But only after checking with others to find out this isn’t a normal request.
I agree it probably isn’t a HIPAA violation (unless there’s a clause about requiring disclosure for treatment being a problem) . But I understand why an unusually invasive request being a requirement for treatment is offputting.
No, it’s more like “We can’t look into your chest pain until i talk to other members of your family to hear directly from them whether they have heart disease.”
Or perhaps, “Whether they think you have heart disease.”
Seriously, I’ve never heard of this requirement for outpatient psychotherapy in 34 years working in mental health. It might be how this professional tuns their practice, but it’s extremely far from the standard.
30 years ago , my OB required that my husband be the witness on the consent form for the tubal ligation I wanted. The law required that I give written consent and that it be witnessed - the part where the witness had to be my husband was the OB’s requirement.
I think it’s odd that the psychiatrist apparently wants permission before treatment has even started and it would probably make me look for another provider - but I don’t think it’s necessarily a big red flag in every circumstance.
My mother has been seeing one therapist or another for years. A few of them have asked for permission to speak to me and my siblings, but she has always refused. Of course, I don’t know why they want to speak to us , but I have a few ideas. First off is the fact that my mother doesn’t want therapy. She doesn’t think she needs it, keeps complaining that the therapist doesn’t know anything about “current events” ( which means the therapist won’t talk politics with her) and is only seeing the therapist to begin with because therapy is a requirement for her to continue receiving prescriptions for antidepressants and Ambien and god know what else from the psychiatrist. Why she needs to see a psychiatrist when loads of people get those prescriptions in particular from PCPs without any therapy requirement is a question I can’t answer (it’s not like she’s taking anti-psychotics) - because she is an unreliable narrator. Which is the second reason the therapist might want to talk to us. A third reason is related to that - she’s the victim of every story. So I can see the therapist wanting to verify some things with us, because they might impact the therapy - I imagine the therapeutic approach will be different if my mother’s story of none of her children and grandchildren being willing to visit her without any reason is true vs. if they do visit but not as often or as long as she would like because she makes it unpleasant.
Which, in the context of therapy, is part of the medical history. Family-of-origin dynamics are as important to mental health as family medical history is to bodily health.
I mean, yes, this therapist’s demand to speak to @Velocity’s family before agreeing to see him is reason to look for another provider. And no therapist I have ever seen has demanded to talk to my family first; a competent one should be able to gain insight into the client’s history just from talking with them. But you and other posters seem to think that the therapist’s desire to understand the OPs family dynamics is completely out of bounds and irrelevant to the treatment. And it isn’t.
Another example:
Internist: “Before I can evaluate you for heart disease risk and prescribe medication and lifestyle changes, I will need to talk to members of your family to confirm what you’ve told me about your diet and exercise regimen and to see what family dynamics are contributing to your risk factors.”
Now, having another source of such information might be at least marginally helpful to the physician in dealing with the patient’s problems. But the vast majority of patients would think that demanding that access is unacceptably intrusive.
Outside of the more extreme situations we’ve alluded to, there’s no compelling reason for psychiatry to have requirements that other medical specialties don’t.
Mental health is far more subjective than most other forms of health, and greater perspective can help someone see what help is needed. If the doctor doesn’t believe the OP to be a reliable narrator, if he relates stories or demands that just don’t make sense, then it would be reasonable for the doctor to try to find outside corroboration for those stories before attempting any form of treatment.
The story in the OP really doesn’t make sense, and so it really seems as though something was being left out, misunderstood, or misrepresented, and if we were more invested in the issue than just being random people who barely know each other on the internet, I’d think it prudent to actually speak to the doctor to get his side of the story before giving advice to the OP or condemnation for the doctor’s actions.
I saw a psychologist 3 years ago. I am older WMM. I wanted to talk about some confusion I was having regarding my sexuality. Halfway through the visit she said this:…“I must warn you that if you reveal secrets about your sexual indiscretions I must share them with your spouse”
I answered her immediately (as I felt threatened) “Ok got it” and then mumbled through the last half hour vowing to myself to never see her again.
I moved on but felt like the whole reason I wanted to speak to someone about my marriage and my sexuality was that the discussion SHOULD BE PRIVATE. Anyway that was what happened to me
Unless it was couples therapy, and you had agreed to a no secrets rule in advance, that would be illegal on her part. I certainly wouldn’t go back, and I’d report them for threatening to violate doctor-patient confidentiality.
Another inaccurate example. A better one: "“Before I can evaluate you for heart disease risk and prescribe medication and lifestyle changes, I need to visit your kitchen and look at the foods in your pantry and refrigerator, to see how they might contribute to your heart health.”
