T want let me see my Files

</font><blockquote><div id="quote"><font class="small">Quote:</font>
mountaindew24 said:
Well Friday i seen my files and lets just say i now wish i had not seen them.
old T wrote in file that i was a snobby, spoil rotten brat, and a smart *** I'm like that hurt. then come to found out that starting in October i will start seeing my old T again. and there was more stuff wrote down about me when i would leave. New T say great stuff about me...................

</div></font></blockquote><font class="post">
Why would you want to see your old T again? You have control over who you see, you know. Some therapists, just like doctors, are unethical and blame patients with judgments, instead of treating the patient. You haven't lost anything by seeing your files, and I'm happy you did see them.

Your not any of those things that your old T said, I guarantee it. It sounds more like the old T was insecure about his/her inability to be a good therapist when you presented so-called "challenging" behavior (challenging in their eyes only, which doesn't mean it was challenging at all).

Take control of this... the worst thing is feeling like you have no control over your situation.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
chaotic13 said:
imapatient,

My list was COMPLETELY off the top of my head. They were things that I would be afraid to hear about myself, not things that are medically "bad"or untreatable. I'm not a T.

My point was that the comments made my mountaindew's T seemed to be very unprofessional and more likely to reflect poorly on the T not the patient. IMO. As a health care professional myself, they would be things that I might think, but they certainly would not be written in an official medical record. Then again, I'm not a T so maybe I don't see the benefit of making statements like that. It's pure opinion and has no relevance to pathology or patient care, What's the value of including it in her chart?

</div></font></blockquote><font class="post">
No, your right chaotic. I work in the healthcare profession with patients charts all the time (psychiatric patients too), and this would not be acceptable or standard practice to write in a patient's chart. I might find something like this written in a 20 year old chart, but very uncommon for any professional in this day and age to write anything like what was written in Mt. Dew's chart.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
mountaindew24 said:
i told my current T that i wanted to see her, at that point i was begging her not to send me back to the old t . my T said don't worry u will keep seeing me. i'm like YES!!!!!!!!!!!!!! this T is great

</div></font></blockquote><font class="post">
Excellent news MtDew!

Those comments looked judgemental and unprofessional to me. I wouldn't write that way anywhere about anybody. Where is the value in it? If you are going to talk to the T who wrote that, I would ask for an explanation, because that doesn't sound very appropriate to me. Is there any chance that your memory of it is distorted somehow? I'm not saying it is, but I just can't conceive of writing notes that way.

I'm curious about the notes my T writes about me too, and I imagine they are not flattering. There have been times that I knew she felt I was noncompliant and choosing to continue being self-desructive, because she told me so. And I'm sure that's in the notes. It wouldn't feel good to read. But, then, I wrote an assessment of myself (never showed it to T - afraid of the confrontation when she disagrees with my self-diagnoses, and I also said some unflattering things about her and past therapy). My own assessment that I wrote is not at all flattering. I would say it's honest. If someone else had written it about me, I might be mad at them.

Assessments and notes have to be honest, even when it isn't flattering. I write behavior plans, and have to have the parents and the client sign them. I've had parents complain that what I wrote wasn't very flattering. I guess it's not. It's about a person's problem behaviors, and has to show it for what it is. Likewise, therapy notes are written about your flaws and shortcomings - the things that you go to therapy because you can't live with it the way it is. I try to balance that stuff out by including the strengths, but when it comes down to it, strengths are important and are what will help the client get better, but the problems are why the client is in therapy and why the notes are being written.

Mountaindew, it does sound like your current T is a keeper. She sounds like she has your best interests at heart.

Great news to hear.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Rapunzel said:
...therapy notes are written about your flaws and shortcomings - the things that you go to therapy because you can't live with it the way it is.

</div></font></blockquote><font class="post">

I think this is an excellent point to mention. Anyone reviewing their medical records should remember that main purpose these records is document potentially pathological conditions and changes seen during treatment. They are not to provide a complete summary of the whole person. These notes are intended to be short, concise, and very specific. Other members of the health care team don't want to know about all the stuff the patient doesn't have or how detailed your comprehensive your examination was. They want to know what the writer thinks the pathology (condition) is and the supporting evidence found to support the diagnosis. Rehab notes then also contain key information or measurements that demonstrate improvement or lack there of. Again I am not a T, but I would think their notes would be somewhat similar.

I may be TOTALLY off here. (T's out there I would appreciate the correction if I am wrong). I IMAGINE a treatment log entry something like: Pt. showed signs of dissociation, avoidance, anxiety when x topic was raised. Based on information provided during previous sessions this is suggestive of potential PSTD. Plan is to attempt to develop tolerance and reduce anxiety through the use EMDR technique before probing this topic further.

This thread makes me want to see actual therapy notes. I am now very curious about them. Not curious enough to request my own person records though. Having just experienced a major falling out with my own T and quitting, I don't think this would be a good time for me to say, "And... I want to see my records." I don't think it would help mend the riff at this point.

