psychology and law

Dr.John,or anyone who has been through courts.

how can u get "healed" if u know what you say to a Psychotherapist,Psychologist,Psychiatrist can come out in a subpoena?I would like to know how deep my issues are if i found the right "help," but with my legal situation post an ins.claim,it'll probably be used against me.

Isn't there a patient/doctor privilege if the information being revealed can make a patient worse?

That is a VERY good question...one I wish that I could answer and I'm sure several here can help a bit with. I would like to know the answer to that myself.

I don't know that they can repeat ANYTHING to outside sources (other than what's necessary to the ins. that pays), unless it's something that they would be mandated to (i.e. child abuse), or unless this counseling is court ordered/recommended? In that case, I'm pretty sure there would be a detailed report and I'd be watching me words as well.

That said, it doesn't mean that you can see a therapist on your own afterwards or during, separate and apart from this one. That's all based on assumption of course.

I wish you well regardless and am glad you've asked this question.

KD

This is an issue you need to discuss with your therapist. Most psychologists keep separate records. The insurance companies don't need to have all the information your doctor does. What the doctor gives them is usually pretty flat and only answers their questions about course of treatment and progress.

IF any more in-depth records are requested, it would take a supoena (court ordered) and for good reason, not just interest of insurance company. Even with that, often a doctor keeps personal information out of those records, and sticks to, again, course of treatment and progress. Personal notes owned by the doctor are NOT open to supoena, and most doctors don't admit to keeping such records anyway.

You can expect any acknowledgement of atrocious illegal behavior(such as murder) might have different guidelines... and that is why you really need to ask these questions of your doctor/therapist. It's a legitimate question, imo. TC

That is why some ins. have you sign a release. I had a problem at first the ins. every month gave me a hard time. My theripyst let the ins. know they were causeing problems by doing that so now I have not heard from the ins. in 2 months.

Im dealing with the court system now. My child is in the foster care system so that he can get the 24/7 therapy programs and supervision that he needs.

Its a tricky thing dealing with therapy and so on knowing that everything can at any point be suppena'ed. But I look at it this way -

From the get go the client is told regardless of if they have other agencies involved that certain things have to be revieled for example if you tell your therapist that you abused your child the therapist is a mandated reporter and so that has to be reported.

And at any time now today tommorow years from now if you have a problem that includes the laws during the investigating and procecuting of that situation the person did those records can be supena'ed.

For example 5 years ago my child entered the foster care system the first time it was because I was suicidal. The court gave intake caseworker a supenia to get my records from over 13 -20 years ago so that if those agencies did not honor her request for my files they had no choice but to hand copies over.

twenty years ago I wasnt thinking about having a child let alone have the knowledge that I would have a child who would have schizophrenia and that I would become suicidal and he would be in the foster care system and my records would get supena'ed.

Now I know 20 years down the roard in the future regardless of what I am doing today if I land in the court system my records from now can be supena'ed. I unfortunately know this from experience.

But even if my child was not in the court system I would still know about the possibility of my files being supena'ed because now when a person is going through the intake process they have to sign and or read many papers. One of those papers read and signed during intake into therapy with any USA therapy professional and agency is a paper with the USA, state and that agencys protocal of confidentiality and release of information forms. These forms explains the circumstances in which that agency has a right to release your files. And those confidentiality rules apply now or in the future. That why medical records and mental health records are referred to as "permanent record" and "permanent files" because they follow you for your whole lifetime.

No there is nothing that says past files and records cannot be supena'ed if it will harm the client.

When my past therapist and I disclosed that I have DID to my lawyer he said we were to work on it and take care of it but don't put it on the files so SKR kept two different files - the "official" file with the agency and a separate file for herself. This way my DID would not get disclosed in the official files but she could also work with me on my DID.

when I had that same lawyer My present therapist would follow the protocal of if it cant be on the official files she does not keep it -journal entries, drawings and so on, and other things and situations she would discuss with the supervisor of my case and the two of them decide if the situation should be in my file and if so how to write it up to put the situation in my file but not disclose the DID.

PTSD does include the person having "intrusive thoughts" (thoughts that interfere with daily life) "flashbacks" (memories of traumatic situations) and "mood swings" (going from happy to sad quickly)and sometimes "dissociative features" (spacing off, daydreams, feelinng numb)

Just because we could not put on the files that I have DID did not mean we could not work on it. its just that instead of the lable DID my file says I have PTSD with Dissociative features.

A therapist is not required to hand over psychotherapy notes just from a subpoena alone. They have the option to decline the subpoena request. The only time it is mandatory is when the judge orders it, and then your therapist can be held in contempt of court if they don't produce the requested document(s).

Cool! LL and I can stop worrying so much about it concerning my childs and my DHS case. Thanks.

Weighing the odds though of handing over the files or going to jail on contempt of court charges.... Well in my history of 19 therapists... I don't think any of them not even SKR would be willing to go to jail.

Given the choices be careful of what goes in the files so that in the event that my files get supena'ed again or not be careful and the therapist faced with the decision of hand over the files or contempt of court charges I prefer being careful. Ive already had to deal with the past biting me in the ***** from therapy files being supena'ed and handed over and I don't want to go through that again and it wouldnt be fair of me to expect my therapist to go to jail when all we have to do is keep certain information separate from the official files. less hassle less stress and no chance of the past biting me in the *****.

