Confidentiality Issue

To all of the wise members of PC:

This is about something that occurred in September of last year that I've been struggling with all of this time though I haven't formally addressed it with T.

This is what happened: When I came to college in August my medication combination was making me feel like a total zombie. My T had been pushing me to see this new PDoc that I was very hesitant to see because I was afraid of being in a room alone with a man (I was abused for a number of years by my brother) and was I asking for a female PDoc that I might be more comfortable with.

Eventually I told my T that I had been tapering off my medication because it was making me feel so terrible (no, I didn't stop cold turkey and I've tapered off medication before). And I emphasized to my T that I was feeling better. I gave absolutely no indication of wanting to hurt myself. But my T went ahead and informed the campus nurse practitioner and security. Security disabled my access to any of the buildings and literally escorted me to the health center. When I arrived, my T and the nurse practitioner were on the phone with the PDoc that I expressed some hesitation about seeing (I asked T to give me a week to think about it; I never said definitively that I wouldn't go) and had already made me an appointment with him! Of course I went because I was very afraid that I would be kicked out of the college if I didn't go.

I suppose in the end everything turned out okay: I faced my fear and found a wonderful PDoc that I continue to see of my own free will. But I have never really "forgiven" T for what she did, for embarrassing me and threatening me as she did (being escorted by security in front of all your friends is about the most embarrassing thing, and I already have severe social anxiety).

I guess I'm looking for some opinions of those of you who aren't immediately tied to the situation. Should I just drop the whole thing because everything turned out well in the end? Was T right forcing me to see the PDoc? Or do you think she broke confidentiality by informing the NP and security (and possibly the school administration)?

Thanks for reading!

There are some conditions were your therapist is allowed to break confidentiality. What you did was called being "Baker Acted," after the law that stipulates, if you are in danger of harming yourself, your therapist is allowed to act to preserve your safety. I am glad you weren't hospitalized if you weren't in any danger.

It is weird to me that a therapist would attempt to hospitalize a patient simply for tapering off medication since a) most therapists don't manage meds and b) this is kind of common as well. Was there no other reason why she would have had to fear for your safety?

Big hugs

It doesn't sound like a situation that one can like? But, not knowing your diagnosis or what meds you were on/how many/how long, etc. and it being school, with all the alarming things that have happened in schools by students with problems, I kind of think your mental health team had to work to help you and keep others as unknowing as possible. Because the situation was so "big" to you, you think it was big with the others, watching, but they probably had no idea what was actually happening so, other than watching you being escorted away, have nothing to "hang on to" in their thoughts about you. Often the police, fire department, etc. are first responders in cases of illness and there's nothing humiliating about their escorting you; I imagine the other students did not know you were locked out or other details.

I would not bother with it anymore since it is over and you have a new pdoc you like and things are going well; I would remember it though and make sure that next time you see the pdoc first before tapering off and work with him, etc. rather than doing things on your own, where those helping you don't know or understand what is going on because you haven't told them, just suddenly surprised them with a situation they didn't know was stable or not.

There is something humiliating about it, as evidenced by the fact that she felt humiliated.

Hey,

As others have said without knowing the full extent of your story it's hard to say if the T acted a bit too harshly or if infact she had reason to believe that you needed intervention to protect you from harm. It doesn't sound like she did it out of badness...even if she was over reacting and I hear that you found it quite a traumatising exprience but I dont think you would have a case against the T. She may not have really broken your confidence in that she probably didnt tell the nurse or pdoc everything you had been telling her..just the main facts that she had a client who shes was concerned about who had taken herself of her meds and thought intervention may be needed??

People make mistakes or errors in judgement and perhaps your T did so by rushing to get others involved but do you think she did it because she infact cared about you and your safety?

I am really glad that you have got something positive from the situation in that you were able to create a good relationship with the Pdoc who has been able to support you

Thanks everyone. I'm beginning to see my T's side of the story a little better.

A little more info:

1) I was on a Seroquel/Zoloft combination for about six or seven weeks before I started tapering myself off. I had a diagnosis of depression and social anxiety at the time.
2) I had only been seeing this T for about 3 or 4 weeks usually twice a week.

She doesn't manage my meds, but she is always interested in whatever I'm taking for some reason. I mean, I had specifically told her that I wasn't feeling suicidal or depressed but I guess she thought I was lying!

The reason I brought this question up wasn't because I'm planning on taking some kind of legal action against T (I mean, I'm still seeing her after all this time) but because it has created a kind of trust issue with me. But I suppose she probably was just concerned about me...

Thank you all very much for the replies.

Hey,

I was just wondering who decided you needed meds and were you happy to take them at the start if they would possibily help? I ask because in the space of 6 or 7 weeks the meds probably hadn't even started working...sometimes they can take upp to 6 months to really have a positive effect and so for the onlooking professionals they had a woman with depression and social anxiety who was seeking help from a Therapist and who had taken meds for a few weeks and took herself off them without supervison (even though you said you had done it before)...this could have set alarm bells of for your T and even though you werent claiming to be suicidal or a risk to yourself, perhaps she seem the signs of depression in sessions with you? Iam just guessing.

I am glad to hear that although this affected your trust in your T that she must be good enouhgh at her job if your still seeing her now and that you must find something positive from her support

xxx

If you are asking if you should bring this up with T, I think you should. It is obviously still bothering you. It is something to bring into session and talk about. It will keep nagging at you if you don't talk about it and could hinder your progress in therapy. I have found that school Ts are especially cautious about safety issues. They are more cautious I have found than any other clinicians because of the pressures caused by fear of students hurting themselves and then being blamed for not stepping in to stop it. There have been a number of lawsuits in situations where students have hurt themselves and then their family's have sued the school. While every situation should be taken individually, it does cause caution on the side of college clinicians.Ts are also more cautious when starting to work with clients as there has not been time to build up trust on either side. I think you should talk about it with your T.

I would definitely bring it up with your T at your next appointment, I agree completely with googley.

*hugs* that sounds like quite an ordeal. i wouldve been both horrified and terrified!

although things worked out okay in the end, you still feel uneasy (to say the least) about how your therapist handled things and its clear you're not "past" it. i think its worth bringing up....it might be something that stands between you and really trusting your therapist, you know?

do you feel like you are censoring/filtering what you say to her now because of that?

guess that answered my question!

i can tell you that, although most therapists do not prescribe or manage meds, they do know a lot about how they work and affect people and its always important to know what your client is taking and how they are responding to it. this is why its a really good to have a therapist and psychiatrist who are in contact with each other....the therapist sees you a lot more and can offer some insight that the psychiatrist needs to help appropriately manage your meds.