This is a BIIIIIIIIIIG TIME violation of HIPAA Purplkid_Caterer! No way should have co-worker’s SD disclosed this. Doesn’t she know not to talk about patients? Like hell! Report this and now! I don’t feel your employee will get in trouble but, her SD needs to, at the very least, have somebody tear her a new one for what she said. Hell, if SD gets fired, you will have done a service for you and all the patients at that clinic. IOW, blow the whistle, and blow it loud!
I would like some clarification first…
- Did the employee already know you were in therapy?
- Is it something you would like kept secret or is it basically something that might come up in the course of conversation at your workplace?
- When they say they discuss patients is it along the lines of
“I saw someone today, that is depressed over their childs cancer - isn’t that sad”
or more intimate deatils that could identify someone?
Richard,
So, based on what I already thought and what everyone else here has contributed it’s OK to talk about me if the employee already knew I was in therapy? I don’t think so. Is it something I’d like to keep secret? Well, everyone knows about the ugly divorce going on round here, but the dialogue originated with the SD, NOT the employee. What do they talk about? How would I know? The impression I got, though, was that the SD comes home and talks about all the wackos that were at work today.
There are a million therapists in this area. There’s no way that the employee would have know exactly where I was going if she hadn’t been told.
Sometimes you have to explain to your spouse exactly why you’re having such a crappy day, but not in a way that lets them know who your patient is.
You don’t discuss names, ages, hometowns, occupations or anything that might allow the person you are talking to to identify the patient. If they’re the only person in the town with a rare syndrome, you don’t name it or describe the symptoms, for example.
“I’m upset because one of my patients died, and he was such a nice man” is OK.
“I’m upset because a patient I like died, the one with the 5 daughters and the gay son. We used to chat about his work in the bank and his collection of classic cars” is not OK, because someone could use that information to work out who he was.
Just as “A guy came in with a banana up his ass” is just about OK, but “you’ll never believe who I saw in the ER with a banana up his ass” is clearly not acceptable.
Tell your clinic they need to address this issue. It is not OK and anything that happens will be exactly what the SD had coming.
Even so, there may be only one guy in town who is likely to put a banana up his ass, or worse yet, only one guy who is thought to. The thing is, you just never know.
The step daughter may have thought that it was OK to tell her step mom, your employee, because she already knew you were in therapy and knowing where wouldn’t be a big deal, right? Besides, she only told her step mom who wouldn’t tell anyone.
Wrong.
The step daughter needs better training about confidentiality at the very least.
It’s never OK to do what she did. Even if she thought your employee already knew everything down to the last detail she’s not allowed to do what she did.
Tell the therapist and let her take care of it.
There is NEVER just one guy in town who might put a banana up his ass!
I was being facetious.
None of this matters from the legal and ethical perspective of the step-daughter’s employment agreement.
Example: My partner is also a therapist. Sometimes one of my students will let me know that my partner is his/her therapist and also tells my partner that s/he has told me. That does not confer any relaxation of vigilance about that client/student’s confidentiality or privacy to either of us. She can’t come home and say, “X is doing such great work in therapy!” (a HIPAA violation) and I can’t come home and say “X did a beautiful final project!” (possibly a FERPA violation). If X wants to sign a Release of Information to have us communicate (e.g., X spent a week hospitalized for suicidal depression and that’s why s/he didn’t do my assignment), s/he may, but still must designate the purpose of the disclosure in writing AND sign a separate and distinct statement if s/he wants HIV status or substance abuse disclosed. Even a legal release is not a blanket release except in certain legal situations; it is not permission to chat about the client.
And: There’s never just one guy in town who puts a banana up his ass, but there may be only one guy in town who is perceived as the kind of guy who’d put a banana up his ass, and whether or not he’s that guy this weekend, talking about Banana Boy still erodes the public’s confidence that their medical records will be protected, and thus, for psychologists at least, may be an ethical violation to discuss because it undermines the public perception of our profession in a way that may keep people from getting needed services.
Oh, thank god! I needed a therapist to tell me I’m not alone in my plight.
What?
I sent a tentative email to the director of the clinic. He responded assuring me that he email was private and that he was happy that I came forward with the information so as to prevent it from happening again. I’ll email him with more details again tonight.
Anyone who does that with bananas… I wouldn’t want to know about it, anyways! 
Actually, we have a club. Agenda, formal minutes, and everything. “Agenda: Today, we are going to put bananas up our asses. Old business: Last week, we put bananas up our asses. New business: Who brought the bananas?”
Fuck that. I’ve been in your situation, and unless you put a stop to it NOW, your employee and her stepdaughter will be discussing your therapy forever.
You’re not getting the stepmother in trouble. She and her loose-lipped, unethical, gossipy stepdaughter did it to themselves.
The stepdaughter is not fit to work where she does. She’s a risk to the whole practice, and the psychologists will want to know what she’s up to and dismiss her immediately. If they don’t, they shouldn’t be your psychologists. Or anyone’s.
