Confidentiality feels violated

Thank you Bill.

I appreciate this Anne2.0! I actually think you're right that they were both doing their best and facilitator was trying to understand as well as t was trying to help. Yes it did feel like a violation, but I don't need to focus much on it anymore today!!

In your first paragraph, you asked if I excluded any content. I did not. I also said I do not remember signing a release. However I definitely could have back in May when I started going to group, and just don't remember, which is something I also previously said in this thread.

Have a great day!

I think it's easy to play monday morning quarterback and second guess a professional's judgment, whether it's your own T or someone else's. Nothing wrong with that. Some posters might find it helpful and others have stated they do not wish for this kind of judgment to be expressed.

To me the larger issue is understanding the reasons underlying why your T might have chosen to have the facilitator listen to the message rather than just talk about it. If you have a better of sense of the choice she made and why, it might help you to feel differently about it.

I would be surprised if any T takes it personally when even cursed at directly by a client, so I guess I don't see how the content of a voice mail message makes a difference. Is it really possible that listening to this message changed something between you and the group facilitator, or is it possible she understands you better and it's a good thing? I'm not entirely clear on the precise issue.

Sorry, sometimes after reading more than a couple pages of a thread, I lose track of some information. I'm glad what I said was helpful regardless. It sounds like you're on your way to feeling better about this, and I'm glad.

I'm glad you brought this up. I guess I didn't say everything. So when I talked to the group facilitator yesterday, she said that very same thing. That this is the nature of her work and she does not take it personally. I should have said that earlier, but I don't think I did. I also apologized to her. Which really did feel right to do. It felt weird under the circumstances. But I'm sorry she had to hear it (especially because I did not mean it).

If not apologise. I'd say "well, I meant it. You are a 'c' and walk out.

I think, there is a confusion here between confidentiality and security.

Saying that emails and voice mails are confidential simply means that legally they are considered private. It doesn't mean that they are secure on the technical level. Also, when I say that they are legally considered private, that also doesn't imply that everyone has a responsibility to keep their content private. You can show your correspondence to whomever you want and let anyone listen to your voicemail unless you are a professional who is required to keep it confidential or for some other reasons. Therapists are certainly required to keep all their communications with and from clients confidential. I am now speaking in general. I am not talking about OPs specific situation. It's just that some comments here suggest that if digital communications are not secure then somehow it implies that therapists don't have to keep them confidential, which is not the case.

@Ididitmyway I think that's a good distinction between confidentiality and security. Thanks for bringing that up. Although I think therapists have the obligation to keep things confidential, I see there are the potential for "leaks" either intentionally or unintentionally because technology has holes and weak spots, also humans have weak spots. Just like in an office employees might look up what other employees make even though they aren't supposed to, or a medical office staff might look at patient's charts when they don't have the authority to or a reason to. I think it is important to consider and remember both the security and the confidentiality of the medium we use to communicate. Not referring directly to OP, more in general terms. One time my former T's cell phone got swiped. Well guess what, I had texted her on that phone, I know she responded to emails on that phone from me, so what other information was on that phone? The information simply wasn't secure even though she probably made attempts to keep it confidential. Kit

i was interpreting the desire in a broader or absolute sense, that in spite of the insecurity, the communications could still magically be confidential. Do you really care WHO lets the cat out of the bag?

Not understanding what ur saying.

I guess I cannot let this go. I can't sleep.

Sorry, i was responding to ididitmyway.

I think you resolved it for yourself fine.

You had feelings, you expressed them. Why SHOULDNT the t be able to do the same? Consult with her co-t for the group - the whole point of t is sharing your burden with someone, testing reality, etc.

That's exactly what I meant. Before the digital age, confidentiality was much easier to protect. Today not so much. That's why therapists should mention the limits of technological security in their informed consent. Data leakage cannot be controlled. Therapists are encouraged to use secure encrypted email services but nothing guarantees perfect protection. Also, with insurance coverage, a lot of information is shared between different entities who are part of the system. In this day and age, privacy in general has been so compromised that it's become a relative concept. That, however, doesn't change that concept from a legal and ethical standpoint.

Because the manner in which t chose to address the situation was significantly harmful to her patient, as evidenced by how upset and embarrassed she made OP, by how OP felt she had to apologize to the facilitator, by how OP is unable to sleep, and so on.

How many of us would want our group therapist to hear something embarrassing and untrue that escaped our lips at a moment of distress? And would we not be rightfully upset if our t, of all people, betrayed us to the group therapist? I myself certainly would be very upset if my t ever did that to me.

I’m confused, Una! Surely you’re not saying that therapists should express their feelings by violating patient confidentiality?

Even the idea that a client’s feelings are a burden- they kind of need to be able to take all that on and shoulder the load. They have professional responsibilities. If they need to share the burden there are other channels.

Sorry - i assumed they were co-ts for the group.

Still, once the cat is out of the bag, which is what happened when the voicemail was created, why are you arguing with me about getting the cat back into the bag? Its not gonna happen. Thats my viewpoint.

