I thnk my T is using me as a case study at a conference without my permission

Today I came across an announcement for a therapy-related professional conference with a very niche focus, which is the focus that my T specializes in. I looked at the presenter list and sure enough, my T was listed as giving a presentation about a case study. When I read the description of T's presentation, I realized that I may be the case study. The description of presenting problem fits me exactly and the therapeutic techniques are what my T has been using with me and increasingly trying to make the focus of my therapy. I do realize that I may not be the focus of the case study as t may have other clients with my same issues, but given the course of our therapy recently it just seems like too much of a coincidence.

T has never mentioned this conference to me or brought up using my story and therapeutic process as a case study. My concern is not that T would reveal my name or other personally-identifying characteristics. But if it is me T is using as a case study, I do feel like this is a breach of trust and confidentiality.

I am going to raise it with T at my next session, but wanted to get some perspective from these boards also.

Do you feel it is a breach of confidentiality for a T to use a client's story and therapeutic process as a professional case study without explicitly obtaining consent from the client?

This is absolutely a breach of confidentiality!!! This therapist is extremely unethical to do such a thing. If you can find a lawyer to stop him from proceeding I would do so. To me, this is an abomination!! You are not a lab rat!! You are a human being with rights!! File against him immediately!!

I don't know where you are, but in the UK a therapist must obtain written consent to use a client as a case study, even if anonymous. Here are some UK guidelines:
The Human Givens Institute's Ethics policy
I would consider it a massive breach of trust if my therapist ever were to do such a thing. I think you are doing the right thing by seeking clarification from your therapist as to whether you are the focus of the study.

Hmm. I found out in retrospect that my first T used me as a case study in conferences and training for therapists working with CSA survivors. Honestly, it didn't bother me. He is the one who told me about it and how he used my case for not only what to do, but what not to do. In other words, he felt there were definitely things he would have handled differently now that he knows more than he did at the time. I was one of the earlier cases he had dealt with as this was the early 1980's when open discussion of CSA was first coming to the forefront of public awareness. I guess I was glad to be of service in a way. I never thought about it as any kind of breach of confidentiality or anything. It wasn't like he gave any identifiable information.

I would be very angry if my T did this without discussing it with me / obtaining my permission. If not a breach of confidentiality technically , I would certainly view it as a breach of trust.

My T is a low-life scumbag capable of anything!! However, if he relates what he attempted to do with me he will be laughed at and ridiculed by students. Even an undergrad/nonprofessional would know better not to do what my T did to me. To discuss my case would be embarrassing for HIM.

I would hold him accountable for his actions forever!! I can't even say what a T like that deserves.

I would consider it a breach of confidentiality, absolutely. However, I would also question if they are really using your case, especially if you say they are increasingly using a particular approach or technique with you. People don't usually talk at conferences about something they are only beginning to use, but they do talk about things they have experience with.

My therapist sees a unique population, which I only just learned about because she told me. I would not otherwise have a clue. If one of her clients with that specific issue saw that she was presenting on the topic, they might think it was them, when in fact it's something she's been doing for decades and is likely someone she saw in the course of her career but who is no longer a client.

That's just to caution that your therapist may be speaking about someone she saw for many years in the past. It would be good to ask.

Even Freud had problems with using a patient (Dora) as a case study because she might be (and she was) identified.

I think there is a school of thought that says it's OK to use a patient as a case study if most identifying information is removed (and so not a breach of confidentiality). The assumption is that when a patient consents to treatment they are consenting to this as well (check the contract you signed with her, if any, by the way). That said, I think it's also frowned on as unethical.

A doctor I had as a child used me as a case study with my parents' permission, which is the way to go in my opinion. I was only identified as a 11-year-old female or some such. But a therapeutic case study involves more details, with greater risk of identification.

But I think you are right to ask the therapist first.

Lolagrace: part of me feels the way you do, which is that if my story can be helpful to others then I am glad to be of service in some way. If my T had asked me to use my story, I am pretty certain I would have said yes and even been flattered by it.

But T hasn't asked me, so that's where the breach of trust feeling comes in.

echoes, thanks for the link to the ethics article. It is useful to see some guidelines about this.

But yes, ruhroh, you are absolutely right that the case study might not be me at all. That is the question I need to ask T before I jump off the deep end.

But if it IS me, then I don't know that I can continue to work with this T. For me, it is not so much a legal or even ethical issue as it is one of trust that the therapeutic relationship is safe for me to open up in without being used for the benefit of others without my consent.

I don't know how specific the details were in the vignette that you read but a lot of presentations are pretty common. Also sometimes they use composites where they distill the details from a few different people or they change some key details to anonymize the client.

That said, if it's about you in any way at all, I think she should have gotten your permission.

I would be like you - if he asked me, I would be pleased and flattered. But if he did it without my permission Id be fuming.

FYI: In my case, he only used my case after I had moved on and was no longer his client. It would have been odd for him to do so while I was still seeing him.

But it is probably more likely he is using a composite of clients he's worked with or a client he is finished with than a current client as it is hard to present outcomes on an ongoing case.

