# Psychiatrist: I can't do counseling with you unless you let me speak with a family member: is this normal? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 25, 2022, 9:52pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787 "2022-10-25T21:52:48Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![burpo\_the\_wonder\_mutt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/burpo_the_wonder_mutt/32/365_2.png) [@burpo\_the\_wonder\_mutt](https://boards.straightdope.com/u/burpo_the_wonder_mutt)\ **Post date:** [October 26, 2022, 1:33pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/41 "2022-10-26T13:33:38Z")
You make a good point. The cynic in me says it’s a cash grab; Dr. gets to charge an office visit for reviewing each questionnaire. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [October 26, 2022, 1:55pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/42 "2022-10-26T13:55:23Z")
> [@ArtBeforeScience](#): > > The red flag is that he refuses to provide care unless you comply with his demand. If it were voluntary, and he candidly explained why, that would be more acceptable. This. Unless you are under court order or something, he shouldn’t be making demands. And if he makes requests, he should explain why. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [October 26, 2022, 1:59pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/43 "2022-10-26T13:59:57Z")
I once had a dentist fire me. I missed an appointment, and they told me they would no longer book me for the prime first spot on the morning. I told them that was the only time i could make, what with my commute. They said that meant they couldn’t treat me. So i found a new dentist and asked them to send over my records. They freaked out. “Why are you leaving us!?” “Um, you fired me.” “We can work something out.” I’m still at that new dentist. I’ve been a lucrative patient (a few crowns, cleaning every 3 months). I guess they were playing chicken and thought i would take a day off work to see them? Ironically, now i work from home and can go any time. ---
**Author:** ![Elmer\_J.Fudd](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/elmer_j.fudd/32/1211_2.png) [@Elmer\_J.Fudd](https://boards.straightdope.com/u/Elmer_J.Fudd)\ **Post date:** [October 26, 2022, 2:59pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/44 "2022-10-26T14:59:34Z")
20+ years ago my urologist required a consultation with my wife before performing a vasectomy. ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [October 26, 2022, 5:23pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/45 "2022-10-26T17:23:27Z")
> [@pulykamell](#): > > I’m not sure what the violation would be. They’re asking permission from the patient to speak to these people. But it is under duress. “I can’t treat you unless you let me do this.” I might understand it if there were issues with self-care or self-harm or maybe if you had a complete break from reality like Cotard’s syndrome. ---
**Author:** ![pulykamell](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pulykamell/32/3166_2.png) [@pulykamell](https://boards.straightdope.com/u/pulykamell)\ **Post date:** [October 26, 2022, 6:06pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/46 "2022-10-26T18:06:31Z")
But is that duress? Go to another psychiatrist. ---
**Author:** ![Jaycat.again](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jaycat.again/32/11525_2.png) [@Jaycat.again](https://boards.straightdope.com/u/Jaycat.again)\ **Post date:** [October 26, 2022, 7:49pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/47 "2022-10-26T19:49:20Z")
> [@Elmer\_J.Fudd](#): > > a consultation with my wife Is that what they’re calling it now? ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [October 26, 2022, 7:50pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/48 "2022-10-26T19:50:13Z")
> [@Velocity](#): > > Apparently, he refuses to do even initial counseling/therapy unless I provide him with access to some family member. > > Yeah, I’m going to go with some other therapist… Good call. This request calls for a tremendous amount of trust on your part that he/she will act professionally and will use discretion and judgement when talking to 3rd parties. You don’t know this therapist. You have no idea if they are even competent yet. You’ve never had a session. Just a big “nope”. ---
**Author:** ![carnut](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnut/32/3531_2.png) [@carnut](https://boards.straightdope.com/u/carnut)\ **Post date:** [October 26, 2022, 8:42pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/49 "2022-10-26T20:42:38Z")
> [@RivkahChaya](#): > > The only time I ever heard of anything along these lines is when someone was being evaluated for social security disability for psychiatric reasons, as opposed to having a physical disability. This could have well been the case for my cousin. But I actually think it was probably for a genetic study about schizophrenia. I’m not close enough to the family to ask for the story, I overheard my mother speaking with my aunt about it. It did turn out that there was schizophrenia running down the other side of the family. They got it sorted with meds. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [October 27, 2022, 4:58am UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/50 "2022-10-27T04:58:03Z")
