Therapist calling cops and looking up friends

I did not show up for therapy yesterday. The therapist called the university that I go to and they sent cops to do a wellness check on me. To top it off, she contacted a friend of mine who is not listed as an emergency contact. This friend joined a therapy session on one occasion. The therapist must have still had this friend's contact on her Skype. And she also contacted the spouse of my friend and left him a voice message on Skype. Is that appropriate?

I understanding contacting my university. But contacting a friend who I didn't list as an emergency contact and even looking up her spouse and contacting him? That doesn't seem right. How did she even get his name?

Although i know some therapists are against looking their clients up on social media, I heard they will break that rule during an emergency.
If you have Facebook, she may have done just that. Searched your friends list, maybe found your friend who has her relationship status public.

Contacting the university is understandable... if she first tried to contact you. She went way too far contacting your friend and their spouse, I think.

I don't have social media. She must have still had my friend's contact information on Skype when we did a conference call. But I don't know how she got my friend's spouse's information. I have never even told her his name before. Wtf.

Yeah, that is strange. Seems like she did a lot of digging, which is ridiculous since you do have an emergency contact. May be she was unable to find your information and panicked? I don't know, man. I think she has a lot of explaining to do.

Did she have a reason to believe your no-show was caused by an emergency?

Yes; she did. But even then, looking up my friend's spouse is excessive. She already called the the university and sent the cops.

I think in the case of emergency and possibly saving lives people do and should do what they think is best. Your T clearly cares about you a lot.

I'm so sorry, I never ask the right questions. I assumed they only felt the need to contact the cops and others because you just didn't show up...which is a bit extreme.

But yeah, if there was an actual emergency going on...damn, she did the best she could, I guess. Still, I don't understand why she didn't call your emergency contact. Even though she may have went a bit overboard, it seems like she meant well.

Did she at least try contacting you first? And did she use your name with your friend's H? If so, I think that's a violation of HIPAA privacy laws, if you didn't have him listed as an emergency contact and grant written permission to contact him. Actually, if you don't have the friend listed, that could be a violation, too.

She did have reasons to believe that I may have done something to myself because of something that I sent her through email over the weekend. I wrote a 17 page paper on my self analysis and sent it to her. She read it over the long holiday weekend. And she sent me a text message saying to not do anything final until we have had the chance to talk this week and to hang in there. She didn't assess the risk after reading what I sent to her. She just told me to wait and not do anything final until we got the chance to talk and to hang in there.

But when I no show for an appointment, that's when she got worried and started calling people. I reached out to her and her emergency contact therapist over the long weekend but they chose to ignore and instead she sent a message telling me to wait and not do anything final until we've had the chance to talk this week and to hang in there. She didn't do an assessment to determine the risk. But when I didn't show up, that's when she starts panicking?

No. She doesn't care. She was only covering her @$$ because of liability.

How do I respectfully bring this up to her?

I think you have every right to say to her what you just said here. I understand why you're angry and I think it's justifiable, especially when she was fully aware of what you were going through. She crossed the line.

This question seems disingenuous to me. Somehow i dont think respect is the issue here. Anything else jump out at you from the 17 pages?

If you are going to ask, what right does she have? I would ask, what right do you have? The answer for me is, it's the same right. Stop pretending you are not in this and suffering together. Your pain may be different but it is still shared. You are let down, but she let you down - do you think she feels joy at that? Would you?

She is not a robot. You are not a robot. Sometimes people fail to live up to expectations. Then what? LIFE HAPPENS.

I think your T may not have accurately assessed the risk over the weekend, but when you failed to show up for your appointment decided that the risk was too great and did whatever was in her power to do to ensure you were safe. I'm sorry you feel like your privacy was invaded, I might feel that way too, but it seems like she went through extraordinary lengths to find out if you were okay. I think that says something positive. HUGS Kit.

I doubt she will be surprised at your displeasure, but be prepared for her to fully justify her actions based on your safety.

@unaluna: It was not an insincere question. The therapist and I can't even communicate with each other in a productive way anymore. There is something dysfunctional and very untherapeutic in our relationship. If I say something, she thinks I'm arguing. If she says something, I think she's arguing.

@SlumberKitty: That makes sense.

Imo nothing justifies violating HIPAA (are you in the US? If not then obviously HIPAA doesn't apply)
Boundaries exist for a reason. In your position I would feel that the boundaries of the relationship had been massively violated. My therapist is a professional and there are rules that are supposed to be in place to keep professional separate from personal. He has my emergency contact info, he can call the cops, but he does not have the right to intrude into parts of my personal life that weren't part of the "agreement," including contacting anyone else from my personal life.
There is usually paperwork at the beginning of therapy where you give them permission to do certain things like contact certain people under certain circumstances. What's the point of that paperwork if they're not going to act within those constraints?

