Contacting a friend's therapist for advice
April 10, 2020 5:48 AM   Subscribe

I'm close friends with someone—call them A. I'm in the unfortunate position of having to deliver bad news to A, news A might take quite hard. A suffers from depression and sees a therapist. A is open about this and has told me who their therapist is. I have been considering emailing A's therapist for advice on the best way to break the bad news to A. Is this ethical? Is it a good idea? If so, how should I go about it? Would A's therapist have to disclose to A that I reached out?

A and I are not in a romantic relationship—the news in question has nothing to do with cheating or anything like that. It is also not about a friendship break-up. It is news which will make our close friendship less close in a way I think will be more upsetting for A than it would be for the average person.
posted by anonymous to Grab Bag (22 answers total)
Don't insert yourself in A's private, personal relationship with their therapist. You have no place in this relationship. If you need advice on this, contact your own therapist, and get advice from them.

Telling a friend you are seeing a therapist is very different thing to having that friend form a relationship with the therapist. Patients need to have absolute trust and confidentiality in their therapist; by reaching out you are jeopardising that relationship.
posted by smoke at 5:54 AM on April 10, 2020 [53 favorites]

I don't think A's therapist would be allowed to tell you anything that comes from knowledge of A they have gained in their sessions with them. They probably can't even confirm that they are seeing A. So they won't be able to help you directly. Maybe giving them a heads up that A is about to get some bad news would help them help A better in their next session, but I can't really see that being much use either, and it would be awkward for everyone.
posted by lollusc at 5:54 AM on April 10, 2020 [8 favorites]

Like, the only circumstance where I might consider reaching out is if you seriously think A might harm themselves as a result of your news. Even then the therapist won't be able to talk to you about A, but might be able to check in on them.
posted by lollusc at 5:56 AM on April 10, 2020 [9 favorites]

Not ethical and not a good idea. If you ask A's therapist for advice they should refuse to interact with you on ethical and confidentiality grounds. The most you could do (which I still do not advise) is to inform A's therapist "I'm about to do X which might cause issues for A and wanted you to know" - but again, don't do it.

Do you know when A sees their therapist? Try to time your talk with A shortly before that so if they need to process immediately they can.
posted by Flannery Culp at 5:59 AM on April 10, 2020 [8 favorites]

The therapist cannot answer your question.
posted by AlexiaSky at 6:03 AM on April 10, 2020 [39 favorites]

^ That is the most concise answer. If they do, you should let A know so they can dump their unethical therapist as well as you as a friend.
posted by Flannery Culp at 6:08 AM on April 10, 2020 [2 favorites]

No ethical therapist will participate in this. Your approach is patronizing and does not treat A as an adult. When you give A the news, be open and ask for A's feelings. Recommend that A check in with their therapist and offer to sit with A while they call the therapist. If A is in danger of self-harm, call 911.
posted by theora55 at 6:39 AM on April 10, 2020 [15 favorites]

You could maybe ask a mutual friend for advice on how to proceed, that would be much normal and reasonable. Still some potential ethical issues though; ymmv.
posted by SaltySalticid at 6:46 AM on April 10, 2020 [1 favorite]

Frankly, this is bizarre and a hugely inappropriate overreach. NO, do not reach out to your friend’s therapist behind their back. What? Their therapist will not talk to you, will find it totally strange, and yes may warn their client about you.

As someone above said, a completely different situation is if a friend is actively threatening self-harm and, with the friend’s permission, you are facilitating scheduling a session for them to talk with their therapist.
posted by amaire at 6:56 AM on April 10, 2020 [8 favorites]

The therapist is your friend’s resource, not yours. If the news is upsetting and they need a safe space to process it, they are very aware that they have a therapist - that’s why they hired them!
posted by Jubey at 7:33 AM on April 10, 2020 [6 favorites]

I'm seriously mentally ill, and sometimes dealing with this has meant giving my friends or my partner permission to communicate with my therapist.

100% of the time, even in urgent situations, it has required my explicit consent and a bunch of paperwork. As others are pointing out, without that, my therapist couldn't even tell people I was their client, even if it was someone who said "I already know Leah is your client, she talks to me about it all the time."

A's therapist may or may not pass the news on that you contacted them. I don't think you can count on them either to be a reliable messenger or to reliably keep your secret. Neither of those things is part of their job description.

