Therapist's Breach Of Trust

[SimplyComplex]

I am not sure about those first hand, and would be surprised if any took it further then HIPAA. There are also ethical guidelines from various professional organizations ts can choose to follow. I think its a complex subject. In general, however, I think medical professionals are allowed (and thank god for it) to consult other professionals without consent.

 

[Srain]

I don't know if it is okay that medical providers do consult without the consent of their patients, without permission when there is misunderstanding and assumption...I have experienced this first hand...I'm thinking that it is a personal experience thing. I'm grateful yours has been positive and to date turned out well. Mine has been a challenged as have many I've come to know through out not only the US but global suffering with various issues. I have had the honor to hear speakers who are Supporters as well as Survivors that have experienced providers that are not as opened minded nor supportive of the trust factor and the importance of building that.

Treating clients/patients as ignorant children. I'm neither a child nor ignorant. I am a part of my treatment and deserve respect. My provider absolutely needs to keep me informed of important directions of my treatment. In therapy, my tdoc informed me from the start that I would NOT be in charge of the sessions, I either agreed or not. I agreed....this did NOT include breaking our agreement that others are allowed information regarding my sessions.

I am looking at what was the main issue or what I see as the issue...trust broken. Not once but twice. That is an issue that for those of us who are trying to build trust in our lives is the very core value that was broken from the start. How can you build trust and work with your provider if they constantly break the core value?? I am not seeing that. It is therapy 101.

 

[sea]

Consultations are perfectly legal. Any medical professional is allowed to consult with someone in order to better understand the parameters of your case. However what defines a consultation is clearly open for debate. If my therapist decided to consult with a teacher regarding something and just happened to choose, for instance, a teacher at my son's school - and decided to talk about my childhood and reveal all of my deep dark secrets, we would have a considerable issue. If he decided to consult with a lawyer regarding specific legalities about my case I would have much less of a problem.

One of those is professional and one of those is not, so there is clearly room there. But, my therapist frequently consults with other professionals almost constantly. Lawyers, teachers, interpreters, other therapists, doctors, volunteer groups, etc. He doesn't ask for my permission. He knows it is very unlikely I would give it in most circumstances. But he does not lie about it either, so I understand that what I am saying may be revealed anonymously to another party.

A therapist cannot identify you, individually, as their patient. They cannot reveal your therapy notes. They can summarize your case and seek opinions and assistance. Think of television shows where a group of doctors will say "female, 45, caucasian, presents with appendicitis" etc etc. It was only with my permission that my therapist was capable of revealing who I was and my contact information to another person that he was consulting. So there is a very thin line between what is ethical and not ethical.

From what you are suggesting, due to the private nature of the group, it sounds like she revealed exactly who you were without your permission. I don't think that is ethical at all. And, I have absolutely no inability calling it a breach of trust. She was extremely dismissive of what sounds like a very important concern on your part.

 

[doglover]

I think it would be much much harder to get the most from therapy by enforcing such a rule. I get it, you need to feel you can trust this person. You need to be able to set boundaries and have them enforced.

I get that the population with PTSD will often have extra concerns related to rapport and trust.

I'm just thinking that this particular rule could get in the way. A lot.

Except right now the main issue seems to be how the choice she made has eroded your trust in her. I hope you can discuss it with her.

You don't keep working in mental health years upon years if you disclose and discuss client information in an unethical way. Staffing a case (where you discuss basics to get a second opinion or ensure you are handling it in their best interests) is really very common. It's also done with the interest of the client in mind. It's very often not something that involves your name.

You have a right to make certain requests of your helpers. I'm just not sure how reasonable it is to expect a therapist to come to you about every choice to consult someone. Sometimes doing so will get in the way of your recovery.

You mentioned that your T disclosed that she discussed the particulars of your case but that doesn't necessarily mean she mentioned your name months ago.Did she specifically say she mentioned your name? Lots of the time they will discuss details about trauma or medical issues that inform the trauma without the person's name. Again, perfectly ethical and again, done with the best interests of the client in mind. It typically means they do a BETTER job.

Situations like this, I try to focus on results more than how I got there. Did this person help me? Do I feel safer than I did before I started working with them? If so, then I can get past them consulting about my case. I can get past it if they confronted some of my cognitions by manipulating me or lying to me in a particular session to stir up my emotions and get me to have a breakthrough. It's not about whether they let me in on every step because doing that can damage the process considerably, depending on the model they are using. I don't WANT to know every detail and I don't WANT to catch them using their skills to help me. What if they make a huge mistake that sets me back months because I wouldn't allow them to speak to a colleague? I just want to get better.

 

[ronin47]

IMHO the therapist should never have promised to carry the burden alone, but at the same time I don't think she should have been asked to.

Couldn't have put it better myself. The T made a promise she apparently couldn't keep.