Well, as I situate myself before getting around to reading my own, I can just send you a copy of mine to read!

Sounds pretty good. Any notes a patient is allowed to see should be quite clinical, and not indicative of any personal ideas the T may have or express to him/herself.

Some just call them "progress notes." Many weeks there might not be any progress.

Well. I don't know why Ts don't let you see inside your folder. I see a mental health nurse and a doctor trained in Mental Health.

I took a sneak in my folder and Richard (my mental health nurse,) spotted me as he came back into the room. I had the folder with CONFIDENTIAL written on it in my hands. He rushed forwards and grabbed the folder - he then asked if I had looked at anything in it. I told him no, which was a lie.

I did see something in there, it was....shocking. I don't want to say what it was but I am still anxious about what I saw.

Anyway, the point of my reply is to say the most Ts don't want you to see in the folder.

Love you x

I had a pdoc read a little bit of my file to me, when we were discussing medication changes. It was very clinical and slightly disconcerting. Now what I really would like to see is the hospital records of a blackout (too much alcohol) to know what happened.

I've snuck looks at the progress notes that my pdoc or T has written (it's in a confidential database online)... I had to laugh, my pdoc has horrible spelling sometimes. Okay, it wasn't sneaking... T was looking for something from last session, I just have *really* good peripheral vision. I didn't hack the computer or look over anyone's shoulder!

But it was all objective... and quite frankly, reallllly boring.

I think most keep their personal opinions in their heads, where they belong. Unfortunately we all judge a person, even if we don't realize ... just matters how we deal with that opinion, and your T didn't deal with it well at all!

Like the other posters said, sounds very unprofessional. I wonder what point putting that in there was. Sounds like your t had more problems than his/her patients. Why do you want to see your old t again? the one that wrote that? Try not to take it to heart although that is hard to do. This is someone who obviously has issues of his/her own.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
mikkyhill said:
I don't know why Ts don't let you see inside your folder.

</div></font></blockquote><font class="post">

Well.. again "playing the role of a T" I can think of a few reasons why they might like to keep patients out of their medical records.

1. A lot of the information is highly technical and because it relates to a pathology, its likely negatively biased. Like I mentioned earlier normal findings are often left out of these notes. When I stay negatively biased I mean, when reading it about ourselves WE as patients would likely judge it as them saying we are "bad" or "abnormal". When talking about mental or personality issues this would be very hard for anyone to read and not get upset in some way. For example how many of us would like to hear that we are even considered to be of "Average intelligence" let alone be classified as "Below Average Intelligence" Whether it is true or not it is a difficult pill to swallow, no matter how nicely or technically it is written. "Chaotic13 appears to have significant deficits in comprehension and retention of content presented orally." "Comprehension of oral communication requires a slower speech rate with simplified vocabulary." "Frequent recall prompts are necessary for retention of key points."

2. Simply letting the patient read the information would likely result in the patient having a lot of questions. Providing a detailed explanation of the technical jargon, why a particular entry was considered necessary, why one approach was chosen verse another, convincing the patient that entries are not good or bad they are just factual information that can help guide the treatment approach.... bah,,,bah... bah... Reading just one page could derail the focus of therapy for many sessions. Instead therapy becomes about teaching psychology and not about helping the patient manage his/her symptoms.

3. Maybe I am being paranoid here but some of what therapist do is manipulation. They read our mental state, predisposing attitudes, thought patterns and perspectives and then they use this information to elicit certain changes or conditions. For example my T must have detected very early on in my therapy that I had at least some sensitivity to physical proximity. Since she sees a zillion patients a day, she probably made a note of this in my chart some where. I've become aware over time that she uses this to her advantage when trying to get my attention or to drive home certain key points. Now that I've become aware of this, it is less effective. If I would have read about her technique in my chart, it would have lost its effectiveness earlier. T's are not the only ones who capitalize on things like this. In education we use techniques like Brain-based learning where the teacher use emotional reactions and responses to facilitate learning, sharpen attention, or improve motivation. These techniques work best when the learner is unaware of what is going on.

I guess the important thing is to determine... Do you trust that your T has your best interest at the forefront of what they are doing? If you do trust that you T is trying to meet your needs the best way they know how, then let them determine the best course of treatment. As tempting as it can be want to peek, keep your nose out of your chart. The info in there is not written for you, it written for them. If you don't trust your T, then don't engage in therapy.

In MountainDew's case I think she did the right thing. She was not comfortable with her old T, didn't really trust that she was being honest with her, so she switched T's. Personally, if I didn't trust my T then I would not have bothered getting my records transfered. Her opinion would not matter that much to me.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
chaotic13 said:
</font><blockquote><div id="quote"><font class="small">Quote:</font>
mikkyhill said:
I don't know why Ts don't let you see inside your folder.