> [@Velocity](#): > > Right, but is the idea, “We don’t trust the patient not to bullshit, so we want someone who can back up their words?” I don’t think it’s about making sure you’re telling the truth. IMO, the therapist is only trying to get some different and additional perspectives of you so they can form a more comprehensive impression. ---
**Author:** ![Biffster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biffster/32/339_2.png) [@Biffster](https://boards.straightdope.com/u/Biffster)\ **Post date:** [October 27, 2022, 5:59am UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/51 "2022-10-27T05:59:08Z")
> [@pulykamell](#): > > I’m not sure what the violation would be. They’re asking permission from the patient to speak to these people. Sounds like they’re telling more than asking. ---
**Author:** ![pulykamell](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pulykamell/32/3166_2.png) [@pulykamell](https://boards.straightdope.com/u/pulykamell)\ **Post date:** [October 27, 2022, 6:26am UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/52 "2022-10-27T06:26:02Z")
I’m still not seeing the problem. They don’t have to choose this doc (and the OP didn’t.) ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [October 27, 2022, 4:54pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/53 "2022-10-27T16:54:00Z")
_If we can help you we will_ _Soon, as you’re tired and ill_ _With your consent_ _We can experiment further still_ ---
**Author:** ![Slow\_Moving\_Vehicle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slow_moving_vehicle/32/291_2.png) [@Slow\_Moving\_Vehicle](https://boards.straightdope.com/u/Slow_Moving_Vehicle)\ **Post date:** [October 27, 2022, 9:13pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/54 "2022-10-27T21:13:56Z")
> [@Velocity](#): > > His words were, “Speaking to someone who has known you your whole life, such as your parents, will help us better develop a thorough and comprehensive understanding of your psychiatric and medical history” If the psychiatrist is setting up a diagnostic behavioral assessment, that’s not an unreasonable question at all – family-of-origin stuff is a significant factor in a person’s mental health. Wanting to talk to the your family is no more odd than, say, a ENT doctor asking for a full medical history before giving you a hearing test. Flat-out saying that he won’t see you without that authorization is sus, though. > [@Velocity](#): > > Right, but is the idea, “We don’t trust the patient not to bullshit, so we want someone who can back up their words?” > > (in my instance, though, the problem is that my family - at least, my parents - **are** part of the reason for my psychiatric issues.) Very doubtful. It’s more like, “Let me look at the whole family, to get a sense of its dynamics and the way members relate to each other.” Because, as you yourself note, that plays a very large part in any person’s mental makeup. You shouldn’t assume he would have taken your parents’ “side” over yours; a good therapist won’t take sides at all. > [@burpo\_the\_wonder\_mutt](#): > > Find another psychiatrist. If s/he did that to my family, there would be six contradictory questionnaires and then you’re back to square one. Not at all. That would help the therapist understand the family context in which **Velocity** ’s issue’s arose. > [@Dallas\_Jones](#): > > He does not believe you, does not respect you, and is fishing for information so he can tell you why your situtation is all due to your own behavior. Working for your parents is he? Seems like it. > > If you are in control of the situation, use that control and tell them where to get off. This is highly unethical. If it were me I would be reporting them to whatever licencing board is in charge of this psychiatrist. He doesn’t need to talk to anyone but you. Whoa, that’s a huge leap to conclusions. Note that the therapist didn’t say he was looking for the “truth” about the OP; that was just **Velocity** ’s assumption. I mean, yes, demanding access is weird, and worth looking for another therapist. ( **Velocity** , I suggest an LCSW or a LPC). But it’s not as nefarious a demand as you seem to suspect. > [@wolfpup](#): > > Where I live (Ontario) it unfortunately works the opposite way. Psychiatrists, being MDs, are fully covered by universal health care, but clinical psychologists are not. This is a gaping hole in mental health care that has existed for decades. The effect is that psychiatrists are, in effect, free, while qualified psychological therapists are expensive without private insurance. > > The practical reality IMHO is that, very broadly speaking (there are always exceptions) psychiatrists are best equipped to deal with the more extreme sorts of mental health issues, while clinical psychologists with experience in counseling and therapy tend to be a better fit for the more common sorts of problems. They can’t prescribe medication, but they usually work cooperatively with the patient’s GP when medication is deemed desirable. Are psychiatrists and clinical psychologists your only choices? What about clinical social workers, or licensed professional counselors, or marriage and family therapists? In my state, LCSWs are popular because they can diagnose as well as treat, and are mostly covered by insurance. Many plans cover LPCs and LMFTs, as well. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [October 27, 2022, 9:50pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/55 "2022-10-27T21:50:53Z")
