[atisketatasket]

Both my therapists dislike using email to discuss therapeutic matters because of security concerns. I can understand this because the same concerns affect my jobs, which is why both my employers have a (sometimes annoyingly) high standard of email security.

Yet clearly a good many therapists correspond with their clients by email and discuss therapeutic matters. I'm wondering, if you and your therapist do this, how do you deal with the security issue? Is it not a concern for you? Do you use a specific email provider that might have better security (e.g., Gmail to Gmail) or an alternate secure method (e.g., Skype IM is encrypted)? Or are emails less direct than you would actually be in session?

To answer my own questions, while I have emailed with both of them, one was for administrative stuff, nothing sensitive, and the other was a check-in email that was terse: (her) "I just wanted to see how you were after yesterday's session." (me) "Fine, thank you for asking, see you next week." So no therapeutic topics. I plan to keep it that way because I'm more comfortable that way, but wondered how others felt. (Feel free to tell me I'm paranoid!)



Sent from my iPad using Tapatalk

[stopdog]

I am not particularly concerned with security by email. The ones I see are sole practitioners (important because I would not want to deal with office staff having access) and I don't send my social security number to them in email. I also write regular letters so if something was of concern like that - regular mail would be my choice. Putting things in writing of any form have security problems so I don't consider email to be the super hysteria area for me.

Also I don't usually look for the therapist to respond. I do better when I tell her not to do so. Usually it is that she talked in the first place that leads me to write. I think better in writing - when talking to the woman it can seem like my brain is mired in sludge dumped into cement.

I've emailed with T. It's not a concern for me. Who the hell would have any use for stuff I've written.

[Nammu]

I wish they would allow email. Confirming appointments letting me know about a cancellation.....it's not SSnumbers, I don't pay though email so no creat card numbers. I'm deaf and they can't figure out how to use TTYs I don't have a smart phone so no text message....so why not?

My last T her office made a password email service. To open the email you had to have your own password.....problem for me is I never remember passwords and carried a card with it written down...kinda defeats the purpose. But there was not her on it, I don't go into details. So .. Why not

This is a huge source of conflict for me.

[atisketatasket]

To the responses so far, I would say:

- it is true writing is a security compromise in any form (never leave a paper trail!), but there is a difference between a letter locked in someone's filing cabinet and an email stored on a server that theoretically anyone on the internet could hack into
- I'm not talking about payment information or SSNs. Your name is attached to your email, so suppose you share your thoughts about whatever thing you don't want the world to know, it comes to the attention of someone not your therapist, and then becomes public in your circle?

It's not the same as a compromising photo on Facebook getting your career derailed or Ashley Madison getting hacked, but there is a danger - I'm just curious how people deal with it (or not).

I am not saying what people should or should not do. I have already made that decision for myself, and no one else's decision troubles me at all. I am only wondering how founded or unfounded others find my concerns.

I used to be very concerned about it, but at some point the need grew bigger than the concern.

As somebody who goes through great lengths to preserve my anonymity and protect my digital footprint, allow me to give a few basic pointers:

First off, if you want the best anonymity and security possible via email, use what is called "PGP encryption" which stands for "pretty good protection" and use at least a 4096 bit RSA key and here's why: a key that big would take the worlds fastest supercomputers millions of years to crack. If you want to learn more, a Google search will net you the knowledge you need.

Of course, the only problem with this method would be both parties need to have a PGP key configured in order for it to be effective. I would strongly suggest any therapist who deals with confidential client information to have PGP for their emails, solid network security, and good encryption for their computers and what not. It would be worth trying to convince your T to do this.

If the PGP option fails, another suggestion would be to get an email account that puts a heavy emphasis on privacy (preferably an offshore one). Sfletter, safe-mail, MyKolab, Jumble, PrivateRelay, RunBox, or Tutanota are all solid examples. If you value privacy and security, NEVER use Google, Mircosoft, or Yahoo as an email provider under any circumstance because they have been known to track you, sell your information, and even give your personal data to the government. I don't know about you, but when it comes to my mental health, I don't want any government or corporate entity knowing about my mental health issues and I will go to any extreme to prevent that.

