T filling out forms

i've been seeing my T for four years. only recently are we arranging for my sessions to be covered by insurance. i get some handful of sessions approved by insurance. then to get more sessions T needs to submit a form/notes about me.

T and i agree that form/notes fall into the category of 'necessary evil' (we both know that necessary in this case means given my financial situation and the insurance bureaucracy. i am sure we can both imagine a better world where there is nothing necessary about forms!)

anyway, i don't want to see the form/notes. she wants to share them with me. she would rather i see them from her than come across them at some other time. i would rather not see them. i worry that, even though i would know why she was writing what she was writing, i would still feel hurt.

she has reluctantly agreed to keep them from me, though i told her she could tell me when she submitted them if it would ease the sense that she was keeping secrets from me. i am sure that we will talk about this again.

would you want to see your T's notes about you? why or why not? i worry that i am being a bit dramatic about the whole thing.

Most therapists try to be as limited as possible about giving information about you. They also keep separate notes, one that will be used administratively and a more detailed set that is not distributed to insurance companies.

Hey. Personally, I don't see the point of a client seeing the notes. If you are using your insurance for reinbursement, who cares what they know. The people in the insurance company don't know you personally, and most are not "educated" about diagnosis, treatment, etc to make personal judgements. They simply look at "rules and guidelines" established by the insurance company and then decide about sessions. For example, my T could tell the worst things in the world about me to the insurance and it would not matter. After 30 sessions, T is required to have a phone "hearing" to determine if I am making progress.

All that insurance cares about is saving money. They don't care about you as a person.

Also, the insurance company has to keep everything about you confidential. So, no one else will see it.

Most T's know how to work the system to help you get the most sessions and coverage you need. Who cares what they say to do that.

Now, about notes in general.
I have seen old T's notes. When I moved, I requested a copy to take with me. Overall, I think it did more harm than good, because it was very clinical and to the point. And I knew in my heart that the relationship was more than "client has this and client discussed that."
Notes are kept for several reasons: to document occurrences in therapy if there was ever a legal issue, to document so that T can remember, and to document for insurance purposes.
They are NOT documenting the true relationship. T can't write in the notes "I care deeply for Rip and I wish she would stop hurting herself." T writes "Client is self destructive." See?????

Ethically, your T is only supposed to submit the least amount of information possible about you in order to gain reimbursement from the insurance company. This usually comes in the form of a treatment plan, which outlines the goals you ard your T are working on and whether you are meeting those goals or requiring more therapy.

You T should not be sending "notes" to the insurance company. The notes that are written about your case, in detail, is not for the insurance company to see. T's are usually discouraged from sharing these notes with patients.

However, treatments plans are often shared with clients. They are not the personal notes that T's keep about us. They are usually focused on goals and objects and such.

Also, T's generally keep two sets of notes-- "their" notes and the "official" notes that go in the chart. "Their" notes are the ones in which they can literally write ANYTHING down and are not to be shared with anyone, not even if the court asks for notes to be turned over. My T has showed me such notes once, from a phone call because it was both beneficial (and hilarious) for the treatment. The "official" notes are the ones that can be requested by you, or by other professionals through release forms and such. Your T should not be sending either of these things to the insurance company.

The personal notes don't exist. wink wink If a doctor admits to having personal notes, they can be supoenaed

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I don't think I would want to see any notes that my T writes about me, I would be afraid it would damage our ability to work together.

I wouldn't want to see any notes either.

Once I did become privy to an email T sent about me to 2 other professionals. It was actually OK. It was somewhat detached, and definitely professional, but he didn't say anything insulting or condescending. I was overall pleased and it didn't come between us, although I did tell him I had received this email erroneously. (I was however pissed off at what the other people were saying, so it made T's words seem just fine.) He did take pains to explain to me that some of what he wrote was referring to an article which they had all read earlier and he was trying to relate my case to that to prove a point to the others.