> [@Slow\_Moving\_Vehicle](#): > > If the psychiatrist is setting up a diagnostic behavioral assessment, that’s not an unreasonable question at all – family-of-origin stuff is a significant factor in a person’s mental health. Wanting to talk to…your family is no more odd than, say, a ENT doctor asking for a full medical history before giving you a hearing test. Flat-out saying that he won’t see you without that authorization is sus, though. “Doc, I think my hearing is going bad. I have to have the TV volume turned up to 11.” “Well, we’ll certainly look into that. But before I can test your hearing, I’ll need to interview your wife and children to get their perspective on your hearing issues and to provide me with their take on your medical history.” ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [October 27, 2022, 10:10pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/56 "2022-10-27T22:10:26Z")
I didn’t realize the OP was about hearing, or something else with such easy objective measures. We don’t know what the history is here, if @Velocity brought up his parents or family or childhood trauma as issues that he wants to work on, then it makes sense to get some perspective on that. If that’s the case, the doctor isn’t going to be taking their side, but knowing where they are coming from will allow him to better treat the OP. Not having that perspective could end up with them wasting time spinning wheels, and could even make things worse, if the doctor inadvertently reinforces certain harmful feelings or beliefs the OP has. I’m not saying that this doctor’s approach is the best or even correct, we don’t really know the context where this request was made, but your example is simply facile. ---
**Author:** ![carnut](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnut/32/3531_2.png) [@carnut](https://boards.straightdope.com/u/carnut)\ **Post date:** [October 27, 2022, 10:34pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/57 "2022-10-27T22:34:38Z")
> [@Velocity](#): > > I had/have an appointment with a licensed psychiatrist here in Texas this week, but he sent me an email telling me he can’t do counseling (or follow-up counseling) unless I authorize him to speak to a direct family member of mine (I assume, so he can verify that what I tell him about my life is true, or something like that.) I think this psychiatrist is serious about wanting the background info. You can certainly ask if he would be willing to work without it. You can ask for clarification as to why it is needed and tell him this seems like a red flag to you. If he insists he needs it and you don’t want him speaking with others, accept that you need to find a different psychiatrist. Easy. ---
**Author:** ![Slow\_Moving\_Vehicle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slow_moving_vehicle/32/291_2.png) [@Slow\_Moving\_Vehicle](https://boards.straightdope.com/u/Slow_Moving_Vehicle)\ **Post date:** [October 27, 2022, 10:51pm UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/58 "2022-10-27T22:51:41Z")
> [@Jackmannii](#): > > > [@Slow\_Moving\_Vehicle](#): > > > > If the psychiatrist is setting up a diagnostic behavioral assessment, that’s not an unreasonable question at all – family-of-origin stuff is a significant factor in a person’s mental health. Wanting to talk to…your family is no more odd than, say, a ENT doctor asking for a full medical history before giving you a hearing test. Flat-out saying that he won’t see you without that authorization is sus, though. > > “Doc, I think my hearing is going bad. I have to have the TV volume turned up to 11.” > > “Well, we’ll certainly look into that. But before I can test your hearing, I’ll need to interview your wife and children to get their perspective on your hearing issues and to provide me with their take on your medical history.” No, it’s more like, “Doc, I get winded walking up stairs, and sometimes my chest hurts.” “Well, we’ll certainly look into that. Do you have a history of heart disease in your family?” TL;DR - what @k9bfriender said. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [October 28, 2022, 12:35am UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/59 "2022-10-28T00:35:33Z")
> [@Slow\_Moving\_Vehicle](#): > > No, it’s more like, “Doc, I get winded walking up stairs, and sometimes my chest hurts.” > > “Well, we’ll certainly look into that. Do you have a history of heart disease in your family?” Read the OP. The patient isn’t being asked to provide info about his family medical history. The shrink is insisting on _talking to the family_ to get background on the patient. ---
**Author:** ![SmartAleq](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smartaleq/32/163_2.png) [@SmartAleq](https://boards.straightdope.com/u/SmartAleq)\ **Post date:** [October 28, 2022, 5:42am UTC](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787/60 "2022-10-28T05:42:34Z")
I dunno, even if the motives behind wanting to talk to family members are completely benign the peremptory approach signals to me someone who’s convinced of the perfection of their process and is likely to be less empathetic and collaborative than I personally would find necessary in a therapist. Comes across as authoritarian and controlling–no thanks. [Previous page](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787.md?page=2) [Next page](https://boards.straightdope.com/t/psychiatrist-i-cant-do-counseling-with-you-unless-you-let-me-speak-with-a-family-member-is-this-normal/973787.md?page=4)