I'm glad your therapist cares, but my personal opinion would be that caring isn't an acceptable excuse for ethical violations, and I see this as an ethical violation. Therapists have to accept that they're not allowed to do anything and everything they might want to do. That's why rules exist. They don't get to make these decisions for you.

Emergencies are a grey area under HIPAA. This isn't a black and white issue.

Here is HIPAA information that I found that probably pertains to this situation:

https://www.hhs.gov/sites/default/fi...tal-health.pdf

"Does HIPAA permit a doctor to contact a patient’s family or law enforcement if
the doctor believes that the patient might hurt herself or someone else?
Yes. The Privacy Rule permits a health care provider to disclose necessary information about a patient to law
enforcement, family members of the patient, or other persons, when the provider believes the patient presents
a serious and imminent threat to self or others. The scope of this permission is described in a letter to the
nation’s health care providers - PDF
Specifically, when a health care provider believes in good faith that such a warning is necessary to prevent or
lessen a serious and imminent threat to the health or safety of the patient or others, the Privacy Rule allows the
provider, consistent with applicable law and standards of ethical conduct, to alert those persons whom the
provider believes are reasonably able to prevent or lessen the threat. These provisions may be found in the
Privacy Rule at 45 CFR § 164.512(j).
Under these provisions, a health care provider may disclose patient information, including information from
mental health records, if necessary, to law enforcement, family members of the patient, or any other persons
who may reasonably be able to prevent or lessen the risk of harm. For example, if a mental health professional
has a patient who has made a credible threat to inflict serious and imminent bodily harm on one or more
persons, HIPAA permits the mental health professional to alert the police, a parent or other family member,
school administrators or campus police, and others who may be able to intervene to avert harm from the threat.
In addition to professional ethical standards, most States have laws and/or court decisions which address, and
in many instances require, disclosure of patient information to prevent or lessen the risk of harm. Providers
should consult the laws applicable to their profession in the States where they practice, as well as 42 USC
290dd-2 and 42 CFR Part 2 under Federal law (governing the disclosure of alcohol and drug abuse treatment
records) to understand their duties and authority in situations where they have information indicating a threat to
public safety. Note that, where a provider is not subject to such State laws or other ethical standards, the
HIPAA permission still would allow disclosures for these purposes to the extent the other conditions of the
permission are met."

https://www.hhs.gov/sites/default/fi...onationhcp.pdf

Did you read echoes recent post about her session? The remainder of my (previous) post hopes you you would have a similar vulnerable, tender moment with your t, instead of figuratively going to court to resolve your differences. IMO, that is the successful resolution of almost any therapy, where you recongnize the humanity of the other person, instead of keeping on trying to nail them to some righteous wall.

The "right thing to do" just wasnt in them. No matter how hard we try to show them. Someone ELSE might be able to do that one thing, but we needed it at that moment, from that person. Why didnt we get it?

Why didn't you message her that you weren't coming to session?

In my experience, acting out (as opposed to talking and workimg something out), often results in some kind of unwanted drama.

Therapist's responsibility and HIPAA are one thing... but this will still make me furious (both contacting the uni and friends), I would let the T know and ask to explain the reasons and choices.

Other than that, same question as octoberful's: why didn't you let her know that you are cancelling, even last minute? If that was done, you could probably argue better that her assumptions and acts were inappropriate.

Yes, unless you signed away rights as a student, then she cant break HiPPA like that. Is this the one who moved across the country ?

in my opinion, if she thin ks that given the 17 page draft you sent her that you are in danger of suiciding and then you fail to show to your appointment with no message...i would say that hippa goes out the window. at that point, lets find out if you are: alive, and in a safe way. you knew you had an appointment and if you didn't want the undue attention all you had to do was call and cancel. could have done that over the weekend when no one was there...in stead, you did nothing. you left her no choice but to notify police.

i believe she had the right to act in that manner ..and the legal requirement. hippa be damned. she thought you were a danger to yourself.

I think she accurately assessed the risk over the holiday weekend, because you obviously lived to write this post and deliberately chose to not notify her you were not planning to attend your session. Actions have consequences: if you write a long letter over a holiday weekend threatening self harm and then don't show up for a planned therapy session, I believe the T would be negligent to not take appropriate actions to check on your welfare. And it sounds like, although you do not include this information, that she may have sought to secure your whereabouts AFTER the cops didn't find you. And unless she started recounting your history of difficulties or relaying other confidential information to the others, I think a breach of confidentiality (which doesn't apply in a situation where you might harm yourself or others) of the sort you're kind of explaining is reasonable under the circumstances. Doesn't mean you can't tell her what you think about it. I do think it might be helpful to you to see this in a more complex way than you see it right now. But the larger issue is that you don't think this is therapeutic for you anymore, so why don't you just end it?