Therapist with patient in jail?

September 21, 2008 5:05 PM

Any therapists out there? What would you say/do if a patient called you from jail claiming they were innocent?

Basically, how do therapists respond when one of their patients has been incarcerated. Where does their commitment to the patient end? Would they get up in the middle of the night to rush down to the station or would the patient have to wait until morning?

posted by PostIronyIsNotaMyth to health & fitness (11 comments total)

They wouldn't get up in the middle of the night to rush down to the station. How would that help the patient? It's not like the police/sheriff/corrections officers would let them have an impromptu therapy session right there in the holding cell.
posted by Sidhedevil at 5:13 PM on September 21, 2008

I think most people first contact the person they think is most likely to post their bail, which is probably not going to be a therapist in private practice, and you don't get to contact too many people when you're locked up.

Beyond that you need to include a lot more detail than this to get an adequate answer. Does the person in question need mental health treatment? Because, no, your private therapist isn't going to be allowed to make a special visit to you in jail, you'll see the prison psychiatrist who will determine what medications you'll get.

And rushing to the station is moot because therapists don't get any special access to prisons allowing them to visit off hours. As a social worker I had clients that were locked up repeatedly and nobody rushed to see them because, well, we knew exactly where to find them when we were prepared to meet with them, which was usually on a set schedule (Friday afternoons). Also, we often didn't find out until well after they were locked up, we had a dude on the prison social work staff who was pretty good about giving us a head's up when one of ours arrived but that guy was usually swamped.

Our treatment team had one person who was given special training to become a "prison contractor," which just means that he got a badge allowing him to skip the visitors line when he showed up. If you don't go through that training, and you don't have that badge, you sit in the waiting room in the queue with everyone else, regardless of whether you're a doctor or a family member.

All this pertains to Philadelphia County, I'm not sure if you had a big city corrections facility in mind, though.
posted by The Straightener at 5:20 PM on September 21, 2008

Several of my psychologist family members have patients in the lock-up. One of them offers irregular (once every 3 months) visits and they exchange letters and emails on a weekly basis. The other doesn't visit patients in prison- he doesn't get compensated for his time.

If they are involved in committing a patient, that is a different matter- they would be involved and visit regularly, liasing closely with the psychiatrist involved. If the patient didn't already have a psychiatrist, they would do their best to get them one of the psychiatrists they have a relationship with so they could closely monitor/control/provide input on the treatment as appropriate.

Neither of them answer their phone in the middle of the night. A few patients have an emergency line that forwards to the home phone, but it is rarely picked up after 9 p.m. The office line gets checked regularly, but the first response would be the following morning. If a patient got through to them, they would act quickly (meet the patients somewhere, etc) if the patient were likely to be a threat to themselves or others- they infrequently meet patients at night, on weekends, etc, when they are in crisis. They wouldn't go to the jail (at all- time doesn't matter) unless it was an extraordinary circumstance.

This is California specific information.
posted by arnicae at 5:56 PM on September 21, 2008

There are other support systems that usually take care of middle of the night emergencies -- we have a population based staff (ie, x clinicians per x,000 citizens) oncall 24/7 that get sent to police stations, emergency rooms, etc. I assume this is similar for other parts of the nation (VT here)
posted by SirStan at 5:56 PM on September 21, 2008

I don't really follow the reasoning behind this question. It might help if you'd give some more specific example of what you had in mind.

Therapists are not parents or best friends. Their professional obligations are like those of a doctor. Most therapists work out of their offices, though many go "off site" as needed, like holding meetings at schools, institutions, or even in people's homes if the person is homebound or agoraphobic.

A therapist should *care* about his/her clients, but the therapist should also have boundaries. Some therapists lose their boundaries at times and become overinvolved with patients (e.g., have sex with), but this is not a good situation. Sometimes clients who have been let down a lot and don't want to trust anyone like to imagine situations that "prove" the therapist doesn't care ("You wouldn't bail me out of jail? See! You don't care!"). But those hypotheticals miss the point, in my opinion. As I say above, the client/therapist relationship is fundamentally a professional one between a patient and a health care provider. A therapist can "be there" for a client without losing his boundaries.

I find it hard to imagine what good would come out of a situation in which a therapist ran down to a jail in the middle of the night
posted by jasper411 at 6:06 PM on September 21, 2008

I would think the therapist is obligated to tell the client to contact a lawyer. If the client is claiming he is innocent, he is asking for legal advice, which the therapist is not qualified to give.
posted by drjimmy11 at 6:17 PM on September 21, 2008

I would think that the only way a therapist could be helpful in this situation is if the situation went to court and the therapist was asked to testify as to the person's character. Even then, I don't know if it would be helpful, "Our therapy sessions are confidential, however, my client wishes me to inform the court that he told me he was innocent and you should let him go."???
posted by misha at 7:32 PM on September 21, 2008

...Only people that can afford good defence lawyers are innocent?

But in answer to your question maybe if I was their Mother or on a retainer! Or had some highly pertinent information... Actually - no, scratch that. I'm not a lawyer! I'd speak to their lawyer (and my own!) and then make a move. You don't know what he's 'innocent' of and could certainly make things worse... (Maybe he's been.. irksome - putting you in a position to potentially/inadvertently give them what they need to be petty and punish him as they see fit or ect.)
posted by mu~ha~ha~ha~har at 9:02 PM on September 21, 2008

Where does their commitment to the patient end? Would they get up in the middle of the night to rush down to the station or would the patient have to wait until morning?

To me, this is a scary question. A therapist has no obligation (nor should they feel one) to bail out their patient. I think you really need to look at your boundaries - you sound very enmeshed in your client's life (which is NOT healthy - just so you know).
posted by The Light Fantastic at 10:12 PM on September 21, 2008

I believe the asker is posing a hypothetical question. Previous queries indicate he is a screenwriter by trade.

But The Light Fantastic's advice still stands: if you sell your screenplay, PostIronyIsNotaMyth, try not to get overly enmeshed in your client's life.
posted by roger ackroyd at 10:38 PM on September 21, 2008 [1 favorite]

And in Hollywood, it is permissible for a therapist to rush to a jail in the middle of the night and demand time with her client if she is brilliant, beautiful, and slightly vulnerable, and he is dangerously alluring and probably a bad guy right up until the very end.
posted by roger ackroyd at 10:41 PM on September 21, 2008