Can my therapist offer up financial services based on our session work?

February 13, 2017 1:44 AM

What are the ethical boundaries for a therapist/psychologist pitching me on a "money management educational system" business that she and her husband are members of, based on things I told her during one of our sessions? Kosher? Or weird?

So I recently started seeing a therapist to address the anxiety and panic attacks I've been dealing with since Election Day. It's my first time in therapy, so I'm not completely familiar with what's ethical and what's out of bounds.

Yesterday, I went in for my fifth session. The previous sessions had been productive, and I hadn't been feeling as bad this past week, so we spent most of the hour talking about my world view, and about what gave me purpose in life. At one point, I was saying I don't set a lot of big long-term goals for myself, and as an example told her I didn't see myself buying a house or apartment, because I haven't saved any money for a down payment, and wouldn't be able to save a sufficient amount for years. (I live in an area where the median home price is more than half a million.) It's not a source of anxiety or stress for me--I only brought it up as an example of my overall approach to life.

My therapist didn't say anything in the moment, but after our session, as she was giving me homework for the next session, she said, "What if I told you that one of the stories you're telling yourself about your life is wrong? I want you to watch a video." and then handed me a card for a financial tutoring business that she and her husband are part of. It's a service that offers to teach you how to get your finances in order and then qualify to buy your first home. She said, it's completely legal, it's really helpful, and, while it would be a conflict for me to work with you on this, I could connect you with someone else on our team.

It made me feel a little weird, but I smiled and nodded and left. Now I'm wondering if I should get out of this situation, or if I'm overthinking things. Are there guidelines on this kind of thing?

posted by anonymous to Human Relations (32 answers total)

Wow. That seems way out of bounds!!
posted by saradarlin at 1:56 AM on February 13, 2017 [29 favorites]

Deeply improper.
posted by pharm at 2:00 AM on February 13, 2017 [12 favorites]

"What if I told you that one of the stories you're telling yourself about your life is wrong? I want you to watch a video."

This has all the hallmarks of a multi-level marketing scam run by your therapist. You should cancel all future appointments and find a new therapist. This is far from normal. I bet this person's certifying body would be interested too. And anyone who has to start by promising "this is all legal" is not someone you should be trusting your innermost thoughts to.
posted by ImproviseOrDie at 2:07 AM on February 13, 2017 [107 favorites]

Yikes, yikes, yikes. It sounds like she is using her practice to direct prospects to her money management business, and not TECHNICALLY entering into a dual relationship (link to a counseling org ethics code) because some other "tutor" works with you???? Yikes, yikes, yikes. I'm not qualified to say if she is unethical, but I would not return to her bc I would feel like her priority in each session isn't my life, it's how she can use what I say to get more money from me. YIKES.
posted by Snarl Furillo at 2:09 AM on February 13, 2017 [6 favorites]

We don't know where you are but my suspicion is that's improper enough to be reportable to whatever body the psychologist is registered with.
posted by deadwax at 2:09 AM on February 13, 2017 [9 favorites]

Ohhhh, I agree with ImproviseOrDie that this sounds MLM-like and that "Don't worry, it's all totally legal" is a TERRIFYING thing to hear from your therapist. Like, "You mean...there's something about this thing you want me to do...that seems illegal to reasonable people??"
posted by Snarl Furillo at 2:12 AM on February 13, 2017 [19 favorites]

I mean, this could all be above board & not an abuse of the patient - therapist relationship at all, but it’s also exactly the kind of come-on someone looking for victims for their MLM scam / pet mortgage agent with big kickbacks for them / bizarre cult / etc would use, so a good therapist would never even consider doing something like this, unless the organisation in question was already well known & very, very above board.

Opening your pitch with "Don’t worry, it’s all legal" does not make me think that this money management org is well known & very, very above board however - quite the opposite. Do you have a name for this "don’t worry, it’s all legal" bunch that you could pass to the mods? A little research would probably resolve things one way or the other.
posted by pharm at 2:17 AM on February 13, 2017 [8 favorites]

If your therapist is a psychologist (in the USA) - check out the code of ethics of the American Psychological Association. Other countries often have comparable codes, as do other therapy professions.

In my initial reading of your post I missed the bit where your therapist offered to link you up with an associate to get this information. On the surface that makes it seem less inappropriate, but I'm still concerned that if she might benefit financially from your patronage of their group, that is a conflict of interest. Aside from that, psychologists are required to limit their treatment to areas where they have an appropriate level of competence. Your psychologist has been to school for many years to gain their competence in therapy, and I'm guessing her competence in financial advising is not of a similar level. I'm also concerned that if this program is as scammy as other posters are suggesting, or depending on your degree of vulnerability, it might count as an exploitative relationship.

