[nottrustin]

Have your T's, pdoc or other professional asked if their students could sit in on your appointment? Do or would you agree to it?? Why or why not?

[AllHeart]

My pdoc asked once. I politely declined. I just wasn't comfortable with having a stranger sitting in the room to listen in.

[RaineD]

Mine sometimes videotaped sessions for teaching purposes, and I had no objections. Not sure about an actual person sitting in on the session. I think if my (now ex, since we officially terminated) therapist asked, I'd probably agree. Probably won't agree to it with a new therapist though.

[downandlonely]

I haven't had it happen with a psychiatrist, but I did have it happen with a gynecologist and also some nurses for physical things. That didn't bother me, but it doesn't feel as intrusive as mental health.

[stopdog]

I was never asked but I never would have let such a thing happen.

[ScarletPimpernel]

Two of my Pdocs have asked if they could have a new Pdoc sit in. The first I said yes to, but when the Pdoc wanted to see my cuts, we told her to leave. When my other Pdoc wanted a new Pdoc to sit in, I said no before she could even ask.

[LabRat27]

In the psych ward I was fine with it. If my pdoc asked I'd be fine with it. If my therapist asked it would be a "hell no."

And I'd actually be really upset that he'd asked in the first place because he would know it would be impossible for me to be open with anyone else in the room, and by asking he'd be knowingly putting a student's education above my needs. Even asking would be a violation of my trust in him to prioritize my best interests.

[GeekyOne]

I haven't had students sit in on my individual treatment. I have been treated by students (intern and resident pdocs), and I have been in hospital groups where nursing students sat in on the group sessions. I'm okay with those things. I knew it would happen when I went to a teaching hospital for treatment. I think it's a good thing - more people, more minds thinking about approaches to treating my illness. For the nursing students, I have liked showing them that not everyone in a psych ward appears "crazy" and that just talking calmly and respectfully to the patient is the best route.

I think I would struggle to allow someone unknown to sit in on an individual therapy session. I have not worked with student Ts, though I've worked with a couple who were newly licensed. I do better with Ts with more experience.

[MRT6211]

I’m a medical student and I have the prospect of sitting in on someone else’s therapy session or psychiatry appointment pretty violating. I’m not sure how our outpatient psych rotations work, but I would never let a student come in my sessions. It’s super weird to think of that from either the patient or provider side. Yet, I don’t know how else I’d learn...watching videos seems better. Not like the teaching pdoc can really teach you with the patient there, anyway...

[Ididitmyway]

No, they never did. I would've never allowed it. I wanted my process to be completely private, never wanted my personal private life to become a didactic material for students.

That said, when I was a student, we got to watch through the "two way mirror" real therapy sessions with real clients conducted by our instructors (the clients were informed and signed a consent form, of course). They got a good number of free sessions (I think, it was 20) in exchange to being watched by the students.

[nottrustin]

Our hospital gets a lot of medical students for their psych rotation I found most people agree to have students in.

Today I went to my psych NP. The first thing she said was I already knew your answer so I had he go do something else. Yo which I said I dont know the question.

She has a student right now but she knew I would say no. I told her I was never asked. So she said would you have said yes you are so private. I told her probably would of said o
It's okay. She said because you would be uncomfortable saying no. I wouldn't really want somebody else in there but I also realize seeing how important it is for the students learning. She said "see I knew the answer is no I have plenty if other people she can sit in on." I am do glad she knows me well so I wasn't put in that position.

Now if do many people weren't leaving the clinic she works for. With the clients needing new providers her next appointment is in 8 weeks. I usually see her every 4-6 weeks. Right now we both are thinking even less than 4 weeks would be idesl.

[unaluna]

Ive done it. I have no boundaries. Ive learned to ACT as if i have boundaries, like not to bother people in the elevator.

Altho tonight doing laundry i had a nice exchange in the elevator - the guy pressed the floor i used to live on, and i said so. He goes what apartment? And i tell him, and i said, i had the elevator in my apartment. And he goes, oh i live in apartment x, and i have the stairwell in my apartment! And it was funny, because i had never thought of the stairwells being in someones apartment before, even tho i had had the (back of the) elevator in my own. And it was nice to have that in common with the young man, cuz i could tell he was slightly amused at the idea.

[zoiecat]

I have not been asked but I would allow it. My pdoc appts are pretty boring. How are you feeling...blah blah blah. Do you want something for sleep. Here are your scripts. Take BP, step on scale and out the door.

My T sessions on the other hand would be different but I would still probably say yes. I simply don't care who hears what. I did sign releases for my T to video tape EMDR sessions which were strictly for use between T and his supervisor when he had to prove hours for EMDR certification.

[starfishing]

I'd never allow a student, intern, or resident to sit in on a therapy appointment. It would make the appointment useless for me, and watching a useless appointment isn't even going to be a good learning experience. So there'd be no point.

[Anne2.0]

I've not been asked by any of my T's. I have been asked by my family doc and GYN/OB and have been willing, usually, to allow them to observe or do, depending on what needed to be done. One medical student followed me for my entire pregnancy for reasons I'm not real clear about, probably a class assignment.

Going from a dyad to a three persons in the room is a big difference. If the student could sit behind me or way off to the side, I might be willing. It's possible something about the situation might be useful to me, such as perhaps I'd be a little more focused/observational of myself given the observer in the room. I also believe in the educational part of it for the student and think a student could learn something from live observing a real therapy session.

[nottrustin]

I can't imagine being asked by a T. My psych np is not a T but we discuss what I am working on therapy and she will ask therapy type question...my appointments tend to last about a half hour if not more. We also discuss work. When I started seeing her she worked at ther same page I do so we briefly discuss how things are going, any changes and update in some of my coworkers.