Hi everyone, thank you for the support. I spent today doing some things I enjoyed. I also spoke to my therapist. It helped. She said she understood how it hurt me, and that it wasn't their intention, and that it was a clinical decision (which I believe was the wrong decision and is sort of a cop out), and also that she told the facilitator that I would be mortified if she listened to it. Which weirdly helped. I felt sympathized with and cared about when she said it. I did not feel like "well then why did you show her." However, I did say "it didn't help anyone." I don't remember what she said in response.

I do feel like I may need more of an explanation from them. Like was it in the right boundaries of their clinic? If yes, what makes it that way? I think I'd just feel better hearing that from them.

Seeing some of your support, helps, but also I feel sad. Like it just validates that it shouldn't have happened. I am getting help here. Like actual help. The weird thing, is that now it seems I have two parts. One part that comes on here and is hurt, upset, and pissed. And the other part that wants to continue with getting help there, because it actually may be helping. I do NOT want to feel like a victim. Again. Though I may be. I may ask for an apology. I do not know if I will get one.

I've been an avoider all my adult life. Every once in a while too, I'll have an emotion of fear and hurt and embarrassment and anger all wrapped in one, triggered by something that hurt me, and I run from that too. I don't want to run anymore. They are helping me, and I want to learn how to manage these emotions.

I think for the people validating me, and sympathizing, I think we can just agree that it was a stupid thing (for them) to do. For the people saying that it sounds like I've got a handle on it, good for me and it looks like I'm being assertive and am working towards moving on from it, I agree with that too.

I am choosing not to leave this place (at least not right now), because 1.) I do feel like I'm getting help and 2.) I've had AWFUL mental health practitioners before. I've had abusive therapists, ****** nurse practitioners, and completely utterly wrong diagnoses for years. These people are not like this. I thought I liked it here. 3.) I guess I also think that if it can happen here it can happen anywhere.

Oh and my therapist said that we can work on gaining back trust, if that's something I need.

I wish I didn't feel so ****** right now.

((((((KnitChick))))))

I completely agree that calling it a “clinical decision” or “professional judgement” is a cop out.

If there was a valid clinical, professional basis for their action they should be able to articulate what it was to you. Just because a t decides to do X does not automatically make X valid clinically.

I think it would be great to see t try to earn back trust, as you mentioned. They might never literally apologize, but acknowledging that trust has been broken, and needs to be earned back, is a very positive statement, in my view.

Thanks Bill. I wrote them both a letter and intend to give it to my therapist tomorrow.

Even if there was an arrangement between the therapist and facilitator, the therapist should not have shared the voicemail itself because you said things you don't wish the facilitator to hear, or said them because you knew the therapist won't share. The therapist could have shared the concern in his/her own words by omitting unnecessary or harmful things.

Even if it was a peer consultation content and names should not be disclosed. I actually don’t think your t should have shared with the other t what you called her. It’s a complete violation of your confidentiality.
It would have been different if one had of overheard the voicemail while it was playing. Then that’s not in any violation.
In my country peer consultation is not allowed- only supervision and the client is always made aware t s are in supervision but names and details are not disclosed. To me there are no excuses for this.

I see it differently still, within the framework that you signed a complete release of information for the therapists to consult about your care. I was once in a group and had a different individual therapist, so this is not a completely unfamiliar context to me. I had challenges with the group that ultimately led me to leave it with the support of my individual T, and I think that wouldn't have happened without their consultation with each other, whatever it was.

I also think that how you are reacting to the "professional judgment" is a distraction from the real issues in your therapy, and allows you to gloss over how you communicate when you're upset and whether you could learn something from this about expressing distress and anger constructively. And as long as you point the finger at the therapist and focus on what they did, you're not reflecting on you and what led to this in the first place. Your T's response was a reaction to you, what you said, and how you said it.

I believe in learning to deal functionally (as opposed to therapy reinforcing social dysfunction) with difficult circumstances-- this was my goal when I entered therapy and I'm not saying it has to be everyone's. But I guess I would consider, in your shoes and having once communicated in ways that were destructive and unkind and dramatic and just about everything negative possible, moving forward with a plan to change how *you* might do things differently in the future. IMO it's a skill to learn how to communicate distress, especially through things that are a "record" like email and voicemail, to learn judgment for when you fire off an email or dump on a voice mail versus waiting to discuss a certain thing in person or on the phone. In the long run I think you might benefit more from examining your communications in and out of therapy.

I think it can be both.

I think OP can learn better ways while also recognizing, and addressing, the negative actions of her t.

I'm so sorry you're going through this, KnitChick I agree with the others that your confidentiality was definitely violated. Definitely talk to your therapist about this. Please don't give up. I hope you'll feel better soon. Take some time for yourself. No need to hurry. Take baby steps. Feel free to PM me anytime. Let me know if I can do something to help you. Wish you good luck! Let us know how it goes. Sending many hugs to you