When is a psychologist not your psychologist?

August 27, 2009 10:54 AM

What are the ethical limitations for a therapist who provides treatment to two members of the same family?

During college, my parents held their financial contributions to my education "hostage", saying they would kick me to the curb if I didn't come home once a week to see my sister's psychologist. The therapist made a short statement up-front at our first meeting, that she was not MY therapist, but that she would treat any non-criminal statements I made confidentially, "similar to as if you were my patient".

She then went ahead and took my statement that I might be gay, and told my parents that I was gay, without warning me she was going to share this with them.

Was it ethical for her to see me in the first place? Does it matter that I was there under duress? Was it ethical for her to out me to my folks, since she wasn't really "seeing me"?

Bonus question, someday I would like to seek therapy, but this and another childhood mental/medical experience, have left me in a state where I find it near impossible to trust mental health professionals. Any suggestions on how to approach a therapist without getting distracted by the mistrust from my past?

posted by No1UKnow to health & fitness (16 comments total)

That's like, Mad Men levels of unethical.
posted by Oktober at 11:07 AM on August 27

What state are you in? Forget it. You can do the legwork yourself.

Contact the board that licensed her, and get that license stripped.

If she does it to you, she will do it to others. You owe it to humanity to do this.

And just in case not all MeFites, or your friends, or your family agree with me...and it confuses you...let the licensing board determine whether she broke ethical guidelines or not.

Damn dude...I'm so sorry.
posted by hal_c_on at 11:07 AM on August 27 [16 favorites]

That sounds pretty horrid, nobody should have to go throught that...

She told you she would treat your case with confidence, and then didn't. That's not only unethical, it's illegal. Not even borderline illegal, well and truly, cut-and-dried, not-a-shadow-of-doubt illegal.

Arguably she should never have seen you, but that's purely a case of ethics. If you had indicated to her that you were their against your will, she should've ended the session there and then, and refused to see you again.
posted by Brother Dysk at 11:14 AM on August 27

Yes, it's ethical for her to see you under certain circumstances. I went and say my brother's a few times so he could get a gauge of family life. Not exactly the same thing, I know. But ethically a psychologist should not see someone when there is a conflict of interest. Clearly this one wasn't able to separate your sessions from anyone else's and spilled everything. That's not cool.

Plus she lied. A liar isn't a good person anyway, but she used her position of power to gain your trust and then abused it. Go report her to the licensing board if she's licensed. Some types of therapists don't have to be licensed and there's not really much you can do about that other than let people know what she did. I know psychologists are generally licenses, but it's a term that tends to be thrown around without really checking the accuracy.

As to future therapy for you, let them know that you've had issues in the past with medical and therapy people. A good therapist should understand and treat you accordingly. Pay them session by session so you don't feel any obligations to keep going because you already paid for sessions.

Finally, I think your parents were just as bad, if not worse, than the therapist. Forcing a college kid to come home to see someone else's therapist is a shit move if I ever saw one.
posted by theichibun at 11:15 AM on August 27 [3 favorites]

This is why ethics and licensing boards exist. Ethical practitioners want people like this out of their profession.

Contact the state licensing board. Let them do the job.
posted by 26.2 at 11:27 AM on August 27

Incredibly unethical and a serious breach of trust. Even if you don't want to go to her licensing board for yourself, imagine the other people that she may be damaging now or damage in the future.

In the U.S., in my state at least (California) complaints about a specific therapist are posted online and published in a journal that goes out to many therapists. I'm not sure if they contain details, but they do describe the type of ethical violation, and might deter other therapists from sending them referrals and be something new patients could see if they googled their new therapist.

For the future...see if you can get a recommendation for a therapist from a trusted friend, and tell the therapist about your trust issues when you go in. This is part of the work you will be doing while you're in therapy with them.

If you're in the L.A. area or in the S.F. Bay area, I can give you several recommendations of therapists who I know are great and wouldn't dream of violating you and their professional ethics the way you've described in this post. Feel free to MeMail me.
posted by arnicae at 11:33 AM on August 27

Incredibly, deeply, uncontrovertibly unethical and probably illegal. Get her licence stripped from her pronto.
posted by dirtynumbangelboy at 11:38 AM on August 27

That is so awful. As everyone has said, unethical to the maximum degree and, if not illegal, it damn well should be. Please report her so it doesn't happen to someone else.

