[bluemountains]

The reason for my question is because my t is going out of town next week, backing up my every two weeks appt. to an extra week in between. Unfortunately, I am not in a good place right now, and she is concerned about this. My children also see t's in the same group. I have never shared my personal stuff with my sons' t, but my t told me to contact son's t if I am in crisis mode while she is gone. This made me wonder how much sons' t knows about me. Do you think that t's who work with the same family share notes? I know they have discussed my children because my t is a clinical psych, so she tested my children.
Now I am going to feel completely uncomfortable when my two sons have their appointments this week. I guess I will have to wait until my t gets back to ask how much they share, but meanwhile, I will be feeling exposed this week and I don't want to ask sons' t because if she isn't familiar with all of my personal stuff I will be completely embarrassed asking the question. Btw, there is also a third t that sees my daughter. I will be wondering about her knowledge now, too.
Bluemountains

[Miswimmy1]

They arent allowed to disclose information without your consent so she most likely knows very little about you. It's comon for ts in the same office to use each other as a backup in crisis. I asked mu about it. Crisis meaning wanting to talk to someone about something urgently but it's not a life death situation. They don't hav to know a lot about you to give you advice in a crisis scenario. But if you hav to hav assistance that minute, you will be directed to the ER, u might as well go straight there.

[junkDNA]

in a private practice i believe it's not allowed unless you signed a "consent form"

[bluemountains]

I believe the only consent form I signed was for my t to talk to my pdoc.
You are making me feel better. I just wasn't sure if it is like my gp's office where all of the medical doctors have access to your medical records for treatment purposes if you have to see another doctor.
Now I am trying to remember what, if anything, I have shared with the other t. Obviously she knows me through my children, and she probably even knows I have bp considering that one of my sons is treated for the same dx. Otherwise, I think it has only been one time, when I barely functioning and in a deep depression that she asked me how I was. I was in constant tears at that time, so she asked out of concern, I'm sure.
I agree, though, if anything goes terribly wrong I will go directly to the hospital-where we live we are fortunate to be able to bypass the ER and be admitted immediately to a psych hospital.

[Victoria'smom]

We have signed forms for each of our (myself, husband, & son) T's and pdoc's to talk to each other. We view treatment as a family thing and to help all of us they need all perspectives. However, my son does not know much other then our dx's.

[critterlady]

When I saw a T in a group practice, I'm almost certain she didn't share her notes with anyone. I saw one of the other T's from her practice in a different setting. When he was planning to move, he referred me to her. I saw both of them for a month or so. I quizzed my first T several times on whether the other one ever talked to him about me. He told me that she'd only told him that she'd seen me, but not a word beyond that.

I didn't sign a release for either of them to speak to each other.

My T is also my husband's T and my son's T, so he knows us all very well. It doesn't bother me that he has all that information from different perspectives in the family. My husband does use the pdoc in his office and they have clearance to discuss him with each other. I know he also consults with that pdoc in a support mode about his patients, but that's more like a supervisory situation (although not really supervisory, more supportive/consultory). It doesn't particularly bother me if he talks to him about me. It's not like I personally deal with that pdoc anyway, so I figure if my T feels the need to consult with him about my treatment that's fine with me. They're professionals. Even if they have discussed your case in context of your children, they realize they don't personally know you just based on a few probably pretty brief conversations and should be able to help you if you need their assistance in a crisis.

[WikidPissah]

Usually if it's a collaborative or group office they talk with each other, although they aren't supposed to use names. I would bet that your son's t and your t have passed info for the benefit of your family.

[bluemountains]

*Mention of sui.*

I am not very healthy mentally right now, and I don't want my own problems clouding my thoughts as I discuss my children. I will be at the therapy practice three different times this week, all for my kids.
All of you have made me feel better with the explanation of the privacy issues. In giving it thought, I probably could talk with kids' t if needed, and I might like this option better than talking to a total stranger. I can always call my pdoc, too. It's ironic that I have been doing great until the past couple of weeks-a sui. of a friend's sister has changed my mood drastically.

[CantExplain]

My T flies solo and she doesn't keep notes.

PS:

Mind you, the group facilitators conferred for half an hour before each session, and they weren't just putting the fees up! I assume they were discussing the group dynamics and therefore also assessing the members' conditions. It is possible that things I told T in confidence were passed on in confidence.

[bluemountains]

Originally Posted by CantExplain

My T flies solo and she doesn't keep notes.

PS:

Mind you, the group facilitators conferred for half an hour before each session, and they weren't just putting the fees up! I assume they were discussing the group dynamics and therefore also assessing the members' conditions. It is possible that things I told T in confidence were passed on in confidence.

I have never been in group therapy, but I've always wondered how confidence could work there. I have a hard enough time sharing with one. I definitely don't think I would open up in a group!

[Dr.Muffin]

no info should be shared without your knowledge and permission....preferably in writing.

[stopdog]

Sadly, the fact it shouldn't is not the same as it isn't.

[CantExplain]

I once asked T: Hypothetically, what comeback does a patient have if a T violates confidentiality?
The answer was: Basically, none.

[Eliza Jane]

Originally Posted by CantExplain

I once asked T: Hypothetically, what comeback does a patient have if a T violates confidentiality?
The answer was: Basically, none.

That T was lying. Without a doubt such a thing could be reported to the T's licensing board!