Finally, it is worth mentioning to secure whatever devices you log in on your email from. Get a solid antivirus and if you're extra paranoid, also get a decent firewall and connect to your email via a SOCKS5 proxy. Also, I would suggest switching your default search engine to Startpage because they're completely anonymous and use 256 bit SSL encryption (the same encryption used via online banking websites) when you search the web.

Hope I helped!

[velcro003]

I e-mail my T occasionally and I don't worry about security. I suppose someone could hack and read my emails, but I don't write long diatribes, and I don't see what anyone would do with my therapy emails.

Originally Posted by velcro003

I e-mail my T occasionally and I don't worry about security. I suppose someone could hack and read my emails, but I don't write long diatribes, and I don't see what anyone would do with my therapy emails.

Same. I'm busy not important enough to have to worry.

[junkDNA]

i email my T but i am not worried about security. he owns his own private practice . i also text my T therapy related stuff. if anyone read it all they would find out is how pathetic i am

[PinkFlamingo99]

I don't care about security either. And I emailed my exT a bunch of stuff.

With the new one, I see her at the psych hospital in outpatirnt and they don't let anyone email because of confidentiality, it's a hospital rule.

[justdesserts]

I'm not worried about security bc my t could and might print out my emails and put them in my file, which would make me very vulnerable. I think there comes a time when you just have to trust.

[ScarletPimpernel]

I email T. She is concerned with security. But she leaves it up to my discretion. It's my choice whether I email her or not, and my choice for the subject matter. I know the risks, so the responsibility? is on me.

I'm not concerned with securtiy and I have yahoo email. I know not to click on links, and my password is strong. And my fiance provides us with good Internet security. And like JunkDNA said, if someone does read my emails, they'll just find out how pathetic I am.

Plus, if I didn't email, I would have no evidence against ex-T for my grievance. It would all be he said, she said.

[AllHeart]

Originally Posted by _Mouse

I've emailed with T. It's not a concern for me. Who the hell would have any use for stuff I've written.

Same here. The only use anyone might get out of my emails would be for a laugh or two. And I'm not writing confessionals or giving up incriminating evidence to past illegal crimes (because there aren't any) so I have no security concerns.

[atisketatasket]

Originally Posted by justdesserts

I'm not worried about security bc my t could and might print out my emails and put them in my file, which would make me very vulnerable. I think there comes a time when you just have to trust.

Not worried about trusting the therapist. Worried about trusting cyberspace.

Sent from my iPad using Tapatalk

[Cinnamon_Stick]

I have been concerned with security from time to time. It hasn't stopped me from emailing though.

[NowhereUSA]

I knew before I started emailing my T how insecure email was. I used to work in payroll and trying to beat it into my clients' heads that sending me personal information via email was *strictly prohibited because identity theft* and that if they wanted to do this they needed to log into our secure server blah blah blah (siiiiiigh SIIIIIIGH). I was meticulous - we had locked doors, I shredded everything, we had spot checks to make sure and we were lectured on how unsecure email is.

Since my emails tend to be nothing more than me venting out my emotions, well, okay, if someone reeeeeeeaaaaaallllyyyyyy wants to read my five page email about whatever, *yawn* Well, I can think of better things to do with my time.

As for them "getting out", I'm not concerned. I'm very open about my struggle with depression (and my subsequent treatment) while I don't share the dirty details or talk as in depth about it as other people, I've disarmed people being able to use my mental illness as a weapon. If anything, I think most people would be very heartbroken to realize how utterly despondent I was and wish they could have been there to help more.

[ruh roh]

I think it's sometimes used as an excuse on the therapist's part. If the individual is okay with the risk, I don't think it's the therapist's place to tell them not to for security reasons. If they are concerned about liability, they can have the person sign something saying they understand the risk.

Mine has never brought it up as an issue, and I don't really care. I'm not going to run for office and I haven't made criminal confessions or anything that would be damaging to my reputation. I mostly email when I'm in despair, so if someone wants to take me down over that, I don't think I'm the one that will end up looking bad.