That’s it. There is no other way to look at this. You’re not the only one at risk. If the stepdaughter is talking about you, she’s talking about everyone else in town too. And not just to her stepmother.
I had a similar situation, though not personal, with a student worker at a library where I worked. We- he and I and some other staff members- were blowing off steam about a hated professor- this guy was an almost retired fully tenured 1st-Order-Horse’s Ass- when the student, who also worked at a pharmacy, announced that he also used Viagra. The students who worked at the pharmacy delighted in saying aloud “Is this for the Viagra Dr. XYZ?” and he had become belligerant and threatened to sue the pharmacy.
I had to put on a boss-hat and warn the student there that he was NEVER to mention anything about that again and that if he did he could get into serious trouble, losing his minimum wage student job being the least of it. That could set up the pharmacy and the student and conceivably even the library up for a lawsuit and this old jackass was just the type who would do it. I also told the other students to “forget you heard that… which I know you can’t… but pretend to forget you heard it, because if you repeat it you could get into deep doo-doo”.
Having worked for Mental Health agencies and having friends who are MH professionals I’m aware that they talk about their patients without naming names (the academic ones of course even write articles), but your co-worker’s SD committed a cardinal offense. You NEVER EVER EVER EVER mention who you see at such a place, and the doctor needs to know because I can guarantee you it’s not just you and she could get him in some deep shit that costs him and his insurance company plenty. (I’d never feel anything was confidential again at the very least, and if anything embarassing or especially anything exaggerated/false was to be told I’d consider a lawsuit.)
Have NO sympathy for your co-worker’s stepdaughter. If your co-worker has a brain in her head she’ll distance herself as well, although the fact she admitted to you that “thy name were somewhat mentioned” by her stepdaughter indicates she might not be the sharpest tool in the Christmas tree* herself.
yes, I know, it was intentional
I might have missed something here. Whose ugly divorce? Yours or your employee’s?
That’s exactly what I was thinking. Even if it doesn’t breach the patient’s confidentiality, it’s unprofessional to gossip about patients as opposed to discussing a case professionally. Who wants to get therapy when you think that the office staff is chatting casually about your case, identified or not? It’s just not done.
I have worked in the area of mental health and I currently work with mental health workers - it is not uncommon for us to talk about people with issues by name because we work jointly on helping them, although we don’t divulge exactly what has been discussed in counselling sessions.
This is pretty standard but quite different from telling someone outside of the helping group about a client and using a name.
However, I think it is pretty idealistic to think that every mental health worker is totally ethical - hell, some screw their clients!
If I was in the OPs position, I would really have to ask myself what I would get out of telling and how does this employee knowing I see a counsellor effect my life/work ie is it worth doing something about it.
Also, it is a small world and there is often a thin line between talking about a client but not mentioning their name and working out who they are.
All of that is understood - but what if he came home and said - X came in today, she sadi to say hi?
But back in the real world: people will talk about the people they’ve seen/things that happened at work. I work in a very HIPAA protected field (MR/DD) and will come home and tell sweet/scary/funny/icky stories. I keep it to first names, or no names. I teach our staff in orientation about HIPAA issues, and tell them “of course you can talk about your work, but just try to be sensitive - imagine you’re the one being talked about.” Because we know people will tell work ancedotes, we just don’t want their names and social security numbers and other protected information flying about.
Years ago a friend worked at a psych hospital, and told me that a girl I went to high school with was a patient there; she went into detail about her diagnosis and treatment. I should not have that information, of course, but part of me was all a-giggle, I admit, having never really liked said person in high school.
But - would I share that information with anyone else? Never! And I never have, tempting as it has been. Would I tell this patient’s friends/family that I know? Certainly not.
I think your employee is the real culprit here. “What you don’t know won’t hurt you,” as the old saying goes. She was an idiot to tell you she knew what she knew. Step daughter was absolutely wrong, no doubt - but the fact that your employee would tell you she knows? Lunacy. I don’t care if she’s your best employee - if she’s willing to acknowledge that she has this kind of information about you, she’s not trustworthy.
Just my two cents.
Wouldn’t happen–if the person with the multiple relationships asked either one of us to do that, we’d say, “That complicates the relationship, so I’m not going to” (if we knew that the person had a multiple relationship). If one of us did not know about the multiple relationship (more likely to be me, since I mostly teach, and most therapists know something about their university students’ school life, whereas I don’t usually know if a student is in therapy), we might pass on the message, but would get a non-commital “thanks” back rather than engagement with more disclosure. It’s true that not all therapists behave ethically. If we were, nobody would need to hire me to teach professional ethics. But confidentiality, like not having sex with a client, is a pretty bottom-line boundary issue. It’s really a cornerstone of graduate training, and I’m working on getting as much of it into undergraduate training as possible.