It sounds to me very possible that the husband is hiding behind the therapist's "policy" as a way to avoid discussing why he's not comfortable with the disclosure.

I'm a LCSW in private practice, which I hate posting on this board because y'all backseat drive everyone's professions and are pretty quick to condemn (see above). My policy is that for coordination of care (including communicating with your marriage counselor, your prescriber, your midwife, your PCP, your kid's school, etc. depending on what care is happening), we talk through the informed consent. The release is topic specific and clearly states what kinds of information will be provide. Session progress notes have to be specifically requested and are not generally provided without a court order in order to protect confidentiality. I wouldn't share my notes outside that context. But coordination of care conversations exist separately from those things in that they are people talking about the collective treatment of a specific problem for a specific person.

If a client's marriage counselor approached me with a release of information I hadn't heard about from my client first, I would want to discuss it with my client, particularly if I was an old school person with a hard line policy. Not in a "pressuring someone to disclose things they aren't comfortable with" or "pressuring someone to talk about childhood trauma" or whatever the PP is being accused of - because I would want to understand their resistance as part of MY work with them. If it seemed like my client had been pressured to sign that release by his wife or as part of a lot of open communication he wasn't comfortable with, I would be ethically obligated to disclose nothing to the marriage counselor. I have never been in this situation, FWIW. It would be a big deal for that case, for me, and I would definitely need to have clarifying conversations about how to handle that kind of disclosure issue.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Your husband is the driver here, not his therapist. If *he* wants her to talk to another healthcare professional who provides care for him, she should do so. I’d argue that not doing so is unethical. That said, her resistance is bizarre and unprofessional - it would make me suspect he’s hiding something huge, frankly.

OP here. This does concern me. I agree - he is totally the driver. He doesn’t seem to get that he is the customer here. (Or client.)

I know he signed it because it was submitted on our account online. Our therapist wouldn’t have reached out to his without it.

Also you only know. What he’s telling you - you don’t know that he actually signed the consent.

And she might think that it would be harmful to him to talk with your marriage therapist

Is the individual counselor’s policy that she doesn’t talk to marriage counselors unless there is a signed consent?

I thought it was she doesn’t talk to marriage counselors unless there is a court order.

I’m not a lawyer, but I think “consent form” and “court order” are different things.

OP’s husband is lying to her or OP is confused. Simplest answer is usually the right answer.

Husband uploaded consent form to marriage counselor to get OP off his back, but told individual therapist he does not consent to sharing. Individual therapist rightly told marriage counselor that without a court order, she cannot share.

Correct.

Now OP and husband need to decide what happens next. Can they live in a marriage where one spouse is demanding access to medical records, and the other is keeping secrets?

This is not a healthy marriage.

Anonymous wrote:I think OP might be an abusive spouse, looking for ways to get at his/her spouse’s therapy notes, so he can use them to continue abusing his/her spouse.

There is something wrong with the situation, for sure.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is there to coordinate, though? Marriage therapy uses a different muscle, and has a different focus, than individual therapy. I wouldn’t necessarily think to have a marriage counselor consult with my individual therapist. I imagine you have specific circumstances that makes it more of a necessity?

Interdisciplinary healthcare is standard of practice. I don’t even consider couples therapy and individual therapy different disciplines, so this example is even more egregious; imagine if, say, someone’s PCP refused to talk to their ophthalmologist because it’s their “policy.” This situation is no different. As a therapist (I’m the psychologist PP), you’re darn right I want information from other healthcare professionals treating my patients, if there’s consent. It only improves my care - I’m one person and I only see this person in one context. When I worked inpatient, we had interdisciplinary rounds daily and at every single one of those, someone in one discipline, e.g., occupational therapy, shared information that a healthcare provider in a different discipline, e.g., psychiatry, hadn’t known about the patient and which was *relevant to their care*. Refusing to talk to any other healthcare professionals about anything is unethical care.

And what would you do if your long-time client cane to you with a consent to discuss his treatment with a marriage counselor, but told you that he signed it to placate his wife and he really didn't want you to have any discussions with the counselor?

