Welcome to therapy, this is exactly how it works. All a therapist’s job is to take that unreliable narrator in the other chair and make them less unhappy with the world they live in. Anyone who strongly believes there’s a “right” and a “wrong” answer when it comes to feelings, perceptions and functioning in the world is not going to be comfortable even getting through the training to be a therapist. Relativity and subjectivity is a constant in the world of therapy, otherwise it wouldn’t work worth a damn.
I dunno about sov cits, they don’t seem to listen to anyone–maybe a life coach who’s a newly retired Marine drill sergeant?
I can’t speak for most places and am not a psychiatrist. My experience is largely in emergency departments which tends to imply crisis type situations, including patients who may not be fully alert and coherent, and is not indicative of standard practice.
In the emergency setting, getting information is important. This is generally provided by patients, fortified by old medical records and paramedics and family members, often with a considerable degree of accuracy. Depending on the degree of emergency and specific situation, and generally with the permission of the patient if they are able to provide this, one does ask relatives for their views or understanding if appropriate.
However, there are any number of situations where the patient has information they consider sensitive; which other family members may not know, or where the patient does not wish others to know what they are discussing. The first step, when possible, is to interview the patient alone. If this is usually the case in standard practice, interviewing others without specific permission may be problematic.
Interviewing other family members without permission would usually be offside. There are circumstances where the patient is not in a medical state able to provide permission and in emergencies one does consult old records or interview people close to the patient but reveals this to the patient as soon as reasonably possible.
As a condition to seeing patients, the psychiatrist perhaps believes they can only get an accurate picture of circumstances by hearing other perspectives. This may be true for a few conditions and sone people. But it does not to me seem like a productive first step or one that necessarily acknowledges appropriate confidence and confidentiality. However, I am not a counsellor and there may be many good reasons for this which are in the interests of many patients. But I do not know enough about the patient population to truly or fairly assign judgement on it.
I can’t express how inappropriate, bizarre, and destructive to the therapeutic relationship it would be if my therapist had ever in any way suggested that she wanted to speak with my estranged parent. Especially if part of the reason for wanting to do so was to find out if the parent had “legitimate reasons” for cutting me off, or to find out the “true” reason for me cutting off the parent.
I don’t know you or your situation or even if you are estranged from a parent or child - but I specified that the person entered therapy to deal with their feelings of sadness and loss about the estrangement and that the person’s goal is reconciliation. You don’t sound like you’re that person - but I’m not talking exactly about finding an objective truth. There are going to be some situations where there is no hope of reconciliation ( such as if the spouse is forcing the child to choose ), and there are going to be some situations where the person has a legitimate complaint (for example, the parent is critical of everything the adult child does) and reconciliation may be possible if the parent gains insight into how this estrangement was caused by their own behavior. I’m not suggesting that the therapist should investigate a reason given by the client - but I’ve known an awful lot of people who claim they don’t know why someone has cut them off, so I am certain there are people who don’t give the therapist any reason for the estrangement.
I’ve worked with 8 different therapists over many years and have never heard one request speaking with my family as a condition for working with me. This seems way off base, to me.
There can be good reasons to bring family together or speak with family members, but only as part of an agreed to way of working, and only after building up to it.
I do think therapists could gain a better insight into their patients by talking with family, and neighbors, coworkers, friends, and so forth. Medical doctors could, too, I think. And doing this is WAY out of line for all sorts of reasons, regardless of whether some useful things could conceivably come of it.
I have no idea if this is standard practice in Psych World, but other specialists routinely review medical records of a new patient (obtained from hospitals or other providers) and if they’re diligent about this, therapeutic missteps and unnecessary tests can be avoided. That should typically be much easier, less intrusive and more informative than trying to track down family members. Obviously it isn’t possible for initial encounters.
Every new physician’s office will hand you forms to spell out your medical history all over again. I’ve wondered who if anyone reviews that information before you get to see the doctor, or how often the physician looks over the forms.
I’m just wondering what I could do if I were in the same position as the OP.
Father is dead.
Mother is crazy.
Step-dad is going senile.
Sister and I haven’t been close for over a decade. Not estranged but we live separate lives in different states and talk a couple times a year on the phone.
So the therapist would be unable to treat me? Or base my treatment on stories my mom tells that might be, but probably aren’t, true?
I can’t speak for others, but I review all of that before the first session, and review and clarify with my client. As a psychotherapist, I have the luxury of a longer session than a physician gets.
We’re never going to get that information, though.
Fortunately, for the purposes of answering the OP’s question, it doesn’t really seem to matter. This is indeed a non-standard practice, and non-standard practices in the psychology world are indeed red flags, as it suggests some non-standard therapy.