Bottom line - this makes me very, very uncomfortable. I would not go back and I would consider reporting.
posted by Cheese Monster at 2:19 AM on February 13, 2017 [5 favorites]

I would nope the fuck out of there and find a new therapist.
posted by wheek wheek wheek at 2:52 AM on February 13, 2017 [11 favorites]

Same. Get out, and report her.
posted by sacchan at 3:21 AM on February 13, 2017 [5 favorites]

Totally unethical.
posted by pompomtom at 4:09 AM on February 13, 2017

Okay behavior = "I think you would benefit from financial counseling, here is the phone number for [professional body for accredited financial counselors]"

Not okay behavior = what your counselor did.
posted by Sockpuppets 'R' Us at 4:24 AM on February 13, 2017 [24 favorites]

Unethical as all git out --- totally, completely, unquestionably unethical. Find another therapist plus report this one to every professional organization & licensing authority that covers her.
posted by easily confused at 4:48 AM on February 13, 2017

Even if this was cool (it's not!) this would give me serious pause:

it's completely legal

I don't want my therapist qualifying any advice as being legal.
posted by Room 641-A at 5:27 AM on February 13, 2017 [7 favorites]

Cancel all appointments with this therapist, find a new one, and in your first new session, tell them about this. This is a breach of trust on top of everything else.

I'm so sorry, but I'm glad you posted. Run away.
posted by schadenfrau at 5:44 AM on February 13, 2017 [11 favorites]

To be very clear, what makes this wrong is that the therapist is a part of this business; that she stands to get indirect or direct benefit from your participation. The other issue is that you didn't identify this as something that was a concern or stressor for you.

If you had expressed concern about the topic, and if she had referred you to a service in which she had no interest, then that might be ok.

When I felt like I needed a financial planner, my therapist gave me some names of people she knew who were trustworthy and had experience with my particular situation. That was ok because (1) I expressed a concern and a need for the service, and (2) she didn't stand to gain anything from me using their services.
posted by jeoc at 6:20 AM on February 13, 2017 [6 favorites]

It's a service that offers to teach you how to get your finances in order and then qualify to buy your first home.

Adding to what everyone else has said, these services are often offered FOR FREE from local banks who are trying to get people prepared for home buying. There's an outside chance based on what you wrote that this is what your therapist is talking about. But those usually don't involve watching videos, etc. And you wouldn't have to qualify it as "legal" because it would be obvious. So I suspect this is not what she is talking about.

Anything a therapist suggests to you that costs money where the money goes to them or to their friends outside of your therapeutic relationship is sketch city and not okay.

If it were me I'd be cancelling future appointments, reporting this person and following up on that reporting. This is super shady. Sorry you had to deal with that.
posted by jessamyn at 8:00 AM on February 13, 2017 [6 favorites]

This makes me sick. Any therapist with a fifth-grade understanding of transference would know that this was taking advantage of her patients, whether or not it's forbidden by the state ethics rules. She sounds like a bad therapist and a bad person.

This reminds me of the attorney ethics rules about sleeping with your clients. Many states (such as Virginia, where I used to practice) forbid it unless you were already hooking up before you became zir lawyer. Texas does not forbid it--but only sketchy lawyers do it, and they get a very negative reputation for it in the lawyer community.

Dump this therapist and complain to the state licensing board.
posted by radicalawyer at 8:08 AM on February 13, 2017 [1 favorite]

Joining the chorus: Get out, get a new therapist, and report this one.
posted by Tamanna at 8:25 AM on February 13, 2017

At one point my therapist recommended that I join Weight Watchers, because I'd talked a fair bit about wanting to change my weight. She didn't even have any self-interest in Weight Watchers and it felt weird to me as too prescriptive. Having a therapist say the fact that you're Not troubled about buying a house means you should join their financial services program just seems that much more troubling. If you really liked them as a therapist you could do what I did, which was just say that no, you won't be joining anything thank you. If your therapist is a good one, like mine, they'll drop it and move on. But seeing as you don't have a lengthy therapeutic relationship, I'd just move on to another therapist.
posted by ldthomps at 9:05 AM on February 13, 2017 [1 favorite]

At best, the sales pitch was inappropriate. Depending on where you are and what the ethics rules are for the therapist's licensing organization, it may also be an ethics violation.