</div></font></blockquote><font class="post">

Well.. again "playing the role of a T" I can think of a few reasons why they might like to keep patients out of their medical records.

1. A lot of the information is highly technical and because it relates to a pathology, its likely negatively biased. Like I mentioned earlier normal findings are often left out of these notes. When I stay negatively biased I mean, when reading it about ourselves WE as patients would likely judge it as them saying we are "bad" or "abnormal". When talking about mental or personality issues this would be very hard for anyone to read and not get upset in some way. For example how many of us would like to hear that we are even considered to be of "Average intelligence" let alone be classified as "Below Average Intelligence" Whether it is true or not it is a difficult pill to swallow, no matter how nicely or technically it is written. "Chaotic13 appears to have significant deficits in comprehension and retention of content presented orally." "Comprehension of oral communication requires a slower speech rate with simplified vocabulary." "Frequent recall prompts are necessary for retention of key points."

2. Simply letting the patient read the information would likely result in the patient having a lot of questions. Providing a detailed explanation of the technical jargon, why a particular entry was considered necessary, why one approach was chosen verse another, convincing the patient that entries are not good or bad they are just factual information that can help guide the treatment approach.... bah,,,bah... bah... Reading just one page could derail the focus of therapy for many sessions. Instead therapy becomes about teaching psychology and not about helping the patient manage his/her symptoms.

</div></font></blockquote><font class="post">
I consider it this way--
The patient has a right to a copy of his/her files unless the therapist (or other medical professional) can make a claim that if the patient saw the files it would likely cause SERIOUS harm to the patient. The burden of proof is on the therapist to prove that it would cause serious harm. The medical professional can be taken to court to prove that it can cause SERIOUS harm to do so. FYI folks---a good way around such a T is to have the T send your complete file to another doctor and/or therapist. They can't refuse to send it to another medical professional if they request it, and the other medical professional can give you a copy and/or let you review the file (keep in mind not everything is worth reading though, and might only upset you).

The therapist's job is to help the patient learn about themselves. If they don't feel confident in explaining to an active patient what they meant when they wrote XYZ, then they are not a competent therapist (or other medical professional). Usually though, it seems to be the reading of the file requests happen after they are no longer seeing the patient.
</font><blockquote><div id="quote"><font class="small">Quote:</font>

3. Maybe I am being paranoid here but some of what therapist do is manipulation. They read our mental state, predisposing attitudes, thought patterns and perspectives and then they use this information to elicit certain changes or conditions. For example my T must have detected very early on in my therapy that I had at least some sensitivity to physical proximity. Since she sees a zillion patients a day, she probably made a note of this in my chart some where. I've become aware over time that she uses this to her advantage when trying to get my attention or to drive home certain key points. Now that I've become aware of this, it is less effective. If I would have read about her technique in my chart, it would have lost its effectiveness earlier. T's are not the only ones who capitalize on things like this. In education we use techniques like Brain-based learning where the teacher use emotional reactions and responses to facilitate learning, sharpen attention, or improve motivation. These techniques work best when the learner is unaware of what is going on.

</div></font></blockquote><font class="post">
My therapist doesn't go for tricks and manipulation. I know that many rely on manipulation, but manipulation doesn't build trust in an intelligent person. When anyone has attempted to manipulate me in the past, it was quickly spotted and I certainly didn't hold the attempted manipulator in high esteem. My therapist will respond in a way that works with a certain person, but that's not manipulation, that's trying to help someone in the way that works best for that person. He certainly never tries to provoke me to anger or sadness just to get a reaction out of me over something he *thinks* I should or should not be learning.

I think my therapist, like most good therapists, believes strongly in the teamwork and partnership that therapy really is. It's not just an almighty T that I'm supposed to worship and adore because he is my T. Would you trust a T who manipulated you? How far would that get most people?

I suspect that you weren't really manipulated Chaotic, but rather that you thought it seemed like manipulation; your T was just trying Sometimes I wish my T COULD read my mental state--- but therapists cannot read minds either. Your just more AWARE now of what's going on, but I don't think of that as manipulation in your case Chaotic. It seems like progress that you are more cognizant of your surroundings and your T's behavior than before.

Yay for progress.. of course I have ADHD maybe I'm just not paying attention to my T? --j/k

OK manipulation may not have been the correct word. I think T are taught really good persuasion or attention getting skills. I do not believe that my T ever tried to force me to think a certain way or to behave a certain way. However, in the example I provided about personal space, I think my T read my body language along with things I said and knew I had an issue with this. She used this information to her advantage. In order to persuade me to trust and open up a bit, I THINK (I don't really know for sure) that she deliberately avoided challenging this boundary. When I might be fading off during the session she knew she could quietly shift forward to perk me up and redirect my attention back to her. Other examples, are I think my T was very care in the way she worded certain things.

All I was just trying to say was...IMO many things a T does are planned and deliberate and sometime done for a specific reason or specific effect. In some cases if the patient was aware of the technique then it might not be as effect.