Safety contract

[Deleted member 42783]

Hi, I'm not sure if this is the right area to post this but here goes.
I started therapy for the first time this past March. I knew I had depression but my T diagnosed me with PTSD as well. The diagnosis fits. I'm not arguing against it. I like my T. We get along but he is not a trauma therapist per say.

Two days ago my T whipped out a safety contract for me to sign at the end of session. He claimed it was a formality required by the agency due to my continued ideation over the last four months. I was actually very hurt by this action. He knows that my SI is always passive. I have no intent to kill myself. He knows that I could not do that to my husband or children. He knows that I have fears of a paper trail in my chart. We had just discussed how I am paranoid about this stuff. He knows that I have deep trust issues and now I feel as though he doesn't trust me. I cannot help the fact that SI is always there in the background. I say every session that I have no intent to kill myself. Is this really a matter of formality or is this an attempt to protect me. I can't tell and its driven a wedge between us.

 

[Deadman]

Is this really a matter of formality or is this an attempt to protect me.

I don't know your local laws but I suspect it is both. Is it the formality you object to or is it the intent of protecting you?

 

[Deleted member 42783]

@Deadman
I guess its him saying that I had to sign it knowing how badly I would react to it and how hurt I would be. It was just a bad move and to hide behind a formality made me not trust him.

 

[EveHarrington]

It's a bit of a formality.

There are no repercussions for breaking the contract beyond your therapist letting you go.

I hate to say this, but I sign them whenever they're put in from of me. Not because I mean what is on the paper, but because there will be hell to pay if I don't sign it. (Termination.)

 

[Deadman]

How did he know how badly you would react? Did you discuss it beforehand? Could he believe your SI is more than merely passive?

 

[Deleted member 42783]

My therapist terminating with me seems hurtful enough. I signed it because he asked me to but the whole thing seems asinine. I had never heard of these types of contracts before this week. They don't make sense and signing it seems like a threat.

How did he know how badly you would react? Did you discuss it beforehand? Could he believe your SI is more than merely passive?

Since we discuss SI at every session, yes it was reasonable to conclude that I would perceive that he didn't trust me. He knew.

So either he made a bad move because his bosses said to or he is not a very perceptive therapist.

 

[Deadman]

I'm still not clear how he would know you would be offended? But even if he did know what would be his priority? Your life or your business?

 

[Joan]

I do not know a therapist in the US who would not ask you to sign one if you have expressed any SI. coming from someone with trust issues....I think it has nothing to do with him trusting you or not, but covering himself legally.

 

[Deleted member 42783]

@Deadman
I would say I am hurt not offended. My life is important. Its not in danger right now. The thing is, my T has made it a point to tell me over and over again that being invalidated has contributed to my ptsd. When I tell him week after week for four months that I am NOT suicidal and then get treated like I am, yeah it feels invalidating and hurtful.

 

[Tornadic Thoughts]

I used to work at a vocational/residential rehab center that is state owned.

Any time a student even hinted at SI, we were required to report them immediately to the psych dept., the medical staff, and campus police, and have them fill out no harm agreements and such.

It used to piss me off the way they handled it all because it never failed to escalate and complicate the situation for the persons seeking help.

I realize the need for paper trails to supposedly cover their asses, but at the cost of losing touch with the basic compassionate human aspect of the whole scene is rather disheartening, to say the least.

 

[zoie33]

I am sorry your T had to go there. I used to have to sign them with my old T. My new T just makes me promise not to kill myself before the next session. One time he followed me to the door and called me back, (I am the last person of the day and the office is empty) and made my promise again and shake on it. I am so glad he does not make me sign them. I think it is purely for legalities. My T is private practice so he can do what he wants. He also knows that I am beyond ideation right now and I actually have high intent with means and a plan. He knows I don't lie so I guess my word is enough for now. He keeps pushing me for a one year commitment though and I keep saying that is never going to happen. We discuss it every session lately. I'm a bit sick of it as I am sure he is too.
I don't think he purposely wanted to offend you. He sincerely is concerned for your safety and (rightfully so) his own legal butt. I told mine don't worry, it is top on my list to right a note and state that he knew nothing about it. He said that wouldn't matter, therapists have lost in court anyway because the lawyer said he is a therapist and should have known. Either way, it sucks. I hope you feel better soon. I understand the struggle all too well.

 

[Deleted member 42783]

This is what I want ^^^^. Zoe, your T sounds awesome. From what I've learned this week, a contract really doesn't provide any legal protection for therapists.
There is a difference between passive ideation and active intent. I do not have active intent. It's more like a voice just pops into my mind a few times a week saying "hey, you could kill yourself". I don't take it seriously. Sometimes its a comforting thought but I don't entertain it.