No Boundary & I’m Spiraling - Struggling with therapist's unclear confidentiality policy

[Midnightmoon]

After 2+ years in therapy I'm starting to work towards talking about riskier things. Even I'm sick of my own 'everythings fine' mantra whilst I'm sinking underneath it.

But...

I'm finding my T's 'no set rule' on confidentiality an absolute nightmare to be able to feel like I can trust. I don't need something set in stone, I just sort of assumed it would be the usual (suicidal with an immediate plan/ vulnerable person at risk/ serious crime/ court ordered etc) and I'd be more than fine with that. The issue is, apperently it's not that. Everythings taken individually and assessed individually, which means I feel completely lost. My confidentiality has been breached before over something that it shouldn't have, which I guess makes me far more cautious of these sort of things.

Does anyone else's T have this sort of policy-how do you feel secure enough to talk about stuff with no idea where the invisible line is for sharing information? I'm not concerned about them 'gossiping', I'm satisfied their not spilling my secrets to the neighbours, it's more my Drs etc. We've talked about it, lots, but it hasn't really changed anything.

 

[No More]

I understand that a therapist needs to use their discretion a little bit when it comes to risk of harm perhaps, especially if they are treating self injury for example, but I would be absolutely OUT if there were no confidentiality policy at all.

 

[arfie]

i can't say that i've singled out professionals in recognizing and rehabilitating my trust issues, but trust, in general, remains a HUGE challenge for me, across the board. it remains difficult for me to trust that the sun will rise tomorrow, much less trust that another human will act with MY best interests in heart. my nurtured reflex is to build lawfully reinforced walls, guarded with watchdogs who continually monitor the compliance required to maintain my highly conditional trust.

remediation in progress. . . i ply therapy tools to my mistrust, wheresoever the mistrust is found. healing is an act of trust.

 

[Charbella]

Does anyone else's T have this sort of policy-how do you feel secure enough to talk about stuff with no idea where the invisible line is for sharing information? I'm not concerned about them 'gossiping', I'm satisfied their not spilling my secrets to the neighbours, it's more my Drs etc. We've talked about it, lots, but it hasn't really changed anything.

Most definitely not, I would no way see someone with such a policy.

I’m wondering if what I’m reading is what you’re saying, do you mean to say you’re afraid that your therapist is sharing with your doctors? Is he sharing with other doctors for advice? If it’s with your doctors what concerns you about that and could you voice that concern and ask how your T can help you navigate it?

My Ts policy is if I’m a danger to myself or others or the court ordered mandatory reporter situation. He also includes that he may consult with other professionals. Something I’d say he’s done quite a bit but it’s done anonymously and in a this is the gist of her story, he does it to get advice on how to help me best. I’d say I try not to think about it.

 

[Freddyt]

IF EVERYTHING that goes on between myself and my T WITH THE EXCEPTION of my personal safety wasn't confidential? I wouldn't be there.

As a matter of fact, where I live, the practicioner MUST get my approval before disclosing ANY personal information. To the point that when I was looking for a new T, I had to sign stuff for my new and old T's to exchange ANY personal information

 

[Friday]

That’s illegal in my country EXCEPT under certain conditions. Below is a list off the top of my head, but it’s not complete.

- They’re not actually licensed to practice and are either a student under supervision, religious counselor, or peer counselor.

- You are not their client, but instead they work for a company, organization, or state agency. Contracts vary tremendously within & between these groups.

- The therapy is court ordered / legally mandated.

- The therapy is only one small aspect of a much larger medical treatment program (inpatient hospital stays, VA treatment, outpatient cancer treatment, & alcohol rehab, etc.) and the consent to share information with oher providers in the group (and often outside of it) is explicitly required, in order to receive treatment.

- The client/patient signs a consent to share form (either under their own request, or at the providers request, or a 3rd party request the patient/client grants,).

Each nation’s laws surrounding medical & psych privacy/confidentiality? Are naturally different from each other.

 

[Friday]

I'm finding my T's 'no set rule' on confidentiality an absolute nightmare to be able to feel like I can trust.

If they’re going to be sharing what you would prefer to be confidential with people, when you don’t want them to, and you have no say in to whom & how much they share? It’s not smart to trust them.