[InnerPeace111]

My T has never asked my permission for a student to sit in on a session. If she did, I’d say yes. Absolutely. In a heartbeat. I would feel comfortable with that at this point in my life and given how far I’ve come along in my progress. It reminds me of my own years as a student doing graduate and post-graduate work. I was always so grateful for all the people who participated in my surveys, interviews, research, etc. I guess agreeing to let a student sit in on a session(s) is my way of paying it forward.

I had students with medical doctors several times and I never objected or felt uncomfortable. Ts never asked and I would not allow it. I especially would not allow videotaping.

[feralkittymom]

I would not have allowed it with former T because of the nature of our sessions then. I would allow it with current T because I'm in a very different place in my life. But I would not allow a strict observer; the student would have to participate, much as I always incorporated observers in teaching situations into whatever the class' activity was on that day. I think it would be a more valuable learning experience for them, and a more natural session for all of us.

Having med students shadowing physicians has become routine here because of an expansion of the Univ med school and its integration with all the medical services in the area. I don't generally mind, but I dislike when a dr saunters in with a student, saying "This is so and so who's an X yr med student--do you mind if he/she observes?" I mean, they're already in the room, and it's awkward to say you'd rather they left. Sometimes my practitioner has the student conduct the exam and then she comes in later. In that case, they're always experienced nurses working on the credential to become NPs.

[nottrustin]

A while back I went to an ob/gyn. The Dr asked if I minded a student. I thought about briefly then remember my new co leader for youth group was doing her rotation there. So I politely declined. I explained it would be really awkward...they agreed

[Myrto]

No way in hell would I allow it. But it never happened in therapy since all the therapists I saw were in private practice. Frankly I find it grossly unethical to even ask because I'm certain some clients don't dare saying no and it ends up being incredibly violating. I've had that happen with doctors and I said no way. But I know some people are too afraid to say no because they don't want to upset their doctor or don't want to come off as "difficult". It's manipulative. I'm not a guinea pig and doctors or therapists don't get to practice on me. I don't care about their training and if they want to train, how about they do it on each other?

Perhaps the best way to handle this would be to make it very clear from the beginning that there might be students and ask a new client if s/he allows it or not. Then it is not a surprise. I don't think that bringing in a student out of the blue is a good idea in therapy for the client, but students still need to learn somewhere and shadowing real procedures is a good way of learning, IMO. I don't think that classroom or simulated experiences can do the same. I very much agree with Myrto that many people would not decline when they are put on the spot suddenly, both at the doctor's and T's office.

What I personally find more disturbing is when Ts who teach discuss their clients in the classroom, in way to many detail, without anyone ever having access to the full reality. They argue that doing it anonymously and changing some identifying details is fine. What is not fine, IMO, is how these anecdotes can be distorted by the presenter to fit whatever agenda they have. I know they do this a lot because I see it happen in relation to my own work. Then, I think having students observe sessions is a much better source of training.

[feralkittymom]

Yeah, I'm not afraid to say "no," but I accept, especially in a therapy situation, some would be and shouldn't be put in that position. But observation is a core part of US medical training. If you live in an area where all the available hospitals are teaching hospitals, it is a common practice. You can theoretically decline, but the system is by default set up to make that a more difficult choice. It's a bit like subscription services in which the default is to automatically renew, rather than re-subscribe; you can cancel, but you have to make an affirmative choice to decline. I do think it should be the other way around in all these situations. But there is also an element of public good in these situations in which we all have a stake in the future sustainability of well-trained professionals. So I pick and choose: if it's a low risk circumstance with minor risk to my privacy and comfort, I agree; if the nature of the procedure is high risk, I decline.

I had a minor surgery not long ago and was presented with a med student observer; the policy at my hospital is to whenever possible, default to single gender OR teams for female patients. So the anesthesiologist, nurse, tech, and observer were all female; the surgeon was male. I felt that was a good compromise, whereas a surgery I had at a surgical center had no such policy, and I found out later that the entire OR team was male. It made me uncomfortable, and if I ever have to return there, I will be pro-active to alter that circumstance.

Originally Posted by feralkittymom

I had a minor surgery not long ago and was presented with a med student observer; the policy at my hospital is to whenever possible, default to single gender OR teams for female patients. So the anesthesiologist, nurse, tech, and observer were all female; the surgeon was male. I felt that was a good compromise, whereas a surgery I had at a surgical center had no such policy, and I found out later that the entire OR team was male. It made me uncomfortable, and if I ever have to return there, I will be pro-active to alter that circumstance.

I don't think it would be good to set the medical team same sex as the patient as a general policy. It's not everyone's preference and most comfortable situation. I, for example, generally prefer male-dominant teams of all kinds. It's not a big deal for me, but my preference if asked. I think this is better to be decided on an individual basis after asking the person who receives the treatment. I know quite a few people like myself who prefer the opposite sex for medical treatments, therapy, friends, whatever really, and we get similarly uneasy if pushed to comply with a generally-imposed same-sex policy.

[feralkittymom]

Well, it may be that preference is the norm for in-patient surgeries; but for out patient procedures, I think it would create staffing/scheduling complexity. I live in an area with a large multi-cultural population. Many of the cultures represented follow strict prohibitions about gender and privacy, so I think the hospital found it most feasible to adopt this policy. And surgeons, except in emergency situations, are always privately chosen.

The surgical center was privately owned by a group of doctors. Although I was comfortable with my surgeon, I found the atmosphere to be overwhelmingly a "boys club" in operation.