[Lili79]

About half a year ago, I began seeing a therapist (let's call her Dr. C). Eight or nine sessions in, she lets me know that she's taking on new associates (trainees in a local PhD program), and, due to the logistical change-ups that entails, can't continue seeing me. She sets me up with one of the trainees instead, who, as a group, will be working underneath her for a year.

I'm frustrated having to start over again, but given how few therapists in my area accept my insurance (MediCal), I agree to see the trainee. Over the course of five or six sessions, we slowly establish a good rapport and I feel like I'm starting to make progress. But then the trainee gets bad news: her training institution is forcing her to leave the practice.

Well, ****. We have one last session, and Dr. C places me with yet another associate. The transition is dispiriting, but I try to hold out hope. I decide associate #2 is actually the best therapist yet, so this may all work out for the best. But this past Friday, associate #2 calls me and very sadly relays the news that she's also being forced by her training institution to leave Dr. C's practice prematurely. I feel like a kid who's being forced to watch his lovingly assembled Lego tower get knocked over, over and over again, on a video loop I can't pause.

Following this third termination, Dr. C sends me an email with a sad faced emoticon and lets me know she's here if I have questions. Hell yes, I have questions. But I don't get much chance to ask them. When we talk on the phone, she informs me she has to refer me out, because her caseload can only absorb so many of her trainees' patients. But given that I'm on MediCal, she doesn't have any referrals. She suggests trying the MediCal directory (which I was already doing, only to learn nearly every practice listed in it has since stopped taking MediCal).

I'm cycling between rage, depression, and confusion. I expected Dr. C to take more responsibility for the situation and to go out of her way to find referrals for me. Sending me a sad faced emoticon shouldn't be the extent of her professional obligation. Six months ago, she took me on as a patient, and each termination I endured at her practice has been stressful and exhausting.

What are my rights as a patient? How pissed am I entitled to be? What would you guys do in my situation?

I did write her a follow-up email after our phone call, asking for more advice and restating that any referrals -- to low cost clinics in the area or therapists who have sliding scales, not just therapists who accept MediCal -- would be helpful.

[Petra5ed]

I'm sorry you're going through this, what a terrible experience. It is awful, really it is disgusting the state of mental healthcare. My therapist stopped taking my insurance recently, it was quite a blow. Fortunately I have the resources to continue out of pocket, for now, all of the therapists who do accept my insurance are right out of college with almost no experience, I didn't want to have to F with that. It seems criminal to me that we have a mandate to buy insurance but there is not a mandate for the insurance to pay doctors & therapists enough so that they actually accept said insurance.

As far as I know you have no rights as a patient, but should you be pissed? I would be. Are you entitled to be pissed? I wouldn't see why not! Maybe a therapist doesn't have a legal obligation to keep you on, but doesn't she have an ethical one? Really it is sad, because you have gone to seek help and this is what you've gotten. You can always file a complaint with your state board, perhaps they will agree and not like the waterfall terminations and give her a warning. Just remember don't take it personal, this is all about money and greed, and most likely not on your therapists part either, they really don't make much at all.

[scorpiosis37]

That's absolutely horrible! If I were in your shoes, I probably would file a complaint. In order to avoid the complaint going further, Dr. C might *suddenly* come up with some referrals. If not, then you have every right to let her and the state governing board know how you have been treated. No one should have to go through that.

[unaluna]

Criminy. I would hope for a LITTLE more than "dont let the door hit you on your way out." She has excuse after excuse. I think she took on more than she could handle and thats why she lost her trainees. I would be worried that any referral from her would be on her (flake) level. Im sorry this happened to you.

Have you tried - are there any local med schools / universities?.

I wonder why the training institutions forced the trainees to leave the placements? Was the original T doing something poorly that they picked up? If there was something, this has adversely affected you, and a complaint might force the T to face up to the impact of her mistakes. This might not help you find a new T in the long term. I'm sorry this happened to you.

[ChipperMonkey]

Unfortunately its not your ex-therapists responsibility to find a therapist that takes your insurance. Most therapists will give you a referral for another therapist if they terminate with you, but beyond that....there's no obligation on their part.

Yes, it sucks, but if you think about it, given the complicated world of insurance, it is indeed beyond the scope of a therapist's job to find you another therapist who will take your insurance.

In your case, you have a right to be mad at being terminated so many times. That's incredibly unprofessional on their part, but you really have no recourse other than filing a complaint with their governing body.