[atisketatasket]

Originally Posted by ruh roh

I think it's sometimes used as an excuse on the therapist's part. If the individual is okay with the risk, I don't think it's the therapist's place to tell them not to for security reasons. If they are concerned about liability, they can have the person sign something saying they understand the risk.

Mine has never brought it up as an issue, and I don't really care. I'm not going to run for office and I haven't made criminal confessions or anything that would be damaging to my reputation. I mostly email when I'm in despair, so if someone wants to take me down over that, I don't think I'm the one that will end up looking bad.

Both of mine have it in their contract. One is more a warning than forbidden, but since that's the one with the better boundaries, I think it boils down to the same thing.

Their concern appears to be that when under sufficient duress to send an email that requires a therapeutic answer, a client may not be thinking of security concerns. I do see the point you and several posters made, that the comfort outweighs the risk.

Sent from my iPad using Tapatalk

[ruh roh]

I guess my issue is that it's just so paternalistic. Why would they stop at the email issue if they are concerned people can't assess risk for themselves? What about people who talk to friends in a desperate state, friends who might disclose their information to others? Should therapists stop that, too? I guess I have a problem with the therapist overstepping their role. If it's more of a concern that they don't have time, don't want to work for free, or that some issues are worsened through miscommunication via email, then they should say so. Any one of those reasons is fine with me, and also feels more respectful.

[neverending]

I used to be able to text my T but it became an issue because so many texts were being sent by so many people and also text replies were being misread n misunderstood so the clinic stopped the practice. I can still call though if I need to.

[NowhereUSA]

Originally Posted by ruh roh

I guess my issue is that it's just so paternalistic. Why would they stop at the email issue if they are concerned people can't assess risk for themselves? What about people who talk to friends in a desperate state, friends who might disclose their information to others? Should therapists stop that, too? I guess I have a problem with the therapist overstepping their role. If it's more of a concern that they don't have time, don't want to work for free, or that some issues are worsened through miscommunication via email, then they should say so. Any one of those reasons is fine with me, and also feels more respectful.

It can also be clinic policy. My T is relaxed so like six months into it he was like, "Oh, I need you to sign this waiver." It basically said "Email isn't secure."

They won't even let him schedule his own appointments. Once he got so sick of the front desk messing things up he was like, "I'm just going to put you in on this date... they're going to send me to therapist hell for this."

[ScarletPimpernel]

A lot of Ts don't like email for other reasons besides security. They don't like that it can become an extention of therapy, that the written word can easily be misunderstood because of lack of verbal and/or facial expressions, and in times of crisis they might not be able to react soon enough or appropriately to help their clients in that situation. Actually, many don't want to be a part of the crisis plan at all. So while emails can be a security risk, it can also be an emotional risk fir the client as well. And in those situations, the client isn't in the right frame of mind to assess the risks.

[atisketatasket]

Originally Posted by ruh roh

I guess my issue is that it's just so paternalistic. Why would they stop at the email issue if they are concerned people can't assess risk for themselves? What about people who talk to friends in a desperate state, friends who might disclose their information to others? Should therapists stop that, too? I guess I have a problem with the therapist overstepping their role. If it's more of a concern that they don't have time, don't want to work for free, or that some issues are worsened through miscommunication via email, then they should say so. Any one of those reasons is fine with me, and also feels more respectful.

Sure, they should say the real reason. And it might well be that they don't have time, mistrust the communication value of the medium, etc. Not sure that it's about working for free - I offered to pay the one I had a lengthy administrative e-conversation with, and she declined, saying that the issue we were discussing was part of her job, even over email. I don't know how common that would be though.

(Do any therapists out there charge for emails as they do phone calls when they primarily see the client in person?)

I suppose if I were a therapist I'd want calls from those who would otherwise email; it seems like I could help better that way. But sure, I'd say why.

Sent from my iPad using Tapatalk

[ruh roh]

My only genuine concern is that I could send the email to the wrong person by accident. I did that once with an email meant for a neighbor that went to someone with a similarly spelled first name who was a distant colleague. She replied that it sounded like a pretty big neighborhood drama and laughed it off. That one exchange has caused me to double and triple check emails to my therapist or a friend to make sure it's not going to a colleague.