In November past year I went to see a new T. On the second app, he told me that he had already talked to my pdoc to inform himself more about me. The thing is he never asked me before for my opinion about talking to him and I got angry but was so zombified that I said nothing. Was T wrong by doing that?
By the way, I currently don't see any of them (T or pdoc)... they s*cked!

[bluenarciss]

I wonder if this could be a case of breaching a therapists obligation of confidentiality.
Beside of this aspect, building up a trustful atmosphere usually excludes acting in secrecy. I think he should have asked you for permission, or at least checked if you consent.

Shortly, I understand your irritation well.

[ECHOES]

I'm glad this isn't your current T

A T who is so lazy as to go to a third party, and to someone who only knows you in one particular context, isn't someone I'd want to see. Yes, I'd be angry that he did this. It would feel like spying and like T not believing me and T not giving me a chance. Sounds like he wanted to take a short cut and possibly knew he had poor T skills to do the getting to know you on his own.

[imapatient]

Did you sign anything with that T when you met the first time? It might have had a clause in there about sharing info.

IF you're in the US, regulations about that stuff are covered under state laws, differing by state. If the T was an APA credentialed member, that org's regulations play a role, likely to require specific authorization by the Pt.

In my state, both the T and pdoc would need authorization from me to talk about me; it can be dual to authorize both on the same form.

I disagree with some of this from ECHOES:

Originally Posted by ECHOES

A T who is so lazy as to go to a third party, and to someone who only knows you in one particular context, isn't someone I'd want to see. Sounds like he wanted to take a short cut and possibly knew he had poor T skills to do the getting to know you on his own.

It's common for mental health pros to share info on current and/or former patients. It's done to get one up to speed to provide greater help sooner rather than having to get to know you for X months before really important diagnoses and understanding of Pt might occur. Nothing sinister. I've had T's do it and T's with pdocs, and pdocs with pdocs. It's done to better help you. On an ongoing basis I've had standing agreements with a current T and pdoc so they can check their assessments, judgments, and perspective. Maybe the Pt has told important info to one but not the other. They need to be as well informed as possible. T's usually consult with peers and/or a supervisor to process what they've been doing to get an objective viewpoint regarding not just the patient but themselves and their behavior. My understanding is that, in my State, T's don't share names or other personally identifiable info about their Pt's. To run things by a pdoc can be even better because both T and pdoc know first-hand far more about a Pt than mere peers.

I wouldn't be happy either had it happened without my knowledge, but if you signed something or even gave verbal approval in some states, it's not against any formal rules, other than with a professional association like APA. It sounds like you didn't give verbal approval, but maybe written?

Don't take it so harshly as betrayal; it's done for important, beneficial reasons.

[ECHOES]

Don't take it so harshly as betrayal; it's done for important, beneficial reasons.

Can't see how going behind a pateint's back would be anything but betrayal. We don't surrender our privacy and right to be respected when we seek treatment. We don't lay ourselves at their feet and give ourselves up to them to think for us. We don't surrender our selves to them. We don't go to have things done 'to' us. We are there for their assitance.

[gardenergirl]

Originally Posted by cat_eyes

In November past year I went to see a new T. On the second app, he told me that he had already talked to my pdoc to inform himself more about me. The thing is he never asked me before for my opinion about talking to him and I got angry but was so zombified that I said nothing. Was T wrong by doing that?
By the way, I currently don't see any of them (T or pdoc)... they s*cked!

It depends, naturally. You may have signed a sort of "blanket" consent for this communication in your initial paperwork, though as someone else pointed out, it also depends on state and federal laws. It also depends on whether or not the two have a business relationship of some kind...whether as part of a group practice or some other professional relationship. If that's the case, sometimes that's enough for the two to share information. That being said, privacy laws can be confusing for both professionals and consumers. It's generally good and ethical practice to get explicit consent from the consumer before sharing information, even when it's otherwise "allowed" or agreed to.

gg

I didn't signed anything to this T, and he never asked my permission to talk to the pdoc, nor they have a business relationship that I know of. I just feel like he went behind my back and did something he should have asked me first if I was comfortable with. That was one of the major reasons I never came back to him. It's a trust thing that he didn't manage well.

(((((((((((((((((((cat_eyes))))))))))))))))))

It seems to me that legally, you would have had to sign a consent with your pdoc for him to discuss you with T....

Do you have a new T now??

No, I don't have a T right now although I know I should. I just don't trust them. I have seen so many and all of them have been soooo bad. I've had very bad experiences with them.
Today I am fortunate because the pdoc I'm seeing since Nov-Dec 2008 is a very good one. She recently dx me with bipolar. Before that I had been under treatment for 10 yrs and had no dx all that time . I guess I have not been lucky with T's and pdocs. But at least, I think I am on the right track to heal/control myself.