Sure, maybe there’s an explanation. But then it would be up to the psychiatrist to tell the patient what it is, not expect them to just do it. It shouldn’t be that hard to say something like “I’ve had plenty of experience with psychologists and psychiatrists before, and none have made this request. I asked some people I knew, and none of them have ever had to do this, either. Can you tell me why you feel you need me to do this?”
I think the psychiatrist should have made it clear up front. Not having done so is a red flag. Not of malpractice, but of a bad fit/poor communication between the therapist and the client.
Years ago, I was directed by GP + insurance to a clinic that specialised in complex problems. During the first few sessions they kept bringing up that they wanted me to bring in my parents, which I didn’t think was at all relevant or helpful. It only later became clear to me that this is how they work: they include those closest to you in the therapy.
I found it very annoying because I wasted several of the sessions my insurance covered talking about my “resistance” to bringing in my parents, only to find out that this was their method and they wouldn’t treat me if I didn’t bring them in. I was there because I was struggling so much with my master’s thesis I didn’t want to live anymore and I still don’t see what good having my parents there could do.
Anyway, different situation because they wanted my parents to be there with me, not to talk to them separately or verify anything. But they were reputable and considered legitimate and it involved speaking to parents.
Years after that, it so happened that my parents were at the same clinic during their divorce. (Because this clinic was seriously reputable, topped all the lists!) They of course had to bring me in, since that is their method. It was completely unhelpful. At one point, one of the two therapists said he felt my mum was being uncooperative and he felt like he was standing there with his foot in the door and my mum kept trying to slam the door. I said to him: “You’re getting paid for this, so keep your foot there, thanks. I am not getting paid to have my foot in this door, so I won’t be back.”
Frankly, they pissed me off in many ways and I think the whole thing of only treating in the wider social context was a load of tosh. I don’t want my foot in the door of my parents’ failed marriage and I don’t want my parents’ feet in my despair over my master’s degree. I spent several of the sessions my insurance covered figuring out that they wouldn’t even treat me at all and they were happily making money. Dirty scammers.
All of this to say: even if it’s legit, I’d run. Unless it’s about testing for ADHD, they usually ask a parent to come in for that.
I’ve never seen that, either. Not with an adult patient, at least. A psychiatrist can ask the right questions and observe.
I can’t think of any evidence-based testing or treatment that requires the parents of an adult to come in, really. This plus the OP’s post history actually makes me wonder if this is actually “Christian Counseling.” My sister looked into that a bit until she found out how bad it could be. And one of the things was how everything, no matter how private, involved the parents. She’s sure that’s why one of her Youth Group kids recanted a rape accusation, despite acting exactly like how a rape victim acts.
At most, the therapist should ask the client if they want others involved in the therapy. It should absolutely never be mandatory. A therapist who is any good knows how to talk to their client and listens well. Extra participants are not necessary. This one sounds like scammer or is maybe trying to find more business. BIG red flags.
It sounds like what you’re describing is some variant of “family systems therapy”, which is a perfectly respectable and recognized approach to therapy.
But it was highly unprofessional for them to not make it clear from the very start that this is how they operate and they aren’t open to negotiation about it. Obviously, what they do isn’t what most people who are looking for “therapy” want.
Because of the obvious logistical and financial burdens, it’s usually only recommended for people who have failed to benefit from more conventional therapy. So unless you fall into that category, your insurance company also sucks for pointing you there in the first place.
Yes, you’re right, I checked their website and they say—after clicking through several links!—that their method is “systemic work.”
The focus of what they explain is that they are a clinic that helps people with psychology and psychiatry both and they talk much more about “seeing people within the wider social context” than they do about “we won’t treat you if you won’t bring in your parents.”
Now, I remember thinking that the wider social context made sense to me, but it wasn’t clear that other people would need to be there. Obviously, you can’t drag your professor + the rubbish uni administration into the clinic. So then you get them requesting my parents and me not seeing the relevance.
And it was absolutely completely unprofessional not to make that extremely clear (or even to just say they weren’t a right fit for me, as my professor wasn’t coming along!) I was so vulnerable at the time, I couldn’t think straight at all. Couldn’t read through a website to see what they do, for example—but that is surely not unusual?
In fact, I’m glad the OP is asking for guidance here because in that vulnerability it really helps if there are people helping you think and giving useful perspective.
I can tell you as a faculty member who trained family therapists for many years that it’s quite possible to use systemic family therapy techniques and approaches with only one person.
I’m still somewhat confused about psychiatrist vs. therapist, due to my understanding of their respective professional roles. My understanding is that therapists do counseling and talk therapy, and psychiatrists prescribe medication
I really can’t see much of a legitimate reason for a therapist to make this sort of request, and that would raise a bunch of red flags for me.
If someone were to make an appointment with a psychiatrist, without being referred by a therapist and they were seeking pharmaceutical treatment for anxiety or ADHD….yeah, I could see the doctor wanting to speak with family to make sure you indeed exhibit the symptoms to claim to have, especially if controlled substances are involved.