Generally, I think it’s helpful in those cases to (1) examine why someone doesn’t want information shared and (2) see if we can come to an agreement on sharing some information. Some people seem to have a misunderstanding about what this kind of information sharing looks like. No one’s handing over audio recordings of any session or even progress notes from every session. It’s about two healthcare professionals having a phone/video call to discuss general issues of relevance, e.g., differential diagnosis, areas of treatment focus, etc.

To the PP who appreciated my earlier post about therapy being healthcare: thank you for your response. I’m glad you understood the point I was trying to make.

To the PP who thinks therapy isn’t healthcare: you’re wrong. Mental health is health. Licensed therapists are healthcare professionals just as much as are physicians, nurses, physical therapists, occupational therapists, audiologists, speech therapists, etc. Societal stigma around mental illness is problematic, but it doesn’t dictate, legally, what healthcare is, thank goodness.

Wow, you are really clueless. OP said her husband has a history of childhood trauma. Insisting, suggesting, coercing, or pestering a client to share confidential information is awful. Your stance shows you cannot be an effective therapist if you are incapable of understanding.

I hope you disclose your stance to your clients before they start seeing you. I would rather see the therapist who was adamant they won’t ever share. Which therapist are people with childhood trauma going to be more comfortable trusting and disclosing information?

You and others need to learn to read before slandering me. I never, ever, used words like insist, suggest, coerce, pester, or pressure. It’s also impossible to provide anything beyond a general response without knowing the individual patient and the situational specifics. Generally, though, it’s good clinical practice to communicate honestly with your patients. That goes for therapists and physicians, etc., alike.

This thread is a painful exhibit on just how deeply stigma around mental illness is entrenched in our culture. It’s heartbreaking. It sure as hell doesn’t help anyone.

Oh stop with the dramatics. You slandered yourself when you suggested you would try to “come to an agreement” about sharing when a patient doesn’t want to share.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Your husband is the driver here, not his therapist. If *he* wants her to talk to another healthcare professional who provides care for him, she should do so. I’d argue that not doing so is unethical. That said, her resistance is bizarre and unprofessional - it would make me suspect he’s hiding something huge, frankly.

OP here. This does concern me. I agree - he is totally the driver. He doesn’t seem to get that he is the customer here. (Or client.)

I know he signed it because it was submitted on our account online. Our therapist wouldn’t have reached out to his without it.

Also you only know. What he’s telling you - you don’t know that he actually signed the consent.

And she might think that it would be harmful to him to talk with your marriage therapist

Is the individual counselor’s policy that she doesn’t talk to marriage counselors unless there is a signed consent?

I thought it was she doesn’t talk to marriage counselors unless there is a court order.

I’m not a lawyer, but I think “consent form” and “court order” are different things.

OP’s husband is lying to her or OP is confused. Simplest answer is usually the right answer.

Husband uploaded consent form to marriage counselor to get OP off his back, but told individual therapist he does not consent to sharing. Individual therapist rightly told marriage counselor that without a court order, she cannot share.

I think OP might be an abusive spouse, looking for ways to get at his/her spouse’s therapy notes, so he can use them to continue abusing his/her spouse.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is there to coordinate, though? Marriage therapy uses a different muscle, and has a different focus, than individual therapy. I wouldn’t necessarily think to have a marriage counselor consult with my individual therapist. I imagine you have specific circumstances that makes it more of a necessity?

Interdisciplinary healthcare is standard of practice. I don’t even consider couples therapy and individual therapy different disciplines, so this example is even more egregious; imagine if, say, someone’s PCP refused to talk to their ophthalmologist because it’s their “policy.” This situation is no different. As a therapist (I’m the psychologist PP), you’re darn right I want information from other healthcare professionals treating my patients, if there’s consent. It only improves my care - I’m one person and I only see this person in one context. When I worked inpatient, we had interdisciplinary rounds daily and at every single one of those, someone in one discipline, e.g., occupational therapy, shared information that a healthcare provider in a different discipline, e.g., psychiatry, hadn’t known about the patient and which was *relevant to their care*. Refusing to talk to any other healthcare professionals about anything is unethical care.