Wow this thread is really informative for me and it scares me too.... do I really want to go back into therapy? (((((((((lonewolf))))))))))))) I hope all goes very well for you. Linda

The therapy is safe. and its not that hard to be careful..tricky but not hard.

My therapy agency had SKR and now LL my present therapist fill in a form about each time she sees me. An example of that is -

Client name: Myself
date: 6/09/o6
summary: (name) came to appointment on time. We worked on PTSD issues, and recorded a relaxation visualization. that she can use at night for sleep.

That it. Thats all that goes in the official file. I may talk about having flashbacks and nightmares but PTSD covers those topics. LL has a notebook day planner kind of thing that she writes notes on sometimes and those are just for her not for the official file. And when she's not sure if she should put something in the official file she asks the supervisor. My drawings, poetry, journal entries and craft projects that I share with her do not go in the official file. She reads them and then gives them back to me or they go on a shelf in her office. She has a wall to wall bookcase. One of the things she uses the shelves for is so that her clients have a spot for things they are using in their therapy sessions. My spot has a basket with some stuff in it and a stack of Nancy J napier conscious living weekly practices that I have printed off. a couple envelops with drawings and I forget what else is there still.

New Jersey R. E. 505 provides:

"The confidential relations and communications between and among a licensed practicing psychologist and individuals, couples, families or groups in the course of the practice of psychology are placed on the same basis as those provided between attorney and client, and nothing in this act shall be construed to require any such privileged communications to be disclosed by any such person."

There are exceptions to this rule such as reporting child abuse, or if the therapist believes that you are a danger to yourself or to others. However, a subpoena or court order is not enough to to pierce the sheild of confidentiality.

While the statute may vary from state to state, I think it is pretty similar everywhere. Also, I don't know if this applies to others who provide mental health counseling such as social workers.

Hope this helps.

DJ

Thanks for trying DJ
Im not taking that chance again. I don't know what is in store for me in the future but I do know this much I have already gone through DHS supenaing my records once and I had to do some fancy footwork to take care of the situation that got exposed.

Im not willing to go through that again by not watching what goes in my files.

Its not some major inconvienence for my therapist and I to keep certain information out of the official records. To me its no big deal that she doesn't keep my journal entries, paintings, sketches and poetry on file. All that matters is that she gets to see and read them and knows whats going on with me. And I don't talk about my Self injury and suicidal thoughts with her because of other reasons not because of files getting supena'ed. and all that matters on those situations is that she knows I am actively working to take care of them and I do that on my own.

in fact most of my therapy program is done on my own. As for disclosing my DID on the files - regardless of what it is called on the files DID, PTSD with Dissociative features, and so on I still work on it.

Its kind of like my child being labeled as 5 different disorders and mental problems and behavior problems because this state doesn't allow therapists to label a child schizophrenic until they reach 18. just because he is not being called that officially does not mean his therapists can't take care of his problems with him. It just means for the time being all the other labels are on there to ensure he gets the correct treatment.

Lables don't matter the treatment does right. the same thing with files. just because something is not listed in there does not mean we cant work on it. Most of my therapy program can't be labeled professionally anyway. I make up my own therapy activities. I have a house project going, I have thought records going, Ive got Dissociation logs going, Ive got journaling going Ive got what I call awareness therapy going, and now I also have hypnotic techniques in the plan, sensory stimulation, walking meditations, nancy J napier stuff, laura Davis books, workbooks for depression, you name it I have all this stuff going at the same time and this one intersecting into that one and so on and accomplishing it 24/7. Even if we wanted to there is no way on earth my therapist could even write half of what I am doing in those files even if they had professional names for what I am doing. and the DHS caseworker I had most of the time would not have agreed with my therapy projects anyway. If I saw my therapist she sent SKR off to the ethics board for seeing me too much, When SKR felt I was ready to cut back on my face to face sessions the caseworker sent her to the ethics board for not seeing me enough.

besides if LL did keep things to put in the file well my family tree / genogram project is now three feet long it needs a box not a file , my house project stands 3 feet tall, 3 feet long and 2 and half feet wide. LOL. I have a wicker trunk here at home and a file cabinent and they are booth full to flowing over into the rest of the room.

dear DJ I really aprreciate that you did some reseach and I hope it helps others. Me. Im going to continue playing it safe and keeping things separate so that I don't land in hot water later down the road. once bitten twice shy I guess. for me the result based on what has already happened to me o this issue its saffer for me this was.

Take care.

Wow, it sounds like you work very hard. Good for you.
As for records, my ethics teacher ask us what we should do if we are supenaed. We all said give the file over. He corrected us and told us to talk to the agency lawyer because you can fight them. He also concurred with you that Ts keep seperate records for themselves in addiction to the official record.

As I mentioned, child welfare is one thing that does trump the doctor-client privelige. What it really boils down to is that the privelige is as strong as the judge says it is...you can always appeal and maybe win, but in the meantime you're hosed anyway. Oh, well!

Good luck!
DJ

thanks hopeful.