report Therapy or Mental Health Issues?
One common worry is, “Will I have to report my therapy to my employer or on my clearance forms?” The answer: generally, no – not unless it involves specific, serious circumstances. Security clearance procedures do include questions about mental health, but since 2017 the SF-86 application only asks about certain conditions or events – not routine counseling for stress, anxiety, marital issues, etc. (Kyzer, 2022). Here’s what official DoD guidance says about reporting mental health:
Initial SF-86 Application: You do not need to list all counseling or therapy you’ve ever had. The current SF-86 (Standard Form 86) focuses on serious mental health concerns that might affect judgment or reliability – for example:
Certain Diagnosed Conditions: The form asks if you’ve ever been diagnosed with specific serious disorders (like psychotic disorders, schizophrenia, bipolar disorder, borderline or antisocial personality disorder) or any mental health condition that substantially impaired your judgment (Kyzer, 2022; DCSA, 2024). These few diagnoses are flagged because by their nature they may affect reliability. Most common issues (e.g. depression, PTSD, anxiety) need not be individually reported unless they severely affected your functioning.
Hospitalizations or Court-Ordered Treatment: The form will ask if you’ve ever been hospitalized for mental health or ordered by a court/agency to get treatment. Voluntary outpatient therapy is usually not reportable unless it was due to a court mandate.
Legal Findings of Incompetence: If you were ever legally declared mentally incompetent or incapacitated, that must be reported.
Importantly, the SF-86 was revised in late 2016 to make these instructions clearer. Federal policy no longer requires disclosing counseling for ordinary personal stress, grief, or marital issues, and it emphasizes that seeking help is not disqualifying (OPM, 2016; Kyzer, 2022). So when filling out your clearance application, you should answer “Yes” only if you meet one of the specific criteria listed. If your therapy doesn’t fall under those categories, you do not need to volunteer it on the form. Investigators may request relevant information (including provider opinions or records) when a reportable issue exists.
After You’re Cleared (Self-Reporting): Once you hold a clearance, self-report significant changes that meet DCSA criteria (e.g., court-ordered treatment, in-patient psychiatric hospitalization, a legal finding of incompetence/incapacity, or a condition that substantially impairs judgment, reliability, or functioning). Routine outpatient therapy for personal growth, PTSD, or stress management is generally not reportable unless it meets those criteria or your agency instructs otherwise. If a serious issue like the above occurs, you’re expected to inform your security manager. Always answer truthfully if an investigator inquires; they may request relevant information when a reportable issue exists.
Bottom line: If you’re getting standard therapy (e.g., seeing a psychologist for anxiety, trauma, or marital stress), how you answer depends on your circumstances—review SF-86 Section 21 and answer truthfully. In general, the form focuses on whether you have: in-patient psychiatric hospitalization or court-ordered treatment; a legal finding of incompetence/incapacity; certain specified diagnoses; or a mental health condition that has substantially impaired judgment, reliability, or ability to function. Routine outpatient counseling, by itself, is generally not reportable unless it meets these criteria. Adjudicators often view help-seeking as a positive factor (Aker, 2024; Kyzer, 2022).
Which Mental Health Conditions Raise the Most Scrutiny?
You might wonder what types of issues do raise red flags for clearance adjudicators. As mentioned, only a narrow set of severe conditions are specifically singled out in the clearance process. These generally include:
Psychotic disorders (e.g. schizophrenia, schizoaffective disorder, delusional disorder)
Bipolar mood disorder
Certain personality disorders (specifically borderline or antisocial personality disorder)
Any mental health condition that has substantially adversely affected your judgment, reliability, or ability to function (particularly if untreated).
The reason these are scrutinized is that they could, in some cases, impact your perception of reality, impulse control, or trustworthiness if not well-managed. *However – and this is crucial – even having one of these diagnoses is not an automatic clearance denial (DCSA, 2024). Adjudicators will look at how you’re handling the condition. Are you in treatment and following medical advice? Is the condition under control? Do you exhibit good judgment about managing it? If so, many clearance holders continue to serve with these conditions successfully (Kyzer, 2022).
For example, if you have bipolar disorder but you’re stabilized on treatment and doing well at work, security officials will see that you recognized the issue and got appropriate care – a positive sign. On the other hand, if someone had a serious mental health condition and refused treatment or lied about it, that behavior (the lack of transparency or reliability) would be the bigger problem. No mental health diagnosis is automatically disqualifying under the current guidelines (DCSA, 2024). Each case is evaluated in context, with an emphasis on behavioral evidence of your stability and trustworthiness, not on labels alone.
Therapy Shows Good Judgment and Reliability
Far from hurting your clearance, going to therapy can actually help demonstrate your reliability. Security officials have stated repeatedly that seeking help is viewed as responsible, proactive behavior (Priester, 2025; Aker, 2024). Dr. Michael Priester, chief psychologist for DCSA adjudications, explains that the best way to show good judgment is to get care if you have mental health concerns – just as you would for a physical injury (Priester, 2025). By acknowledging an issue and responsibly addressing it, you’re showing the qualities of honesty, self-awareness, and commitment to duty that clearance adjudicators value.
