If someone signs up to go to a psychotherapist, will their work know? Would they fire a worker who is?

There is something called the privacy act. Doctors, hospitals and health care workers, including psychiatric counselors, are not permitted to share your records with anyone. Who's to know, unless he tells them, that he is seeing a counselor? (There may be a record of treatment, however, if he asks for payment by the insurance company provided by his employer. There are clinics, however, who would see him and charge him on a sliding scale basis, according to his salary, if this is a problem.)