Therapy can be a life saving thing, and it sucks that this plays a part into you not trusting the profession. Many, many of them are highly professional and good people that can help greatly improve your emotional life.
posted by caveat at 12:00 PM on August 27

Please, please, please report her. I once had an ethical problem with a GP and was in no emotional state to deal with it. Although I recognize that I just couldn't cope at the time, I regret that the GP had the chance to treat others the same way he treated me.
posted by Kimberly at 12:15 PM on August 27

Are you in the US? If so, then you may have cause for a civil suit against her. I think you should start be reporting her to the licensing board. It's sad that your sister is still going to see her. It doesn't sound like this woman should be practicing.
posted by parakeetdog at 12:37 PM on August 27

Was it ethical for her to see me in the first place? Does it matter that I was there under duress? Was it ethical for her to out me to my folks, since she wasn't really "seeing me"?

Did she know that you were there under duress? Specifically, did she know that your parents were threatening to cut you off... or, worse, was this -- the application of duress, if not necessarily the method -- potentially her idea? If the answer to either of these is yes, then the ethical breach is much more serious than her having simply "slipped" by telling your parents.

I would imagine that her explanation of her behaviour (i.e. breaking confidence by outing you to your parents) would be that she was seeing you not as a patient but to get information potentially relevant to your sister's therapy. By your account, she told you as much, but perhaps there was a misunderstanding on your part (or hers) about keeping the information you provided confidential. For example, she may have meant that it would be confidential in the sense that she wouldn't tell anyone uninvolved in your sister's therapy (after all you were seeing her on that basis), as opposed to it being completely confidential (as would be the case if you were her patient. I don't see any details about this in your post, but depending on your sister's age and diagnosis/situation perhaps your parents are very much "in the loop" regarding the content of your sister's sessions, and by extension, the contextual information that the therapist was seeking from you.

Finally, given that your parents were clearly willing to manipulate you into participating unwillingly in your sister's therapy in the first place, might it also be the case that they misrepresented to her therapist that you had agreed that your parents would be brought into confidence with respect to your statements to the psychologist? I do not mean any of the former as a justification or rationalization of the therapist's behaviour. Even if this was a good-faith misunderstanding it remains a serious issue that absolutely merits a complaint. I only mean to offer a speculative but, I think, not improbably explanation for the way things transpired.
posted by onshi at 12:57 PM on August 27

Agree with everyone else that what she did was awful, and unethical, and full of yuck.

When seeking mental health care in the future, be upfront about this experience in your first meeting with your perhaps-therapist-to-be. You may or may not like the first therapist you meet, and that's okay; you may have two or three or more sessions with one and discover that you don't like them. That's okay, too - sometimes it takes a while and a few meetings with different practitioners to find one you click with. But do tell them what this therapist did and how it affected (affects) you, and keep as open a mind as possible.
posted by rtha at 1:06 PM on August 27

If this psychologist is a member of the American Psychological Association, you can file a complaint with them in addition to the state psychology licensing board.
posted by Traymoon at 2:13 PM on August 27

This was in Oklahoma, almost 10 years ago. I barely remember her last name, and my family would not give me her name if they knew why I wanted it.

Thank you all for the responses
posted by No1UKnow at 3:43 PM on August 27

That it's not cool to do that is very obvious. I just don't think it's ethically okay for a therapist to treat two members of the same family. I remember when I was switching therapists I considered going to my brother's therapist. FWIW, my brother and I are best friends and all of both our issues have nothing to do with each other. Anyways, the shrink said he wouldn't feel okay with doing that, and I think that's a really good stance to take. Therapists should come towards their patients with a clean slate.
posted by alona at 6:09 PM on August 27

In my experience, a shrink might take another relative on in the service of the first patient. Like if they need group therapy or something. But yeah, this shit is not right, especially outing someone while they are still dependent.
posted by jenfullmoon at 6:42 PM on August 27