Is this not supposed to be a confidential relationship? How does this supposed professional contact the family without letting them know @Velocity is the client?
For lawyers, the fact that I’m your lawyer isn’t protected, just what you say to me. Maybe it’s the same for therapists.
I presumed that the contacted would be told of the client. How else would/could it work?
Once again, we don’t really know how the request was phrased, or what the OP may have done to prompt it.
We don’t know if it was, “I refuse to speak to you again until you give me contact information so I can verify your story with your family.” or, “From what you have talked about, I don’t know if I can be of further help without some outside context and perspective about this issue you are dealing with.”
If the former, very unprofessional in my opinion. If the latter, pretty reasonable.
Everyone seems to be assuming the former without any information to back it up, as well as contrary evidence in that it’s not something that is typically done.
Would you agree that an adult telling a story about something that happened to them when they were eight is going to generally be an unreliable narrator?
It’s not about finding the “truth”, it’s about helping the patient. That may require more information than the patient is willing or able to give.
Now, it may be that therapists will generally take everything that the patient says at face value, and therefore miss context that may help deal with their issues, but I don’t see a problem with trying to get a fuller picture.
If I go to see a psychiatrist it is nobody’s business but mine and the psychiatrist, therefore telling others about this relationship, even and especially family members, is totally off the table.
I’d assume that part of giving contact information would also be authorizing them to divulge minimal details.
Unless you let them. Now that I think of it, when I was in rehab I did allow my counselor to call my wife and talk privately about whatever the heck it was they talked about. I personally don’t care, so I allow it. Most others do, so, hey, don’t allow it. You have a choice here.
As someone already said above, a therapist in the US may not breach client privacy except under clearly legally delineated circumstances. Wanting to talk to you family for other reasons isn’t sufficient. You could lose your license and be sanctioned. Thereore, you obtain the client’s permission. If you’re nominally smart, you get permission in writing.
The truth value is largely irrelevant. How the person feels about it, for example, is more important if the goal is to function better, feel better, and make decisions thry feel good about.
INAT, nor have I ever even been a patient. I have taken a couple undergrad psychology classes, which I believe qualifies me to act as a lump on a log.
That said, if a patient says, “I think I have sexual dysfunction because I was molested by my babysitter when I was eight.” is it worthwhile to find out if they ever even had a babysitter?
Not necessarily. What brings them to therapy? If it’s legal, they need a lawyer, or a forensic psychologist, but that’s a different goal than “…and I’d like to get over the trauma so I can have more enjoyable sex,” for example. That requires no evaluation of truth, and is focused in the present, which is where a person is able to act.
Nope, as a lawyer you can, after spotting a client in a restaurant, go up and say howdy. A therapist can’t acknowledge a client outside of therapy in any way, UNLESS the client addresses them first and even then the therapist can’t mention anything about how they know each other, it’s 100% in the client’s control whether or not they wish to disclose that they see the therapist in a professional setting. This is also protection for the therapist, since seeing a client out in the wild can be disorienting to the client and can sometimes lead to stalkery/obsessive behavior from an unstable client.
You would be wrong about that. Let’s say that you have a friend who invites you to a party, and at that party is their family member and that family member turns out to be your client. As a therapist you can’t even acknowledge that you know that person AT ALL, unless they decide to say, “Oh, hi there–hey, did you know I’m seeing Therapist weekly?” If they don’t disclose you have to operate as though you’d never met them, in spite of them maybe having told you they were molested by the person you know as a friend. EVER. Any disclosure of the therapeutic relationship has to come from the client and transgressing those boundaries of disclosure risks your licensure.
Not in the slightest. The objective “truth” of what happened to a person takes a very distant back seat to what their perception of their own reality is. For example, I had an ex who was definitively molested by his babysitter when he was ten–she was an adult and taught him cunnilingus. The fact that he has no feelings of trauma in his present reality doesn’t change the fact that he was absolutely molested, and vice versa. Objective “truth” is basically useless in a therapy environment.
I think there are many situations where objective truth is useless in a therapy environment - but I’m not sure it’s all situations. Take , for example someone who ends up in counseling because of their feelings of sadness and loss because a family member cut them off and whose goal is reconciliation. Is it never useful for the therapist to find out the reason for the estrangement? Is it possible that the person who cut the client off had legitimate reasons for doing so? Might the therapist take a different approach if a child cut off a parent who the child felt was overly controlling than would be taken if the child cut the parent off because of a spouse who said “your parent or me” ?
Fair enough, I would have thought that some level of perspective would be useful, but maybe not.
I’m just spitballing scenarios from the OP’s pretty vague description of events that don’t cast the therapist that no one here actually knows as some kind of controlling monster that should lose their liscense.
Is there any scenario where you would tell a patient that you cannot give them any more help without talking to someone who would be familiar with the patient and their issues?
Does any of what you said follow if the patient has authorized the therapist to talk to a family member? Because I’m not sure that you properly parsed what I said.
I never knew that, I guess that’s why some people look down on it.