EJ

[bluemountains]

In talking about confidentiality, my former SIL worked for a group of therapists. She transcribed their notes. She shared lots of information that I am sure could have caused big legal problems. I knew things about people that I really did not need to know, and that I felt embarrassed knowing sometimes. It was not out of concern that she shared, she was just a gossip. This is now where my thoughts immediately go when I share with my t. Sometimes I share copies of my journals and writings with her and she asks to keep them. She assures me that she doesn't keep these in the official notes, but instead in a separate file. I guess I may sound extremely paranoid, but privacy seems to be very had to actually protect.

[Perna]

I would not be overly worried; T's have their own clients and don't really have the time, energy or interest to be gossiping or learning about other clients, especially by name. I'm sure your son's T knows some about you and your circumstances just from your son but T's aren't really interesting in our details but in us, and you can't be reduced to notes. What "happened" to us is not nearly as interesting to them as how we respond to what happened and what we're working on right now, etc. If you were to be in crisis and see your son's T because your T were away, your son's T would only be interested in helping you now, in this crisis, with this particular problem you were having. That you were arrested for shoplifting five months ago in Podunk, Missouri and wrote a lovely poem about the experience would not be something your son's T would know, want to know, or care to know, unless it were related to the problem you are having now.

[stopdog]

I think therapists probably do laugh and share anecdotes about clients regardless of how busy they are. I doubt other therapists are taking notes about it while they do it and they may not use names, but I have been in professional situations where therapists have done it, so I fully believe it happens all the time.

[amandalouise]

bluemountains

my therapist is now in private practice with a receptionist. but she used to work in a county mental health agency where they had staff meetings, at these staff meetings the clients were discussed but not in whole details. example

therapist: Im going on vacation next week. I am working with my clients to prepare them for this, but I am concerned about a couple people, one is Amandalouise, shes DID and though I can prepare her for my upcoming vacation the others with in may not understand. Pete you work with dissociative's do you think you could run back up on this case for me should she need some help?

Sure anything I need to know about?

thanks yes I prepared this summary of the case, handing the print out over to "pete" meet with me later if you need more information.

As you can tell my therapist and I talk in great detail about how she handled honoring my confidentiality while at the same time having to present her cases at staff meetings.. overall she just did summaries and then if more details are needed she would come to me and let me know I was the topic of the staff meetings and did I have her permission to discuss such and such with another staff.

now that shes in private practice she doesnt have staff meetings but she does arrange for someone to cover for her in the event she's out of town or on vacation. and like at the staff meetings she gives a general summary, enough so that they are prepared should the client need help but not enough to violate confidentiality.

[Dr.Muffin]

Originally Posted by bluemountains

In talking about confidentiality, my former SIL worked for a group of therapists. She transcribed their notes. She shared lots of information that I am sure could have caused big legal problems. I knew things about people that I really did not need to know, and that I felt embarrassed knowing sometimes. It was not out of concern that she shared, she was just a gossip. This is now where my thoughts immediately go when I share with my t. Sometimes I share copies of my journals and writings with her and she asks to keep them. She assures me that she doesn't keep these in the official notes, but instead in a separate file. I guess I may sound extremely paranoid, but privacy seems to be very had to actually protect.

i dont think you sound paranoid at all. it's a valid concern! the only issue is that, for the moment, nothing can be done. for right now, you can choose to let the questions drive your nuts or choose to trust your therapist and pose these questions to her at your next session.

i know, MUCH easier said than done.

[critterlady]

Originally Posted by bluemountains

In talking about confidentiality, my former SIL worked for a group of therapists. She transcribed their notes. She shared lots of information that I am sure could have caused big legal problems. I knew things about people that I really did not need to know, and that I felt embarrassed knowing sometimes. It was not out of concern that she shared, she was just a gossip. This is now where my thoughts immediately go when I share with my t. Sometimes I share copies of my journals and writings with her and she asks to keep them. She assures me that she doesn't keep these in the official notes, but instead in a separate file. I guess I may sound extremely paranoid, but privacy seems to be very had to actually protect.

This makes me very glad that my T has no office staff. It's just him and his wife (also a therapist) in the office.

[emptyspace]

T's in practice together definitely talk to each other. They may not use your name, but they consult; especially if there are issues of harm, or if a client is challenging, or if a T needs feedback.

I have had T's ask to consult others, without signing anything.

Think about this.... can you work without talking things out with co-workers at times?

[Eliza Jane]

I must say that I wish my t would sometimes consult with others about me. We could use all the help we can get!

Although come to think of it, sometimes she will abruptly change her approach and I wonder if that has to do with misguided consultation.

But in general, I don't mind if she talks to others so long as she is respectful and they are not my family members!

Best,
EJ

I've always had T's and Pdocs who worked in a group of some sort and had regular consultation meetings/support meetings about their clients/patients, so it doesn't really phase me too much. The therapist I saw in college met with all of the other therapists at the university each morning and discussed cases they needed help with or input about. I'm assuming they didn't use names, not that that would really matter than much to me. They wouldn't have known who I was if I walked up and bit them as they dealt with so many students.

I know when I'm in the hospital, the treatment team (pdocs, nurses, social workers, techs, etc.) meet each day to discuss each and every patient on the ward. I'm very certain they use names there. I'm sure I signed something somewhere that allows them to do this, but again, it doesn't really bother me. I'm all for professionals being willing to ask for help from others if that leads to helping me.

I've personally not run into a situation where I felt my confidentiality was breached or that any consultation about me harmed me in any way, but I can see where this has to be handled professionally and not just be fodder for gossip.

[Skywoulf]

trust me, I have it based upon personal experience that T shares not only notes, but potentially damaging information as well.

there is no such thing as confidentiality any more.

tell something to your T, and I guarantee you by the next day half of the staff are laughing at you over coffee in the break room.

this actually happened to me.

great therapy, huh?