Just tell A the truth directly and let them react how they react. You aren't entitled to their calm acceptance, and you aren't responsible for any rash thing they do as a result. They might be mad or sad or scared, and you might feel some ways about that reaction, and that's how this shit goes. Just be honest, support them as best you can, and let it be what it is.
posted by nebulawindphone at 7:36 AM on April 10, 2020 [23 favorites]

Just tell A what you need to tell them and let them react however they react and trust they can manage their responses with their therapist if they feel the need to.
posted by koahiatamadl at 8:21 AM on April 10, 2020 [1 favorite]

I agree with everyone above, but I also acknowledge that you're coming to this from a compassionate place, and you're trying to help your friend with the tools they have available. But obviously this isn't the right plan.

Perhaps you might try saying to A: "I have some difficult news to share with you. Would you like it if we talked about it with your therapist present?"

Maybe the therapist could act as a helpful third-party to help A process the news you need to deliver?
posted by hydra77 at 8:29 AM on April 10, 2020 [11 favorites]

You absolutely cannot and should not engage with their therapist on this unless your friend has given you and the therapist explicit written permission for it. At the very most, if you know e.g. what day their therapy is, you could time the advice-giving for when you know they'll have therapy within a couple of days. But even that's a bit much; just tell your friend what you have to tell them, honestly and kindly, and leave it to them to manage their own emotional response to the news.
posted by Stacey at 9:20 AM on April 10, 2020 [1 favorite]

If you are in the US, the therapist is legally obligated not to respond to your email. They aren't even allowed to confirm or deny that A is a client. The exception would be if A had explicitly given the therapist permission to speak with you as an informed other, and even then, the therapist should have some ethical way of confirming your identity beyond an email.

Other juridictions may have similar rules ; I recall a big scandal in the UK several years ago when a tabloid reporter pretended to be QE2 and called the hospital where Kate Middleton was hospitalized for hyperemesis. A nurse gave them the information they asked for, was fired, and then died by suicide.
posted by basalganglia at 9:45 AM on April 10, 2020 [1 favorite]

No, the therapist won't (should not) talk to you.
If you know when your friend's therapy appointment is, you might want to deliver your bad news shortly before that so your friend will have the support of the therapist shortly afterwards.
posted by SLC Mom at 10:23 AM on April 10, 2020 [3 favorites]

Emphatic nope. And even if you did contact the therapist, unless that therapist was extremely unethical and unafraid of potential legal consequences, they wouldn't talk to you.
posted by less of course at 10:23 AM on April 10, 2020 [1 favorite]

(To be slightly more specific and give you a sense of the degree to which this is a non-starter, the therapist can not ethically acknowledge to you that your friend is a client.)
posted by less of course at 10:30 AM on April 10, 2020 [2 favorites]

aside from absolutely everything else, even a therapist willing to violate all professional standards to try to help you would not be able to help you, because nobody can answer the question you want to ask ('what is the best way to break bad news to this particular person.') That isn't something their work equips them to know. only wizards are professionally trained to answer such questions.

And if you are A's close friend, you should know them better than their therapist does, no matter how good a therapist they are. If knowing a person well could tell you how to upset them correctly, you would be the best person to answer your own question.

(and hey, if you know so much about their therapy/therapist, why not schedule your bad-news drop for two hours before their next therapy appointment. that's at least practical. sort of.)
posted by queenofbithynia at 12:07 PM on April 10, 2020

The therapist likely would not even acknowledge your friend as a client. I once reached out to a colleague's mental health counselor. My colleague was at home and in a major mental health crisis and was reaching out to me (we weren't really friends and it was really difficult for me to know what to do). I kept asking her to contact her counselor but she wouldn't but she gave me that person's name and contact information. I contacted the counselor. The counselor said, "I can't confirm if that person is my client. However, I would suggest if you were in a situation with someone having a mental health crisis, you could reach out to so-and-so."

This sounds like a situation where you might talk to a therapist to figure out how to approach this with A, or time your conversation. But this idea, while perhaps well-intentioned, is not the way to approach this.
posted by bluedaisy at 3:00 PM on April 10, 2020 [1 favorite]

Why are you so eager to insert yourself into this? How does it concern you?
posted by cookie-k at 10:41 AM on April 11, 2020 [2 favorites]

I think the best you can do, if you know which day/s they see their therapist, is to tell them the news the day before or day of their next appointment, so they don't have to wait long to process their feelings with some professional support.
posted by Zaire at 10:55 PM on April 11, 2020

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