The appropriate thing to do, if you had been very distressed about your financial situation, would have been to refer you to a reputable (preferably nonprofit) organization that offers financial literacy education.

Plus, whenever anyone says, "It's completely legal" when they're trying to pitch me something, my Nope meter goes to 100%. That's just me, of course. YMMV. IANAT, IANYT, etc.
posted by tuesdayschild at 9:24 AM on February 13, 2017 [2 favorites]

You said this therapist had been helpful to you, so let's start by being charitable and call this a mistake, a lapse in judgement. People make mistakes all the time - the issue is what they do about it.

I can imagine a well-meaning therapist feeling enthusiastic about the progress you've made. She hears what you're saying about your financial issues, and she believes that this thing she and her husband have gotten into could help you too. She realizes that this is tangential to the therapy, so she waits until your session is over (so you won't be paying for this part of the time) and she also realizes that she shouldn't work with you directly on this as it could create a conflict of interest, so she offers to hand you off to a different person.

What she *should have* done was to say nothing to you at the time, but to consult with another therapist or with a lawyer from the local professional association, asking if they thought this was a good idea. Presumably, that person would have said no, and that would have been that. Consultation with other professionals is a hallmark of high quality care, and it's called for in ethical codes. It's vital in these instances as many people's thinking on dual relationships has evolved from the old days of NO - NEVER HAVE A DUAL RELATIONSHIP. (I'm not referring to sexual dual relationships, btw, which are unambiguously unethical.). The problem here is that, in addition to her behavior likely being unethical, it's compromised the quality of her care because it has given you a new problem of deciding whether you can trust her or not.

What she should do *now* is to open the next session by saying that she thought about it and realized that her suggestion during the last session was inappropriate and apologize for doing it. She should also offer to refer you to a colleague if her mistake has damaged the therapeutic relationship. If she does that, you can decide what seems best to you.

You could cancel future sessions as many people advise above, or you could meet with her and explain that her suggestion was sufficiently disturbing that you now have concerns about working with her. Indeed, that a number of people who you told about this incident advised you to not only terminate work with her, but also report her to the licensing authority. Is she defensive? Open to talking about it? Chagrined? Supportive of you for taking the step of confronting her? See how she responds and take what action you think is best.

But don't consider having this discussion or reporting her to be an obligation for you. Consider it to be something you could do in the name of seeing if this to-date productive therapeutic relationship is salvageable.
posted by jasper411 at 10:21 AM on February 13, 2017 [4 favorites]

I am a therapist. I am not your therapist. I am a therapist in the USA in a state with fairly strict licensing requirements which are ongoing. In the US, licensing varies by state.

Her behavior is definitely weird, borderline unethical. Legality depends on her licensing; every state has different demands, from thousands of hours of on-the-job training plus ethics tests to absolutely no requirements what-so-ever. I don't know your state, so I can't speak to the effect reporting it to her state Behavioral Sciences board would have.

"Dual relationships" is a major issue for therapists but can't always be avoided. The example my professor gave was a mechanic in a small town with only one garage - driving to the next town is not always possible and the mechanic shouldn't be denied therapeutic care because the therapist has a car. Her giving you information about something else she's part of does invite a dual relationship, which is something we try to avoid in general; her placement of it indicates to me she knew she was crossing that line and was trying to do it as gingerly as possible.

Depending on how the system is set up, she may or may not profit by it. If she profits by it, I would consider it even more unethical, but her lines may be different. Because of situations where dual relationships are inevitable, though, the regulation around them tends to be lax unless the second relationship becomes sexual. It's definitely worth calling your state regulatory board if you are at all concerned; google your state Behavioral Science and it should be near the top.

It may also worth bringing it up in therapy if you feel comfortable doing so. One interesting aspect of therapy is that some of the most productive work can be between the client and therapist, working on that relationship in a healthy manner. She may or may not be equipped to do that with you - I can't speak to that - but if your issues are around advocating for yourself or communicating when you disagree with someone, this is an excellent time to do so knowing the repercussions are fairly slight.

However, your ethical boundaries are also important here. Even if it doesn't violate hers, or her legal mandate, if it violates yours that is fine, understandable, and there should be consequences for it beginning with you not working with her again. You never actually need a reason to stop seeing a therapist, and while endings may be something you want to work on, I think it's important to work on those endings with a therapist you trust and not one which you have reason to mistrust.

