The study examined the impact of confidentiality law in the two countries in three common situations in psychotherapy that may jeopardize strict confidentiality: treating potentially dangerous patients, giving testimony, and serving as a psychotherapist in prison. Under the strict provisions of the Austrian Psychotherapy Act, a breach of confidentiality may be excusable in the case of a highly probable danger, but Austrian psychotherapists cannot serve as witnesses or as experts in civil or criminal cases, as can American psychotherapists. Under the Austrian Psychotherapy Act, there are no specific provisions for psychotherapy in institutions. Psychotherapy is offered where indicated as a professional service, much like dental or medical treatment. It remains to be seen whether Austria's strict provisions of confidentiality will lead to the abandonment of psychotherapy in institutions and prisons or to distinctions being made in psychotherapy legislation for institutional psychotherapy. In the United States, as in Austria, there is a general professional consensus that a treating psychotherapist should be precluded from giving testimony in legal proceedings and from making forensic assessments. Because Austria is the only western country that provides for strict confidentiality, there is hardly any litigation on claims of breached confidentiality, as there is in the United States. This may also reflect a generally lower tendency to engage in litigation compared to the United States. 47 references