How horrible! This therapist has demonstrated the worst in our system when it comes to providing the correct level of care. I agree with some of the others that you have the right to be ANGRY and you also have the right to file a complaint with her governing board. I think the fact that two interns placed with her have been removed by their school is revealing. It strongly indicates to me that she was doing something wrong in her attempts to provide supervision; I have to wonder if she was simply taking on clients willy nilly to increase her income and she was transferring clients to the interns but she was failing to provide close supervision. When someone is an intern,not yet officially a graduate and doing an internship, he/she can not collect a fee for service, the fee is paid to the clinic or clinician (that's how it works where I'm from anyway). Graduate schools are very careful about making sure that their students get adequate supervision--sounds to me like this woman was so busy collecting clients and fees that she was perhaps failing to provide adequate supervision. Where I'm from, supervision is per individual intern and the time is based on the number of clients the student is working with--so she would be required to work INDIVIDUALLY for a minimum of an hour a week with each intern, plus crisis intervention sessions when the interns were dealing with a difficult case. It sounds like the woman had so many clients of her own that she might not have had the time to do the minimum level of supervision.

The least this woman would have done is have you come in for an appointment to discuss what happened. Sending you an email with a sad face icon is ridiculous and juvenile. Telling you to consult the MediCal manual to find your own "new" therapist is also inadequate, especially considering that she took you on in the first place and then switched you to two separate interns! Governing boards do seriously consider all complaints filed with them and since this woman is an established and experienced therapist, who has taken on therapists in training, expectations of her level of professionalism and training could very well be held to a higher standard That said, going through the complaint process can be exhausting and you're struggling emotionally and need support. Only you can weigh whether or not you want to add another stress to your life, but this woman really didn't hold up her end of the whole relationship. I'm so sorry you had to go through this and I sincerely hope that you're able to connect with a new therapist.

[ruh roh]

I guess I'm more cynical than others, in that I believe your original therapist knew that the trainees were time limited. The fact that this happened twice in a row suggests that it was supposed to happen this way. I would file a complaint. There is nothing here to suggest that she had any intention of treating you (low reimbursement for Medical) and was simply providing experience for her interns. I hope I'm wrong, but only an investigation would show whether or not the trainees' agreement had always been short-term. The other alternative, of course, is that she did not meet the program's standards. Regardless, the emoticon would put me over the edge. I would have asked her to use her words. She showed seriously shallow disregard for your pain in this.

[AllHeart]

I find it concerning that both new trainee's were suddenly forced to leave Dr. C's office prematurely by the training institute. And given the way Dr. C. handled the situation with you (seriously! A sad face emoji?) tells me something isn't quite right with this woman.

"What are my rights as a patient?" IDK but if you are up to it, call the CA Board of Behavioral Sciences to find out...

The Board of Behavioral Sciences (Board) licenses and regulates Marriage and Family Therapists (MFT), Licensed Clinical Social Workers (LCSW), and Licensed Educational Psychologists (LEP). The Board registers and regulates MFT Interns, Associate Clinical Social Workers (ASW) and Continuing Education Providers.

A complaint should be filed by anyone who believes that a licensee, registrant or applicant has engaged in unprofessional conduct, related to his or her professional responsibilities. The Board will review each complaint regardless of the source.

"How pissed am I entitled to be?" As little or as lot as you want to be!! I'd be pissed as hell if that happened to me.

"What would you guys do in my situation?" Depends on what other things you've got on your plate, and how fueled you are by the situation. I would at least make a call to find out if you can make a complaint. Dr. C. took you on as a client, passed you off with fail twice, and is now pretty much leaving you out to dry by all by yourself (oh wait, she left you with a sad smiley face). Seems pretty unethical to me.

[missbella]

I understand it's blatantly unethical for a therapist to drop you without a viable referral and this would be clear grounds for complaint. Setting you up with two time-limited providers without your informed consent about what that entails doesn't sound ethical either, but I'm less certain how this is covered.

I once assisted an elderly Medicaid patient who providers were residents. I definitely was informed they would rotate out of the program in summer, so it wasn't a surprise. (They were excellent, by the way.)

[Lili79]

Thanks to everyone for your thoughtful and empathetic responses.

To answer some of the questions that came up, I was promised the trainees would be working under Dr. C for a full year. When the first trainee abruptly departed, I was given every assurance in the book it wouldn't happen again. Yes, trainees rotate in and out, but the news that they were already "out" took everyone -- me, Dr. C, and most especially them -- by surprise. Both trainees were clearly shaken up by the experience.

I'm weighing whether it's worth filing a complaint. I worry the process will just feed my anger instead of helping me let it go. On the other hand, I do think Dr. C's behavior and treatment of me was borderline unethical, and I don't want other patients put in my position. (She was a ****** therapist in other regards, too, and raised a dozen little red flags throughout the six months I used her practice.)

Have any of you filed complaints with governing boards? How was the experience? Did it bring you any relief or just more strife?