Again, an inappropriately intrusive requirement, just as is the psychiatrist’s demand. But the data he’s seeking is completely relevant to the issues he’s being asked to treat.
I might be misreading you, but the assumption it seems you and others are making is that the psychiatrist’s desire to learn about @Velocity’s family comes from distrust and the need to verify @Velocity’s claims. There’s a lot left out of the OP, I think, but therapists don’t take “sides” or act as impartial arbiters. They’re counselors, not judges.
Thank you! I did feel like I was supposed to have confidentiality before I went in. It occurred to me that maybe she was thinking to herself;;.“:Uh Oh I do not want this patient”
I’m sure you were. There are some laws that can require the mental health provider to break confidentiality – these might vary a bit by state – but your provider should have told you about those circumstances up front.
In my state, they definitely could not tell my partner/spouse anything, unless there was a court order. They can break confidentiality if they think you’re going to physically harm yourself or someone else, if you are going to commit a serious crime, or if they learn that a child has been abused, or is going to be abused. And of course, by court order. I’ve had a few therapists, and they’ve all informed me of those things at the beginning. Oh, also they might have to provide information to your insurance company if you are using insurance.
One of them also told me that they keep fairly minimal notes because of some of those requirements. And they’ve discussed with me things they think might trigger insurance review, and what the options are around that.
I would certainly consider reporting the provider to their licensing board for threatening to break confidentiality, if I were you. That’s harmful to you, and probably left you in, or had the potential to leave you in, a worse state than when you came into therapy.
I had similar thoughts. My parents are both dead and my only sibling is more than 6 years younger so he has no clear memories of me from before I was 10 to 12. Is that close enough to knowing my whole life? To be frank, most of the most traumatic childhood things that happened to me are things that happened before he was old enough to remember, so he in no way could collaborate on events no one told him about.
I’d choose a different doctor too, OP.
I am not going to report her but at the same time I stopped searching for a therapist. I have confided in friends a couple times and both times it came back to haunt me. Not a good feeling.Thank you for your reply!
For the record I was not thinking of doing anything illegal or immoral. It was a sort of bi-curious direction I was going
I assumed you weren’t talking about committing any crimes. 
ETA: I’d encourage you to try to find another therapist. When I say I’ve had a few, it’s because I tried several who were not a good fit for me before I found my current one. She and I have now known each other for 18 years, I think. I haven’t been in therapy that whole time, but I recently returned to seeing her and I’m so grateful that I have her as a resource to deal with some pretty intense stuff that came up.
How in hell would anyone’s input be helpful when the psych hasn’t even started treating yet? It would be exactly as helpful as asking randos on the street what they think because there’s no context and no way for the psych to even begin to ask pertinent questions relatiing to family dynamics on account of he doesn’t even know the first thing about the family. Some random family member could get talking about completely imaginary family members and the psych would take it all at face value because he hasn’t gotten even the faintest inkling of what the situation is, what the patient needs and how family might be affecting him.
Basically, at this point, that therapist is asking, “So, how long is a string?” as though that question made ANY sense whatsoever. A few months down the road, family interviews might be helpful. BEFORE even beginning treatment though? Seriously, WHY?
Before you see a therapist, you generally do fill out a fair amount of questionnaires so that you are not going into the session blind. They already know what it is you are asking for help with, and the basics of where you think your problems stem.
Why would they do that? It would be information that would be useful, but a therapist knows better than most not to take anything anyone says at face value.
We also don’t have context. We don’t know what the patient (the OP) needs, what reasons that he has reached out for therapy, what answers he gave to the intake questionnaire, or how exactly the request to contact family was phrased.
Without more information, it’s not really fair to draw the conclusions that some have jumped to in this thread. If the OP doesn’t want to share more information about his mental health needs and treatment, I completely understand, and don’t really want to know anyway.
But, for example, it the OP says that he thinks that his problems stem from some trauma experienced in third grade, then it would be completely reasonable to get a second perspective, as anyone telling stories from when they were eight is going to be something of an unreliable narrator.
And yet, demanding contact with other people when an adult client requests therapy is not a standard practice and is in fact an odd practice. If it’s how the psychiatrist runs their practice, it’s not illegal or unethical, yet it’s non-standard and odd, and I’d look for a different practitioner. I assure you that I or any competent therapist can be potentially helpful to a client without collateral contacts.
Therapy isn’t about hunting down and figuring out the “truth” of the past. If that’s anything, that’s legal/forensic, not therapeutic.