My sister is in textbooks on the treatment of early onset ovarian cancer. It's rather interesting to read actually. In fact, our whole family was part of a cancer study years ago: grandparents, cousins, etc. May have something to do with this scenario not bothering me in the least so long as identifying information is not revealed. Generally I've found most of the time these case study presentations are very general and not at all identifiable.

Assuming the t keeps the clients identity 100% confidential, I would see it more of a breach of trust with the therapist had s/he not sought out permission to use the client as a case study ahead of time. I can see where that might cause a rupture within a good working therapeutic alliance.

I personally would have no problem being used as a case study as long as I was assured complete anonymity and received the common courtesy of being asked ahead of time. If my "case" can help others in any way I would give my blessings in a heartbeat.

Let us know what you find out.

Thank you for raising this topic and the APA (I will look into them). I will also follow my T more closely. He is the most deceitful, despicable excuse for a human being that I have met. I am fuming mad just reading that this kind of thing goes on. I already know my T has used me without any consideration to me or my feelings. He literally made me an emotional wreck and then on top of that, he wrote about me to make extra cash. He lives a high lifestyle that is costly. I won't say much more as he might be identified.

Wouldn't want to reveal his secrets even though he thinks nothing of anyone else's.

Do you still see this t? Or is he an ex-t now?

I still see him. I recently found out he was deceiving me. He denies it. I don't know what to believe or who to believe anymore.

Recently? Seems like you've been posting about this for a long time. Why do you still see him with the level of hate you seem to have for him? Seems like it might be better to discontinue seeing him since you clearly feel he cannot be trusted.

As long as no identifying details were given I don't see how it is a breech of trust or confidentiality? I suspect Ts talk about their clients way more often than we expect, and as long as they aren't giving names, dx, any other specific details I don't think they are breaking any rules.

Based solely on your numerous posts about this t, you seem to be consumed with hostility, anger, and at times rage. I can't imagine there is much (if any) benefit for you seeing this t is there? Obviously, I don't know the whole story so maybe I'm wrong. I am just perplexed as to why you are still with a t that you outwardly seem to abhor and loathe so much. Whatever the case, I do hope you can figure out a resolution in order to work towards finding inner peace.

Sorry for the thread highjack.

I would ask him. It is murky because it may be that you see him for X reason and he has other patients who also do and so to treat X problem he has come up with Y solution and applies that to most people who have X problem. I have anxiety and I know the same breathing techniques taught to me would be to others.

My t co-presented at a training session for professionals on the exact topic I am seeing her for. I honestly did think about whether she would bring any knowledge or practice she's gained through working with me, but then I thought I am not the only person facing this issue. So I didn't *think* she would automatically talk about me. The only thing was that she always tells me she's presenting at training sessions and the topic she's presenting on, but this time she didn't mention anything before or after. I stillhad a nniggling feeling that maybe, just maybe, she didn't want me to know she had presented on that issue. I never saw it as unethical or a breach of my trust, as I trust her unequivocally to do right by me.

From my understanding the professional associations and some professional publications are moving or have moved in the direction of informed consent. But, not all. I just submitted a transcript, and because I changed the names I was told I did not need written permission to submit it. I was told this before I spoke to my subjects, and I did let them know while my recorder was running. What I did realize right after submission was that anyone who knows where one subject grew up will figure it out quite easily. I am concerned about this.

My therapist did ask to read some of my poetry at a conference once, and I gave my consent. She even shared with me their responses. I also gave consent to speak about my case professionally to colleagues and clients if it would help them or help me while I was still her client.

I would be sore at my therapist if I found out another way, so I would have the conversation with my therapist to be sure.

hi chartes,
it sounds like it to me your therapist broke her trust and use your case without written permission from you . she needs to ask permission from you if its okay to use your case in the conference that she w attending . she broke the confidentiality rules for counselor and client .



Diagnosis: Anxiety and depression
meds: Cymbalta 60 mgs at night
Vistrail 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia with an additional 25 mgs=75 mgs when up past 1:00 in the morning

In the UK, ethically a T could use a client as a case study without permission as long as the client were not identifiable from the info, and it's generally recommended that people bring a mix of experiences to create a 'case study' which is actually a combination of clients.

If your T is using a specific technique, I agree with others that it's unlikely she would present on it if she is only recently practising in it, I would expect that it's something that has been used on a number of clients before going to conference?

And @Cloudburst, wow you're still seeing your T? Could you look for another one? You really seem to have a lot of negative feelings towards your current one, can it be helpful for you to continue?

My T works at a university and he is a counselor educator - he teaches and supervises in a graduate programs for counseling students and maintains a private practice. Because of his academic work, he is involved in many professional conferences. He has this in his paperwork:

"Additionally, I may also present programs at professional conferences and/or publish in professional publications on the topic of counseling. In this case, I may refer to my experiences as a counselor. If I make reference to my counseling with you, I will do so in
a way that disguises your identity. If I cannot make such a reference without revealing your identity, I will ask you to sign a waiver. If you do not agree to sign, I will not make identifiable references to you. You are not required to waive your right to confidentiality at any time."