confidentiality and billing question

My wife tells me about her work every day.

MKAC I am so sorry this happened to you. especially after the very sensitive issues you have been dealing with with him . he sure seems to have fallen hard off his pedestal . I know I have been advocating for you to stick it out with this T but it seems you have moved from dealing with your stuff and having it be therapeutic to having to spend a lot of time talking about your relationship and his mess ups .not a lot of healing going on . I have always felt if you spend session after session having to work out differences in the relationship that maybe it is time to move on .
as far as her dealing with the billing .that is BS she is his wife not just some random person with no real investment in weather a patient wants to sleep with her husband (not you just saying ) there is a big difference and wrong on many humiliating levels.

I am so sorry this is happening to you. Just imagining this happening to me makes my stomach tighten into a knot. How can you feel safe if she has access to your file?

This writeup helped me to understand the concept of feeling safe in therapy.

http://www.metanoia.org/choose/gethelp14.htm

MKAC, have you ever seen your files/his notes? I never saw mine but, unlike stopdog's and others' implication that their therapists do/do not take notes, mine did her notes (when she took them) after the session (while her memory was fresh) and not in my presence (she told me). I think my T's notes were more to jolt her memory? So, perhaps she would have said, "talked about feelings for me" without indicating what those feelings were so I would not cared very much if her husband had read them.

I think I would feel the same as you do though if I had mutual acquaintances, the story had changed, the response was what your T gave, etc. I would have a very hard time getting past all that. Too many questions too; presumably your billing paper goes into your file? When and who does it? His wife could conceivably finish filling out the paper and put it in your file and the file, in a cabinet (in neat alphabetical order) in his home/office. I would not like a therapist whose wife was his bookkeeper; my dentist's wife is his nurse/hygienist but I don't want my therapist or OB/Gyn saving money by using his family member or anyone I might know(!) in his office.

I don't think my t does anything for billing except sign off for the diagnosis, but I woukd be furious. That s a breach of medical confidentiality.

As a technical matter, it probably isn't a breach because in our State, t's are allowed to let their staff do certain things. I emailed him this morning saying I know it is not technically a breach of confidentiality, and the legalities of it are not the issue. I explained my position again and asked him to imagine the situation reversed and he were the one with information exposed to someone he has issues with already. He called and finally apologized.

I'm so glad he apologized!

I'm glad he apologised, too. How do you feel about the whole thing now, mkac?

I'm not sure. It's better, but ... Still feel pretty sick to my stomach about the whole thing. At least he finally understood what I was saying and agreed it was a mistake and a big deal.

Ugh...I am so sorry this happened. Your example is really quite personal and I am glad he finally understood. I hope you can talk to him more about this when you see him next.

Now that I am no longer homicidal about the whole thing, I don't really know what to do from this point forward. How do you get past something like this? He says she will not see the file anymore and he will create a separate one for billing. BUT ... I don't feel like I can email him much of anything. I want to look at his notes after every session from now on. Not sure it is worth trying to salvage this relationship at this point or whether it will take more time than it is worth. It might faster to bring some new therapist up to speed than it will take to try to trust my current T again.

It would certainly be legitimate to point out that you are not sure you can trust him in the future, and if that is the case, why bother going on?

But also, learning to forgive might be part of your journey.

MKAC, I think there is value to be found in the process of recovering trust that is transferable to other relationships. But--and it's a big but--a lot depends on his response in action. OK, he apologized and is going to protect your file. But is he apologizing only because he sees that he's violated a concern you hold dear, or does he understand the greater principle involved? The first is relational, but the latter is about soundness of judgment. Is he going to revamp his system to protect all clients? If he doesn't see the compelling necessity of that action, then I would still have serious concerns about his judgment that would undermine my ability to work with him. You know I've felt you should continue with him previously.

idk, this is where i appreciate my t in a larger clinic. there are people who see his notes (not billing). he got pinged recently because he hadn't made me sign a safety agreement (he hates paperwork lol so he had verbal agreements but they were like 'nooooo must have paper!'). plus i know i come up during his regularly scheduled consultation with other ts. but i think it'd be weird if i knew his wife knew all about me. i guess i figure she probably knows something but not my name since i'm a long term client.