It's also 100% all right and healthy to cancel your next meeting and find a new therapist. If standing up for yourself isn't one of the issues you want to work on, the returns are diminished in spending more time and money on someone who put you in this position.

Good luck. I'm sorry she did this to you.
posted by Deoridhe at 11:07 AM on February 13, 2017 [7 favorites]

Textbook unethical. Like literally an example I'm going to add (deidentified) to the ethical trainings I provide.
posted by OmieWise at 11:19 AM on February 13, 2017 [3 favorites]

I have worked with therapists in the past who have given me more directive advice than a therapist probably should. It was helpful for me at the time and I am grateful, but this is WAY over that line.

A therapist should not be directing you to do anything that is not directly related to helping you process your thoughts and feelings about what is going on in your life, and those directives should be negotiated with you. Examples:

- Spend 20 minutes a morning journaling
- Try meditation
- Make your bed every morning
- Get 8 hours of sleep

Sometimes a therapist might notice that you are struggling materially in a specific way and might make a suggestion that is a little farther than that boundary. Those directives MUST be negotiated and should be made in the form of a suggestion. Such as:

- WHAT IF you started a savings account with a goal of saving $15,000?
- WHAT IF you wrote a letter to your ex and asked him to return the $3,000 he owes you?
- WHAT IF you took a pottery class?

Sometimes a therapist might make a suggestion that you see someone for auxiliary treatment. In those situations they might refer you. This is a little bit trickier, because it's possible that this person might get kickbacks - but as long as it is directly related to your treatment it is probably above board. Examples:

- I think you should consider taking an anti-depressant to help you get through this particularly difficult time. I can't prescribe, but you can talk to your PCP, or you could talk to this nurse practitioner whom I work with who is great.
- You might consider acupuncture, acupressure or yoga to help you meditate. Here are some friends of mine who you could reach out to.

A therapist should NOT be life-coaching you in this regard or referring you to services that will OBVIOUSLY help them or their family out. Examples:

You have talked about feeling a lack of confidence in your appearance. My best friend is a stylist!
You said you want to lose weight. I'm also a personal trainer!
You want to focus on performance, my uncle is a vocal teacher!
You said something about buying a home, please check out my time share business.

I have never in my life heard of a therapist doing something like this. It definitely seems over the ethical line to me, but even if it weren't, all trust would be broken between me and said therapist forever.
posted by pazazygeek at 12:45 PM on February 13, 2017 [6 favorites]

Red flag. Find a new therapist
posted by eusebis_w_adorno at 2:36 PM on February 13, 2017

Licensing violation, straight up. Report her to your state board. The reporting part is IMPORTANT. If you just don't go back then she can continue this wildly unethical behavior unchecked with other clients.
posted by The Noble Goofy Elk at 4:08 PM on February 13, 2017 [1 favorite]

Not a lawyer. Am a privacy and security professional. This likely falls afoul of the marketing prohibition of HIPAA.
posted by bfranklin at 4:52 PM on February 13, 2017

Holy shit, that's basically the worst therapist story I've ever heard, and I've heard some lulus. Get the hell away from this person, as far and as fast as you can, and absolutely consider lodging a complaint with the licensing board in your state.
posted by holborne at 7:46 PM on February 13, 2017 [1 favorite]

This is against almost everything that the American Psychological Association and American Counseling Association stand for.
posted by RainyJay at 8:14 PM on February 13, 2017

The "what if I told you," and video part screamed MLM scheme to me when I heard it, even from the preview. Praemunire is right. That and, 'this is perfectly legal,' disclaimer totally feels like a textbook MLM thing; I know because one of my best friends (and others from the organization) tried hardcore to recruit me a few years ago. I'd feel better about it if she just said, 'I know some financial advisors if you feel you need help saving,' and giving you a card and leaving it at that. It's still a bit iffy, but wording it as she did, and the video? It's super skeevy and she is abusing the trust people put in her-- taking confidential things people tell her to further her own interests.

I'd immediately change therapists, and I'd very strongly consider reporting her. It's totally out of line.
posted by Dimes at 1:35 AM on February 15, 2017

Mod note: From the OP:

Update: Thanks to everyone in this thread for the confirmation of what I was already feeling. I’ve cancelled all future appointments with the therapist, and have lodged a formal complaint, complete with documentation, with the state Board of Psychology, which licenses psychologists here in Hawai‘i. Not sure what kind of sanctions, if any, might be applicable, but I feel better knowing I’ve done something constructive about the situation.

posted by restless_nomad (staff) at 5:10 PM on February 16, 2017 [7 favorites]