On the flip side, avoiding needed treatment can raise concerns. If someone is struggling with significant psychological symptoms but refuses help, that could be seen as poor judgment or a potential risk (DCSA, 2024). In fact, in the rare cases where mental health plays a role in clearance denials, it’s often because the person didn’t seek or comply with treatment when it was clearly necessary (Kyzer, 2022). As one DCSA publication notes, failing to get care “in the face of a clear need for mental health support” can be disqualifying – not the act of getting care itself.
Let’s look at the numbers to put this in perspective. Security clearance denials or revocations due solely to psychological issues are exceedingly rare. In one DOD analysis covering over 7.7 million clearance cases (2012–2023), about 142,000 had some mental health aspect noted; only 1,165 people (0.015%) had clearance eligibility denied/revoked with any psychological factor involved – and in zero cases was the clearance lost just for seeking therapy (DCSA, 2024). Another report found that from 2012–2020, just 0.00115% of all clearance denials involved mental health, and even those involved other issues as well (Kyzer, 2022). The take-home message: statistically, your chance of losing a clearance because you went to counseling is virtually zero. If anything, using support resources is likely to count in your favor during adjudication (by showing you’re addressing problems responsibly).
All major federal agencies – including DCSA, ODNI, and the Department of Defense – have been pushing to destigmatize mental health treatment in the cleared workforce (Aker, 2024; Kyzer, 2022). They want clearance holders to get help early, before issues spiral into something that could affect job performance or trust. As DCSA puts it: there are no automatically disqualifying mental health conditions or treatments. What matters is whether you manage any issues in a healthy, trustworthy way. Getting therapy, following medical advice, and stabilizing a condition are all mitigating factors in your favor (DCSA, 2024). In short, taking care of your mental health is viewed as an asset, not a risk, in the clearance process.
Confidentiality in Therapy – What Gets Disclosed (and What Doesn’t)
At Next Mission Recovery, I know that privacy isn’t just a preference – it’s a necessity for my clients in sensitive roles. I’ve structured my practice to be clearance-safe and privacy-forward at every step: I use HIPAA-secure video platforms, do not share information with any third parties (including insurance companies) without your consent, and keep documentation minimal and strictly need-to-know. What we discuss in therapy stays in therapy, except in a few legally mandated situations (more on those in a moment). You control any release of information unless the law requires otherwise.
It’s important to emphasize that going to therapy does not, by itself, automatically trigger any report to your employer, security officer, or anyone else in your agency. Mental health treatment is considered a personal medical matter, protected by privacy laws. Therapists are ethically and legally bound to confidentiality, so I will not inform your employer or security officials that you are in counseling. The only time therapy information might come up in your clearance context is if you disclose it (on an SF-86, in an interview) because it met a reporting criterion – as we discussed above, that’s uncommon for routine therapy. Otherwise, neither your agency nor the clearance investigators will even know you’re seeing me. This is by design: federal privacy laws (like HIPAA) and DOD policies shield mental health treatment information in most cases, specifically to encourage people to get help without fear (Aker, 2024).
However, it’s also important to understand the few clear limits to confidentiality in therapy. As a licensed psychologist, I am a mandated reporter under state and federal laws, which means there are specific scenarios where I must break confidentiality to protect safety:
Imminent Risk of Harm: If you tell me you intend to seriously harm yourself or someone else, I am legally obligated to take action (this could include notifying law enforcement or medical emergency services) to prevent harm.
Abuse of Vulnerable Individuals: If I suspect or learn of ongoing child abuse or neglect, or abuse of an elder or dependent adult, I must report it to the appropriate protective authorities (Child Protective Services or Adult Protective Services).
Legal Orders: If I receive a court order or lawful subpoena for your therapy records or testimony, I may be compelled to comply. (If that ever happens, I would discuss it with you and attempt to limit the information, but a valid court order can require disclosure.)
These situations are relatively rare, and they exist to protect life and safety. Outside of these exceptions, everything in our sessions remains confidential and private. In my practice, I go above and beyond standard requirements to ensure discretion (for example, using self-pay instead of insurance means no diagnosis goes on any insurance record that could be queried later). You can engage in therapy knowing your privacy is respected.
How Therapy Actually Supports Your Clearance
Engaging in treatment can benefit not just your personal well-being, but your career as well. By managing stress, trauma, or other challenges in therapy, you’re likely to perform better in your role and reduce the chances of any work performance issues. This is one reason many agencies encourage proactive care – they recognize that a stable, healthy employee is an asset (Aker, 2024). When you build coping skills for anxiety or address PTSD triggers in therapy, you’re not only improving your life – you’re also strengthening your ability to handle sensitive duties reliably.
In therapy with me, we use evidence-based techniques tailored for high-pressure professions. I specialize in trauma-informed approaches like Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Cognitive Processing Therapy (CPT). These methods are proven to help with anxiety, PTSD, and related issues, often the very challenges many clearance-holders face. By learning practical skills – for example, strategies to manage hypervigilance or regulate stress responses – you enhance your performance and resilience on the job.
