Is this normal? Can I expect this from other therapists?

This is not true. Many therapists do not demand this of their clients. I personally would feel invalidated if she told me that "patients feel empowered" when I am sitting there not feeling empowered at all. I don't like it when people tell me how I feel. I know how I feel and they can ask if they want to know, and I will tell them. She just seems very pushy to me and stretching the truth (all therapists demand this) just to get you to do this thing she wants.

There are so many therapists that don't demand this, so if it makes you uncomfortable, tinker10, let your feet do the walking!

FWIW, my therapist gave me a referral to a PNP, but he has never asked to speak with her. If he is interested in asking me a question about meds, he just asks me. Likewise, my PNP has never asked to speak with my therapist. If she is concerned with how I am doing, she does her own assessment based on our conversation as well as instruments she may use. I don't see she would learn anything useful from talking to my T. She's a very competent practitioner in her own right. Also, she and my T treat me for very different things--that's why my T referred me to her, because he does not treat what I needed help with (ADHD). So I do ADHD with my PNP and other issues with my T.

I don't think that someone wanting to be present during conversations about their treatment is being demanding or unrealistic. That is your interpretation, not my words. I believe in clients' autonomy, so if it is their choice, so be it.

But I do think it should be a topic of discussion and the possible benefits of either policy discussed.

Your demand as a client to be present is your choice, to which you are entitled. Your insistence, however, in making that assumption of your clients' thinking/preferences is paternalistic (being an academic, I am quite familiar with the language) because it is you deciding for them that they should be concerned in the same way that you are concerned as a client. The fact that you say you would behave differently as a provider in front of the client than you would outside the client's presence seems to support this.

If I don't know that a therapist is ethical and authentic enough to represent me in the same spirit outside the room as inside the room, then I would not choose to trust that therapist. That is my choice.

In my role as an academic, sometimes serving disadvantaged students, I am bound by certain regulations regarding privacy. I am frequently called upon to act within dual roles, both advocating for students and supporting the goals/mission of my University. In order best to serve both constituencies and maintain a personal sense of ethics, I choose to be authentic in my interactions with both. I don't alter my perspective/judgments/language depending upon the audience. Unlike your experience of meetings without clients in which providers REALLY talk about their prejudicies.

I think it is possible to trust a therapist for some things and not others. It is not necessarily a blanket thing. And when I work with therapists and mds as an attorney, my experience has been they are very different about clients who are present versus clients who are absent. I don't see it as more or less authentic, although certainly more or less tactful, careful, etc. the same is true with, in my experience, lawyers and clients, colleagues and students, and so forth. My experience, even in academia, is much more of the sort where people are different when the client or student is present versus absent.

In general, I think that's unfortunate. Different circumstances can require different information, for sure: like referring to a diagnosis, using technical speech, or sharing of interpretations that have not yet been reached by the client.

I don't believe that the character or spirit or respect of the client should be portrayed in a radically different way depending upon audience. The authenticity for me is about the intention underlying the communication and connects to trust. I agree that trust needn't be 100% across the board in all matters, but in the spirit of respect for me and my best interests, I do need that.

I've had colleagues who have shown great disrespect to students behind closed doors, and I've usually confronted them about it. I think it's unprofessional behavior, but also deeply unethical. But certainly, the content of info shared with the student versus colleague to colleague may be different for good reasons.

I have not encountered what I would describe as great disrespect for students. I have encountered it professionally with therapists and mds towards clients. For me, I would not allow a therapist or an md to consult each other about me no matter how good their intentions.

I wonder if this is because you're encountering them as consultants on cases rather than as part of a continuing treatment team? I can see where being asked for what amounts to a brief assessment of someone with whom there's no ongoing relationship could open the door to a more cavalier attitude. Doesn't make it right, but I can believe it happens.

I've encountered some really deep undercurrents of resentment towards students, I suspect provoked by the increasing consumer culture in Universities and higher admin taking on the role of management of faculty. I understand the pressures, but it's still ugly.

I'm sure you would not allow such communication to happen outside of your presence ! Even if only because you're an attorney!

My T gave me a recommendation for a p-doc, and then asked me if I wanted her to contact him first. We discussed how much contact my T and p-doc would have, what they would talk about, and then I signed a waiver. My T NEVER demanded that I agree for her to contact him. She asked if I wanted her to, and asked if I would be okay with them talking to each other. For me, because I was terrified about having to explain things to the p-doc, it was incredibly helpful having my T contact him first. When I saw the p-doc, he asked my permission to talk to my T about our appointment, and has done so at every appointment since then. Neither one has demanded that I allow them to contact each other as a condition for treatment. They both respect my wishes, and if I ask what they've talked about, both are willing to share with me. I'm sure that if I said no, they can't communicate, they would respect that, but I feel that would be detrimental to my treatment, since my T knows me incredibly well and sees me more often than my p-doc.

Something seems a bit off with the requirement. Alot of T's will ask for you to consent to them speaking with your other mental health providers. You have to sign a form for them to do this, but they cannot force you to. It's completely your choice. If you choose to sign the consent form and then change your mind, then you are free to do that also. They must respect your decision and not have any further contact with your other providers.

Yes, but they can also set requirements for treating you and this one seems to require contact with the other provider. They can let limits on their practice, whether the clients like it or not. I would find it coercive to be required to give access to the other provider, but I guess if the client has a strong relationship with the T, they might be willing to accede to demands so as not to lose the relationship. Personally I think the T could get better buy-in from clients if she didn't present it as a requirement, but explained to the client how it could benefit him/her and asked for rather than demanded compliance. It reminds me of the situation with my first therapist, back when I knew zilch about therapy. She told me she would refuse to treat me if I took any psych meds. She was really horrible about it (said in a snarky voice, "Oh, so you want meds, do you?" when all I had done was raise the idea), so I backed off of that idea right away because I didn't want her to cut me off. In retrospect, now that I have better awareness of my feelings, I realize that her requirement that I be med-free had a negative impact on our relationship. We never really did become close, and perhaps that was partly why. Tinker, if you have only just started with this therapist and you feel uncomfortable with her demand, I would look for another T, since many do not have this requirement and your relationship with this T may be tarnished before it even begins. "There are many fish in the sea."