I’ve worked for several companies who have in house therapists. No matter how much they may like me, individually? Or how good of a working relationship we may have, otherwise? They are required both by law, and their contract, to report back to the company I work for… so they’d be the very first to recommend that if I want to keep sessions private? To hire someone else. Whose allegiance is solely to me, as their client. That doesn’t mean I don’t make use of their expertise. It does mean that I’m careful/cautious not to put either of us in a difficult position.

Just to be clear? I am not saying to not trust them. I’m saying that trust is earned. Not just by force of personality, character, & skill level… but also by what outside forces are involved.

What sort of laws &/or situation are you currently dealing with?

 

[Midnightmoon]

I'm in the UK, with a private T who is registered with a professional body. Hugely experienced and knowledgeable. First ever experience of therapy for CPTSD.

I just can't seem to move past the 'no set rule' to the point where I'm thinking I need to walk away. (I don't want to walk, I've done two years and my trust is still really poor, I can't help but panic at the thought of starting again... But maybe my trust is poor because I'm not feeling safe in the lack of boundary )

Every time we've spoken about it, it's like it's my fault for not trusting, but trust when I don't know what I'm trusting is proving virtually impossible

 

[Friday]

I'm in the UK, with a private T who is registered with a professional body. Hugely experienced and knowledgeable. First ever experience of therapy for CPTSD.

I just can't seem to move past the 'no set rule' to the point where I'm thinking I need to walk away. (I don't want to walk, I've done two years and my trust is still really poor, I can't help but panic at the thought of starting again... But maybe my trust is poor because I'm not feeling safe in the lack of boundary )

Every time we've spoken about it, it's like it's my fault for not trusting, but trust when I don't know what I'm trusting is proving virtually impossible

So are you taking ‘no set rule’ the opposite way as intended?

1. If they’re private, and are under no obligation to report to anyone (Colleagues, Govt., NHS, insurance, employers, family, etc.) the ‘no set rule’ would seem to indicate that they tailor any info they share by client request? Like someone needs assistance with housing, or employment, or to attend a trauma center this therapist is willing to write letters of recommendation for them; meanwhile someone else who doesn’t want their info shared, is kept entirely private, unless there is an immediate threat to life?

2. Could you & they sit down and create a bespoke rule set, just for you?

 

[Midnightmoon]

1. If they’re private, and are under no obligation to report to anyone (Colleagues, Govt., NHS, insurance, employers, family, etc.) the ‘no set rule’ would seem to indicate that they tailor any info they share by client request? Like someone needs assistance with housing, or employment, or to attend a trauma center this therapist is willing to write letters of recommendation for them; meanwhile someone else who doesn’t want their info shared, is kept entirely private, unless there is an immediate threat to life?

2. Could you & they sit down and create a bespoke rule set, just for you?

Unfortunately our definitions of 'at risk' our very different which is where the sticking point is. My initial reason for seeking therapy was medical trauma, I've stumbled upon a CPTSD diagnosis along the way. My huge boundary is NO talking to my GP etc (unless threat to life), and there's is very much that they'll talk to them if they feel it's in my best interest- even if that's for something minor, as has happened before.

I'd love a set of rules, I've asked and asked. Apperently that's not possible

 

[MM3Mac]

I get my care from the Veterans Affairs and they only share what I’m aware of them sharing. I have a care team that shares their knowledge.

 

[Charbella]

My huge boundary is NO talking to my GP etc (unless threat to life), and there's is very much that they'll talk to them if they feel it's in my best interest- even if that's for something minor, as has happened before.

Yep, that’s a hell no. I’d be seeking someone else. Ask for a referral, tell your T the sticking point so they know not to refer you to someone else who’d have the same policy.

I find that completely ridiculous, clearly they don’t quite understand CPTSD and how much it makes you trust no one, then to have them break your trust. No way I’d pay someone for that. Plus I don’t see progressing under those circumstances.

Side note: I see your new and the quote thing you did. In case you wanted to know you highlight the text then hit the quote button if your doing multiple or the reply button if not. Reply will just past it and let you start typing, multiquote you have to hit insert quotes.