HIPAA violation? Professional Misconduct? Proper?

In My Humble Opinion
1

A friend of mine has kinda a messy situation. I will attempt to keep it short and succinct.

A friend of mine (A) recently went through a long, messy custody fight over her 5 year old son. Her ex-husband (B) opened this in response to an order for an increase in his child support.

Court found in A’s favor, numerous adjustments to custody arrangements all generally in A’s favor. A represented herself, B had a lawyer.

Secondary to this whole thing, the judge ordered them to attend a series of co-parenting/family therapy sessions to help them improve their communications/interactions with regards to the son.

6 months and dozens of therapy sessions pass.

Fast forward to a few days ago. B shows up with the sheriff’s dept with a court order to take emergency full time custody of the son (who normally lives with A, B has him for every other weekend and various holidays.)

The order is supposedly secondary to the therapist saying that A has a Histrionic Personality Disorder and is somehow a danger to the son because of it. B has taken custody until a court date can be arranged. A has a few 30 min supervised visitations until this is resolved.

In the meantime A has sought out her own therapist for a second opinion.

It has also turned up that the therapist is on retainer to the company B works for (it is a high stress occupation where occasional psych screening is seen as appropriate) and that B has been seen by this therapist several times prior to these family therapy sessions.

Therapist has supposedly allowed B to engage in abusive behavior during sessions, while refusing to allow A to reply/explain/present her side of the story. Generally A feels like this was just a giant evidence gathering session to have her custody taken away.

The therapist gave the information needed to request the emergency custody order to B, not to CPS, or the courts, directly to B.

The big question in my mind is this:

If a therapist is supposed to be treating a family unit, she should be doing so in an even-handed manner. If a therapist feels that there is a disordered behavior on the part of A or B, that they should arrange an independent session with A or B to attempt to address that individually. If I understand this correctly, if there is treatment needed for either partner in this, it is not necessarily the business of the other partner especially since they are no longer married. If so would this scenario give rise to some form of professional misconduct on the part of the therapist? One of the things I often hear is, the last thing you want is a therapist ratting you out to family, employers, etc, because you end up creating a person who will never seek therapy again.

Would something like this give rise to a legit HIPAA violation on the part of the therapist? If she felt the child was in danger, she can make that phone call to CPS all by herself without the ex-husband being involved.

I know A, I acknowledge that I may be biased in her favor. I think she is a little odd and I disagree with some of her parenting choices but I would never consider her dangerous and feel that her choices are within the bounds of normal.

I have advised her to discuss the matter with her new therapist WRT to the details of professional conduct under these circumstances. Based on that discussion she will pursue further legal action as needed.

I am just curious where the doper lawyers and psych professionals might weigh in on this type of thing and/or be able to comment on better questions to ask, perspectives to seek, or agencies to contact to deal with this type of situation.

2

I have discussed the situation extensively with her and am pretty familiar with the details. I will do my best to answer any questions that may help better explain things.

3

This part isn’t true. At best a gross exaggeration. The counselor probably never discussed anything about A with B that didn’t pertain to their joint sessions.

My advice is to stay out of it.

4

If B was able to get a formal statement from a professional therapist that A’s behavior is dangerous enough to warrant losing custody I think the issue of potential HIPAA violations is far secondary (at this point) to whatever the behavior at issue is.

What exactly is it that A is claimed to have done that endangers the child? If it’s serious enough there might be a legal “duty to warn” forthe therapist to report it.

Just as a general note A should have an attorney representing her if she wants to get control of this situation. Representing yourself is really not the way to go at this time.

5

I used to be an EMT, I understand the mandatory reporter obligations. im just wondering why it would be pursued via the ex rather than say cps. As I understand the order was requested by the attorney representing B with documentation from the therapist. I am just curious if this is normal method for handling this kind of thing.

6

I’ve never seen it before. The paper you sign only allows them to contact the authorities when you are a danger to yourselves or others. And even that is explicitly stated in the contract. There is no way that any medical staff should have let B know about A’s disorder unless she signed a paper waiving her HIPAA rights to him. That does happen, but I’ve not heard of it happening in this context. Usually it’s done for your emergency medical contact or for people living with you so they can leave a message on the answering service.

That doesn’t mean it will have any bearing on the custody case, however. I’m not a lawyer, but I seem to remember that that is a separate issue that has to be fought against the medical provider. If I remember correctly, HIPAA does not mean that evidence gets stricken from the record or anything. And, anyways, all they’d then have to do is have the psych come in and testify.