Of course, I’m trying to make it completely clear that the therapist has NO latitude to disclosure while the client has ALL the latitude. The only disclosure a therapist can make is if the client is a clear danger to self or others. If during a session the client says “I hate Bob at work and next time he pisses me off I’m gonna shoot that fucker” and they’ve already told you they own guns–yup, you can report that to the cops and you’re in the clear. If the client has a clear intent and plan for suicide, likewise. If the client discloses they’ve molested a child or committed a murder, confidentiality doesn’t cover that. Otherwise a therapist has to keep mum unless the client specifically allows them to speak to someone regarding their therapy–and as susan points out, the smart therapist will get that in writing.
And I’m not saying the therapist IS a controlling monster, I’m not saying the OP absolutely has the right of it. What I’m saying is that if the reported interaction is as it’s stated the therapist in question is, in my opinion, way too didactic and much too authoritarian to work as a therapist FOR ME. Someone else might find that strong daddy energy helpful, I dunno, but I wouldn’t see that guy for even an initial consultation if that’s the way he’s going to go about things. Therapy is a collaborative process, the therapist is there to be helpful and guide self discovery–therapists don’t CURE you, they lead you in paths that help you to cure yourself. A therapist who thinks of themselves as the be-all end-all healer of broken minds is an asshole, that’s my opinion.
The problem here is that from OP’s description, there has been no (zero, nada, zilch) talk yet at all. There’s been no “from what you have talked about about” because OP hasn’t had a single appointment with this psychiatrist yet. The provider probably has a general notion of what the client wants help with (“stress management” or “marital problems” or “work/life balance,” for example), but has no detail yet, so on what basis can they possibly conclude they need outside context and perspective in order to provide any help at all?
The OP was pretty vague on how things played out. It is assumed by posters that he hasn’t had a session, but I don’t know if the “(or follow-up counseling)” is meant as an addition or a clarification. We also don’t know what has been discussed and disclosed by the OP to the therapist, IMHO, it is much more than zilch.
My only dog in this fight is that I didn’t like seeing people pile on this therapist without actually knowing the whole of the story.
Maybe we get the rest of the story and this is a sketchy guy who shouldn’t be treating people, and maybe we get the rest of the story, and the request makes sense in context. I don’t know which way it would go, and I doubt we will get much more context to make that determination.
Here’s the thing–what people have been doing is exactly what therapists are trained to do. When someone comes to a therapist with a problem, the job of the therapist is to say to themselves, “Okay, we assume everything this person thinks is objective reality to them–what does that world look like and how is it causing problems with the objective reality of others and the consensus reality of human society in general?” Then the therapist gently guides the client into figuring out how to make their worldview more comfortably congruent with the world around them. I have a very strong worldview of my own and I find this difficult to do and this is why I’m not a therapist, because it’s not helpful for a therapist to tell a client, “You’re wrong, this is why/how you’re wrong and you need to this that and t’other to get right with the world, miscreant!” This exercise of radical acceptance of the worldview of others is precisely why my friend who is a therapist won’t work with actively delusional schizophrenics–she goes into their world too easily and too far and can’t keep her boundaries straight to be able to guide that person. Other therapists get along with schizophrenics just fine, just as some therapists love taking on borderline personality disorder clients and others won’t touch them with a ten foot pole. It’s all about understanding your own biases and boundaries (this is why therapists have therapists!) and how to keep them separate from your clients in order to be able to work with them effectively.
Huh, well I was going to say that the OP never clarified, but, using a trick I learned from @Max_S in another thread, I found that he has, so my bad on coming from that position before.
So, the therapist said, “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.”
Now, I see that as a reasonable request, though I do find it pushy for it to be a demand. Maybe that’s not what he needs. (Or maybe it is what he needs, but not what he wants.)
Seems it could be, sometimes. I really wish someone would tell my brother that.
If it comes down to this therapist making the OP uncomfortable, then he should absolutely find another. Comfort and trust is important in such a relationship. The bit that I was objecting to was just the implications that this therapist was unqualified or malicious for making this request.
Well, we did hear from a licensed and practicing therapist that she found his requirement to be offputting and definitely not standard practice–whether it’s malicious or not and whether the psych is qualified or not would require a bit more digging. Let’s just say his approach is giving big red flag vibes to a lot of people who have empirical experience in how therapy usually goes, from both sides of the interaction. Whether or not the OP decides to proceed with this particular therapist is their decision, but I would say that it wouldn’t surprise me one bit to see another thread in a couple years, “Therapist done fucked me up bigtime, can I sue?”
And you could send your brother to a life coach, that’s EXACTLY what they do lol.
I grant that, but I also see that we only have one side of the story, and I do wonder if, when put into context, those opinions would change.
I feel I’m pretty much in the position as the therapist. The OP asks for advice, but doesn’t give enough information to be able to give anything more than the vagues of advice, and he gives information that really seems to very off from the norm. I don’t think that I’d be in a position to help him unless I got the therapist’s side of the story. And it’s entirely possible that the therapist finds himself in a similar situation.
And maybe the therapist didn’t want to work with the OP, and this is how he brushed him off.
Any that deal with self proclaimed sov cits?