-Cat

[deliquesce]

Originally Posted by imapatient

It's common for mental health pros to share info on current and/or former patients. It's done to get one up to speed to provide greater help sooner rather than having to get to know you for X months before really important diagnoses and understanding of Pt might occur. Nothing sinister. I've had T's do it and T's with pdocs, and pdocs with pdocs. It's done to better help you. On an ongoing basis I've had standing agreements with a current T and pdoc so they can check their assessments, judgments, and perspective. Maybe the Pt has told important info to one but not the other. They need to be as well informed as possible. T's usually consult with peers and/or a supervisor to process what they've been doing to get an objective viewpoint regarding not just the patient but themselves and their behavior. My understanding is that, in my State, T's don't share names or other personally identifiable info about their Pt's. To run things by a pdoc can be even better because both T and pdoc know first-hand far more about a Pt than mere peers.

I wouldn't be happy either had it happened without my knowledge, but if you signed something or even gave verbal approval in some states, it's not against any formal rules, other than with a professional association like APA. It sounds like you didn't give verbal approval, but maybe written?

Don't take it so harshly as betrayal; it's done for important, beneficial reasons.

i agree completely with this.

i'm in a situation now where i'm trying to find a new T. my pdoc said he bumped into the T he wanted to refer me to the other day, and had a chat to the T to see whether we would be a good fit. i have a long-standing agreement with pdoc that he can talk to any of the professionals i consult if he needs more info to help me better.

also - did you pdoc give you the referral to your T? if that is the case, then there may well be expectations that they will consult. here is australia, Ts are required to provide written reports to referring drs every 6 sessions.

[imapatient]

Originally Posted by ECHOES

Can't see how going behind a pateint's back would be anything but betrayal. We don't surrender our privacy and right to be respected when we seek treatment. We don't lay ourselves at their feet and give ourselves up to them to think for us. We don't surrender our selves to them. We don't go to have things done 'to' us. We are there for their assitance.

Because, as I prefaced my comments, it's a legitimate and common thing for mental health pros to do--with permission of whatever sort is needed in her location.

If it was done with permission--perhaps a blanket one like I asked about, it isn't betrayal. Whether it was done with or without (which would be wrong) permission, pros don't do it for any nefarious reasons or to betray their patient, they do it an attempt to help serve the patient by gaining more info about them so they can be as well-informed as possible.

Obviously she wasn’t made well-enough aware of any info sharing polices, if agreements were somehow in place.

If they violated laws and rules, you could file complaints against them.

[sunrise]

Originally Posted by cat_eyes

Was T wrong by doing that?

Are you in the U.S.? If so, the answer is yes, your T was wrong. Both of the professionals involved need to get your signed consent. (There may be exceptions if they work in the same practice group.) My therapist has done this a number of times. When he wants to talk to someone else about me, he has a standard consent form, and he fills in the person's name he wants to speak to, and I sign it. The person he'll be talking to has to sign it too. My daughter's therapist followed a similar procedure. She wanted to talk to my therapist. She had both me and my daughter sign forms, and my therapist had me sign a form too. They are very careful to do things by the book. If I found out my therapist had talked with some other professional about me and not gotten my signed consent (verbal is not enough), I would probably hit the ceiling. (But I know he would never do that.)

cat_eyes, I'm glad you are no longer seeing someone who can't be bothered to follow standard confidentiality and consenting procedures.

No I'm not in US, I'm in Mexico and don't have the slightest idea of what procedures must be taken here. My question was more about the ethical and confidential aspects of it. I got angry because I went to see this T against the advice of the pdoc I was seeing at that time. The reasons of the pdoc for not wanting me to go to a T weren't clear and he insisted that he would give me therapy but wasn't giving me a thing. At sessions with him we just talked about meds. So I went to see this T and wasn't planning to tell the pdoc. That's when, at the second app with the T, I found out he already have spoken with the pdoc. I had already seen the pdoc after the T talked to him and he never said a thing! I don't know, it just got weird and there was a lack of communication with both guys. I didn't like that and finally decided to terminate both of them. That was the best thing I could do: now I see a great pdoc who is intelligent, prepared and caring enough to treat me well and give me an accurate dx. I think that, at the end, things went for the best.

[bluenarciss]

In order to avoid such experiences in the future, you nevertheless should inform yourself about the existing rules and procedures about sharing internal information with third parties, whether they are Ts, pdocs or whatever. Read carefully the paperwork and insist on a fixed agreement according to the applicable local law.

Every serious health caregiver will have no problem at all with that.

You are right, I should do that and should have done that. In Mexico things are a lot different from US or UK. Most of the agreements are done verbally and most of the pdocs and Ts don't make you fill any paperwork (specially Ts). But with previous Ts I had been, there was always a verbally agreement that all information I gave to them was confidential and would be told to third parties ONLY if I was a threat to myself or others. I guess this last time I was so zombified by the meds I was taking (thanks to that pdoc) that I didn't even had that verbal agreement. But at the end I learned something and I will be more cautious next time I see a T (if I ever see one!).