Visitor in Session

It's ok to be too vulnerable to say no. That does not make it a legit yes. It's ok to have a hard time saying no. Therapists shouldn't put us in difficult situations and if they do they should own it and hold your feelings.

It's ok to feel violated even if you said yes in the moment.

You can still feel (and be) violated and later get angry that someone you trust has put you in a pressured situation to make a snap decision like that--and then blame it on your anger issues. I hope you find the courage to not go back there.

"Why are you looking for reasons to be angry"is condescending to the extreme and I'd be beyond enraged if someone said that to me. That comment strikes me as the opposite of therapeutic--it's thoroughly discounting. And no, I wouldn't want someone sitting in on a session. And yes, I'd be intimidated denying a therapist what he/she thinks is a good idea.

The client pays for the session. It's not for a therapist's benefit or agenda.

I agree. Just because you have issues letting go of anger doesn't mean you are always looking for reasons to be angry. It doesn't mean anger can't be a legitimate response to idiotic therapist behavior.

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My ex t asked me if a student could sit in, also at the last minute. I said yes, and we had that session. The next session I told him that I didn't want the student, and that was fine.
The student in question was an intern, working on her doctorate.

Playing the devil's advocate here, but how else is a future t to learn about how to do therapy? Book learning can only take you so far.

I don't have to pay them to train therapists. I believe they can do simulations if they want to observe - or hire actors to play clients.

I agree observation is important - I make my teaching assistants do a lecture or two each semester so they get their feet wet - but I don't think the OP is questioning the practice of observation, just how his/her own therapist dealt with it.

That's a fair point, but I think there are plenty of alternatives...

1. As Stopdog said, simulations, actors, etc.

2. Perhaps students in the class (who should be doing therapy) could observe therapy for other students. For example, if I'm in class with Jen... I could sit in on Jen's therapy, and she could sit in on mine.

3. Observing real clients who have had more than a couple of seconds to decide that they were OK with it, and have had a chance to discuss (in-depth) the ramifications with their therapists.

To me, there's a huge difference between being *surprised* with this when you show up for therapy ("hi, before we get started... do you mind if Lucy, the intern, watches us today?") and talking about it a week before, with the therapist being sensitive to the clients needs, fears, and mental state.

Plus, I think the session should be discounted or free, since it's unlikely that the client will receive the full benefit/value of the session with an observer.

3. Teaching clinics on campus, where part of the deal is observation, video taping, supervision, etc - in return for reduced/free therapy (which I believe was already mentioned earlier by someone)

4. Teaching videos that already exist (someone previously posted the "Gloria" videos, where "Gloria" was taped in sessions with several therapists of different styles, so that the students could watch and compare.

5. Getting their own therapy and supervision. That should give them a great, huge window into how therapy works plus the perspective from the client-side, without compromising another person's safety/privacy.

I just think it's rotten to:
- put pressure on someone by asking when the student is already there, on the premises. I suspect a lot of people would have trouble saying no in this situation.

A lot of people also might not immediately understand how they'll feel/react to having someone else in the room. Plus, for me, I'd have questions about what this means... for example, if the person observes, I assume you'll be talking/debriefing them later about me? What information about my history/past that I've previously disclosed (but not talked about in this session) is the therapist going to share? Everything? The student might need context. That doesn't feel OK to me. What safeguards are in place for my privacy? The student is not yet a licensed T (and who knows, they could end up leaving the program and never becoming a T) - so who's going to protect the privacy of my information with this student? Are they going to be discussing their experience watching me in class, with other students?

None of this makes me feel safe, and for me, safety has been a HUGE (enormous, #1) priority in therapy that's already been impossibly difficult to achieve. I don't think I'm unique in this !

Plus, it just feels icky to me that I'd have to pay full price for my therapist's time, when I'm not getting the full value of the session. As I mentioned before, it's highly likely, just due to human nature, that both I and the therapist will be acting differently when under observation.

I couldn't do it. I understand that different people have different issues, and some people might have no problem with an observer, but I've had a really hard time even being able to trust one therapist, adding someone else to the mix would not work, and would likely make me less stable when I left. And honestly, understanding who would be OK with this and who would not be and helping clients understand their emotions about stuff like this should be part of the therapist's job! Not dropping this on them at the start of a session!

Ha... and to give an example, I've taken piano lessons with the same teacher for several years. He's Russian, and once when I arrived, there was a lady sitting quietly at one of the desks in the room, doing something... as I came in, he talked to her in Russian and she left. He then told me that it was his mom, but he knew I would hate to have someone else in the room, so he made her leave! It sounds like my piano teacher has a better capacity to understand people than the original poster's therapist!

Is this really a standard part of therapists' training? Aren't the alternatives Guilloche has outlined far more the norm? It seems like there would be a lot more added value in those alternatives rather than a random drop-in on an unprepared client.

I talk about some things in therapy that I have never revealed to anyone else in the world, because we have a relationship of trust that has built up over years. If I had someone sitting in for a session I would be forced to edit myself, it would be a total waste of my time and money, and the student would see something vastly different than my typical therapy session.