7

A is under the impression that the potential that the potential confidentiality issue is secondary to the custody situation. there is alot more details to the therapy sessions she told me about some of the issues with them when they started…so either she is playing a very long game with all her friends, or she is being honest even if she is exaggerating to some degree.

8

I suspect (as I think you may) you’re getting very filtered view if what’s going on. I’ve had some acquaintances give me their side of terrible injustice stories only to find that when it went public via legal action they left out some pretty huge details of their own actions that precipitated the mess.

9

IF your friend has HPD, everything she says about this situation may have to be understood by you to potentially be greatly exaggerated and possibly misunderstood/misinterpreted.
Of course the therapist would be a mandated reporter, but you are correct in that the person the therapist would report to is certainly not the person’s ex. The problem (for us bystanders) is that it is hard to say who the therapist should report to - for example, in my job as a nurse, I report to my immediate supervisor who sends the information up the chain to the person who is responsible for reporting such things to outside agencies. Self-employed therapists wouldn’t have to go through all of that, but should report to the proper authorities - not a relative, an ex, an attorney or even a judge (without an order, of course).

I think something is definitely off here - but because your friend MIGHT have a disorder that could cause her judgment to be significantly impaired, I’d be careful about believing everything she said at face value.

If things happened exactly as she said and the therapist just handed over a diagnosis on her without being told to do so by the court, it is likely a HIPAA violation as both parties were patients, regardless of who the payor is.

Unfortunately, it is also my experience that people with personality disorders are frequently misinterpreting things that happen “to” them, exaggerate almost everything and will absolutely lie to make a story more interesting or make themselves appear victimized.

I’d tell the friend to certainly consult an attorney - HIPAA violations are worth a little chunk of change to the wronged party - but if I were you, I wouldn’t be surprised if there were more strange developments to the story down the road.

~Jaade, psych nurse and mother of a daughter with borderline personality disorder

10

Your friend needs a lawyer, one who specializes in custody arrangements and family courts. And possibly, she needs a private eye who can look into a connection between the therapist and the husband. It seems strange to me that the therapist would give the husband the info rather than call CPS, but maybe that’s how things are handled in your local. A lawyer who specializes in custody matters would know the usual way things work.

That seems to be the best strategy, I think. I get a family court lawyer, stat, and pursue the possible medical legalities as it relates to family court procedures.

11

Why is this your business and why are you bringing this mess here?

We do not know these people; we are not qualified to assess the situation, escecially a situation “as presented by” a probably-not-neutral party.

We have lives: get one.

12

If you don’t have anything to offer, you don’t have to post. This is IMHO, though, and the place to post threads like this one. Don’t reply if all you have to say is this, because it’s not far from threadshitting.

13

ISTM that, at minimum, this situation is a conflict of interest. If the therapist had seen B on an individual basis, s/he should have referred him to an outside therapist for couples counseling, especially if there was a custody issue involved. Had A had a lawyer, the lawyer could have made mincemeat of the therapist and B on that basis alone.

That being said, A really, really, really needs a lawyer who can advocate on her behalf. She now has a label that has been applied to her by a professional, and that’s not an easy thing to overcome because everything she says now is tainted by that label. The lawyer will be able to lay out a strategy to overcome that and work toward that achieving that strategy. This may mean going for an independent psych evaluation or something else, but she can’t do this alone anymore.

14

In my personal experience, I had a non-therapist “neutral” third party most definitely develop a personal relationship with my opponent and also shared my private information. So I believe this situation as described in the OP is possible.

Also, there were accusations made about my mental status. Getting upset and being like “I’m NOT crazy!” generally makes everyone think you’re just exhibiting your craziness. So yeah, the OP’s friend could be not telling the truth as part of an episode, or she could be genuinely getting screwed here. Classic crazy-making.

15

I want to know B’s side of the story.

You know the saying “Ask two people what happened, and there’s three responses: his side, her side, and the truth”? Right now you’re only getting A’s side - I’m sure B’s side is much different, and the truth probably only bears superficial resemblance to either.

For all we know “The therapist gave B my diagnosis and then he and the cops took my babies!” could translate into “The therapist gave CPS the diagnosis per mandatory reporting, CPS contacted B as he would receive the child, and CPS agents went to A’s house with B to retrieve the children”. Of course, it could also translate into “The therapist is in cahoots with B and is making things up for bribes”, but that seems somewhat less likely.

16

So much this.