Ultimately, addressing mental health concerns boosts your “whole person” readiness, which is exactly what the clearance process evaluates. You’re showing that you take responsibility for problems, you prioritize mental fitness, and you’re willing to do the work to remain a high-functioning, trustworthy professional. Those qualities reinforce your suitability for clearance. Therapy is not a weakness; it’s a tool for maintaining your strength.
Getting Started with Confidential, Clearance-Safe Therapy
If you’ve been hesitating to seek support, remember: getting help is safe, encouraged, and often crucial for long-term success. The official guidance is clear – you will not lose your clearance for going to therapy (DCSA, 2024). On the contrary, you’ll likely gain tools that make you an even more effective and stable employee. There’s no need to struggle alone or “white-knuckle” through fear of repercussions.
You don’t have to sacrifice your well-being for your career – you can have both. As a psychologist experienced in working with military and federal personnel, I provide a safe, judgment-free space to work through operational stress, trauma, high-functioning anxiety, or anything else weighing on you. Our work stays private, and I’m mindful of the unique privacy concerns that clearance-holders have.
When you’re ready, I invite you to schedule a confidential consultation. We’ll discuss your needs and goals, and I can answer any lingering questions about therapy and clearance (it’s normal to have a few!). My practice is 100% online for convenience, and I’m licensed in California and Virginia, serving clients statewide in those areas. It’s possible to improve your mental health without risking your career – in fact, it may be the best investment you make in both.
You’ve dedicated yourself to serving and protecting others; you deserve to have support for yourself as well. Let’s work together to strengthen your resilience, so you can continue to excel in your mission. Reach out for a confidential consult, and let’s begin your healing journey with the assurance that your clearance is safe while you get the help you need.
(To schedule or learn more, visit my security-clearance-safe therapy page or contact me.)
Further Reading & References
Defense Counterintelligence and Security Agency (DCSA). (2024). Mental Health and Security Clearances [Fact Sheet]. DCSA Personnel Security Adjudications.
Aker, J. (2024, October 3). Get the Facts About Mental Health and Security Clearances. U.S. Department of Defense News (Defense Health Agency).
Kyzer, L. (2022, July 22). Security Clearance Experts Encourage National Security Workers to Seek Mental Health Treatment. Government Executive.
Office of Personnel Management (OPM). (2016). Standard Form 86 – Questionnaire for National Security Positions (Revision effective Nov 2016). OPM.gov.
Priester, M. (2025, May 5). Behavioral Mental Health Treatment Not an Automatic Disqualifier for Security Clearance. Defense Counterintelligence and Security Agency News.
Frequently Asked Questions
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The DCSA has explicitly stated that seeking mental health treatment is viewed as a positive action and is not disqualifying (DCSA, 2024). In fact, no one has lost a clearance solely for going to therapy. Official DOD statistics confirm it’s extremely rare for mental health alone to cause a denial – and never just for getting counseling.
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You typically do not need to list ordinary therapy at all on the SF-86. Since 2017, the form only asks about very specific issues: e.g. certain severe diagnoses, court-ordered treatment, or serious mental health incidents that affected your judgment. If your past therapy doesn’t fall under those categories (and most don’t), you answer “No” and you don’t volunteer it. In other words, routine counseling for personal issues is not required to be disclosed on the SF-86.
If you disclose plans or intent to harm yourself or others.
In cases involving suspected child abuse or neglect.
If there is suspicion of elder or dependent adult abuse.
If therapy records or testimony are subpoenaed by a court (subject to careful review, consultation, and client notification).
These reporting situations occur only when required by law, specifically to protect safety and vulnerable populations. In all other circumstances, your sessions remain entirely confidential and private.
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Yes. Getting therapy and following professional recommendations is seen as a sign of good judgment (Priester, 2025). Adjudicators consider it mitigating – it shows you take responsibility for your well-being. By addressing issues proactively, you demonstrate integrity, reliability, and self-awareness, which can strengthen your clearance case. On the flip side, not seeking help when it’s needed can raise concerns about judgment.
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Only a few severe conditions trigger additional scrutiny: for example, psychotic disorders (like schizophrenia), bipolar disorder, and certain personality disorders (borderline or antisocial). These are flagged because they could affect judgment if uncontrolled. However, even holding one of these diagnoses doesn’t automatically bar you – adjudicators will look at how well it’s managed. No condition is an automatic disqualifier; they just may ask for documentation from a doctor to ensure you’re stable (DCSA, 2024).
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The policy changes in late 2016 clarified that seeking counseling is not, by itself, a clearance issue, and removed the requirement to list most counseling. As a result, even fewer cases of clearance denial involve mental health now. Recent data (2012–2020) show only ~0.001% of clearance denials had anything to do with psychological factors – and none were denied just for getting help (Kyzer, 2022). The trend since the SF-86 update has been toward greater reassurance and clear guidance: getting therapy is encouraged and not a threat to your career.
Disclaimer: This post is intended for educational purposes only. It does not create a patient-provider, legal, or advisory relationship and should not be used as a substitute for agency or legal guidance. Security-clearance policies can change; rely on the most recent SF-86 Section 21, ODNI adjudicative guidance, and your agency’s instructions. When in doubt, consult your FSO or legal counsel for advice specific to your circumstances.