That's why I always let whoever observe whatever. They have to learn BUT that doesn't mean everyone should be ok with it. That's why it's not obligatory to have somebody there.

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I think that contingency then should included in the agreement when one begins therapy. Otherwise the hour is to be exclusively for client benefit absent any responsibility for future generations.

Those guys tend to go on about the sacred space of the therapy room. Some go so far as to talk about it being a sacred vessel. The two I see give about a month's warning if they are going to cancel an appointment. I think it not out of the realm of reasonable therapy client to expect more than a minute's notice of a stranger being invited to sit there while a client tries to tell the the therapist about extremely private things. If after exploration and notice and not being expected to pay for that exploration time about bringing in a third party from the therapist's side (I would be pissed if I had to pay to have a therapist tell me they wanted a student there and how did I feel about that)

Is he part of the university where they do have students/like residents as part of their practice or was this just some outside student who wanted to know what a session was like?

I remember being in the psych hospital at UCLA , a teaching hospital & that happened constantly. Hated it but no choice.....

However if just private practice....my answer would have been NO. My therapy session is private & doesnt need to be a show for anyone.

I do like that he is asking you to search your rational Behring your feelings. We all need to do that. It helps us to learn how to express ourselves more thoroughly in the future when we know WHY we feel the way we do.

I always had a hard time even defining what I felt let alone why until I got into DBT therapy. I couldn't tell what I was feeling one session. T have me a list of emotions. I wrote down 2 pages of what I was feeling & why I was feeling that....it was my huge break through.

Sorry to hear about this. I had some students watching when I was a kid and saw a clinical psychologist together with my mom. Also last minute notice. But back then I didn't care and I should mention this is before the psychologists'profession was regulated in any way in my country. I could not believe it if my long-term therapist did this to me and I would say no immediately. There may be some things to explore about your anger, and you did give your consent even though you may not have wanted to, but I agree that this was intrusive.

That's my take on it as well. It's not the practice of observation per se I would be objecting in this case but HOW it was done. The devil is in the details.

When the client is presented with the choice in advance and is fully informed about what the observation would entail including how they will be compensated such as getting a free session or free counseling all together and when they are given as much time as they need to make a decision, they it's a fair game.

Overall, every ethical decision is not just about what T is and isn't allowed to do, it's not about following formal instructions, it's about the entire context of each situation and how this or that particular decision will impact the client's well-being. In the OP case, the T demonstrated a complete lack of sound judgment.

It's not clear to me whether this occurred in private practice or in a University/hospital clinic setting. Either way, it's problematic, but for different reasons. And either way, the manner in which the T handled the OP's reaction is appalling--even if he therapeutically believes her anger is reflective of her issues.

If it's private practice, then the T may be offerring supervision services--for which the student pays. So essentially collecting a double fee for the same time period seems a bit dicey to me.

If it's a teaching hospital/clinic, the possibility of observation and the opportunity to opt out or not should have been declared in any intake paperwork. In any event, a last minute request is either disrespectful or incompetent or bullying--none of which speaks well of a T.

I can say that this issue is similar to academic protocals for human subjects research regarding consent: his actions would definitely not meet the standard required.

Oh hells no! Your t,regardless of what you are working on in therapy, should not be turning the situation around on you. Even if you had said yes weeks in advance, and then become upset afterwards, t should be exploring that with you (and certainly not challenging your anger in email)...

There have been several times I've felt pressured to agree to something because there was a person in authority asking. Luckily, this was never with a trusted t... I I'm sorry your t sorting that on you and is reacting the way he is now.

Trainee T here (used to post regularly but am now just passing through).

We learn by practising on each other - sessions where one student is the therapist, one is the client and anything from one person to the whole class observes. On my course, when trainees start seeing clients we get written consent to tape sessions to discuss in supervision in return for which clients pay a very low fee. We don't get to sit in on other people's real sessions.

I think that it's time to change therapist. Firstly you should have been given much longer to think about this, talk through what it would be like, be told if you could change your mind during the session, discuss whether there are things you don't want T to mention in front of them, etc and I also think maybe some form of written consent is needed. This is not something to spring on you at the last minute. Furthermore, your therapist's response to how you're feeling is not okay.

I don't think it's fair to say well you agreed as you didn't get to make a considered, informed choice. The T presumably knew the student was coming in advance so why did they not discuss this with you?

Personally I would only be okay with a student sitting in on my actual therapy session after lots of discussion and I would want the students name and details of where they were training.

Well I'd have freaked right out. I've actually several dreams where my T includes strangers or other therapists in my session. In one dream she brought in a another therapist and they had this good cop/ bad cop thing going where one was blunt and rude and the other was kind and gentle.

Anyway after each dream I wake up in a total rage wondering how I could possibly have allowed this to happen. I feel extremely angry at my therapist for having violated my trust so badly IN MY DREAM. I have to spend a good while calming down and reminding myself that she didn't actually do this IRL.

I had that happen to me IRL with another therapist at an intake session when I was much younger. The teacher was argumentative and I felt like he was ridiculing me in front of three students. It was awful.

I feel your pain and think that his response to your email was gross. I don't think you're overreacting at all.