And what would you do if your long-time client cane to you with a consent to discuss his treatment with a marriage counselor, but told you that he signed it to placate his wife and he really didn't want you to have any discussions with the counselor?

Generally, I think it’s helpful in those cases to (1) examine why someone doesn’t want information shared and (2) see if we can come to an agreement on sharing some information. Some people seem to have a misunderstanding about what this kind of information sharing looks like. No one’s handing over audio recordings of any session or even progress notes from every session. It’s about two healthcare professionals having a phone/video call to discuss general issues of relevance, e.g., differential diagnosis, areas of treatment focus, etc.

To the PP who appreciated my earlier post about therapy being healthcare: thank you for your response. I’m glad you understood the point I was trying to make.

To the PP who thinks therapy isn’t healthcare: you’re wrong. Mental health is health. Licensed therapists are healthcare professionals just as much as are physicians, nurses, physical therapists, occupational therapists, audiologists, speech therapists, etc. Societal stigma around mental illness is problematic, but it doesn’t dictate, legally, what healthcare is, thank goodness.

Wow, you are really clueless. OP said her husband has a history of childhood trauma. Insisting, suggesting, coercing, or pestering a client to share confidential information is awful. Your stance shows you cannot be an effective therapist if you are incapable of understanding.

I hope you disclose your stance to your clients before they start seeing you. I would rather see the therapist who was adamant they won’t ever share. Which therapist are people with childhood trauma going to be more comfortable trusting and disclosing information?

You and others need to learn to read before slandering me. I never, ever, used words like insist, suggest, coerce, pester, or pressure. It’s also impossible to provide anything beyond a general response without knowing the individual patient and the situational specifics. Generally, though, it’s good clinical practice to communicate honestly with your patients. That goes for therapists and physicians, etc., alike.

This thread is a painful exhibit on just how deeply stigma around mental illness is entrenched in our culture. It’s heartbreaking. It sure as hell doesn’t help anyone.

OP forget about marriage therapy, it’s going to be a waste of time. You need to reflect on your financial and personal life and consider whether you are going to be better off with or without your husband.

I chose to stay because financially it was the right thing to do for my kids and myself. I realized ten years ago when I found out my husband was cheating that I didn’t have my ducks in a row to leave him and end up ahead or even at the same level. He made $750k while I made 75k. I met with a financial planner which was way better than spending money on marriage therapy. I came up with a game plan to set me up financially and didn’t disrupt our kids’ lives. I ended up quitting my job so I wasn’t so stressed out, and I had time to travel with my husband on several business trips (he cheated on business trips to one city). I made sure my husband got a vasectomy so assets wouldn’t have to ever be split with a new family, we took up a new hobby together, and I learned how to squirrel away money. Life isn’t perfect but we get along so I realized it was better that I stayed with him.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Your husband is the driver here, not his therapist. If *he* wants her to talk to another healthcare professional who provides care for him, she should do so. I’d argue that not doing so is unethical. That said, her resistance is bizarre and unprofessional - it would make me suspect he’s hiding something huge, frankly.

OP here. This does concern me. I agree - he is totally the driver. He doesn’t seem to get that he is the customer here. (Or client.)

I know he signed it because it was submitted on our account online. Our therapist wouldn’t have reached out to his without it.

Also you only know. What he’s telling you - you don’t know that he actually signed the consent.

And she might think that it would be harmful to him to talk with your marriage therapist

Is the individual counselor’s policy that she doesn’t talk to marriage counselors unless there is a signed consent?

I thought it was she doesn’t talk to marriage counselors unless there is a court order.

I’m not a lawyer, but I think “consent form” and “court order” are different things.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes he signed a release.

He did it for show. He doesn't want his therapist talking to the joint therapist. His therapist is being the "bad guy" by refusing, but is doing so at your dh's request.

If the therapist says it's her policy not to speak to other therapists, but that's not actually her policy and she is covering for a client, that would be dishonest and wrong.

Does OP actually know this is her stated policy? Or is she just hearing this from her husband?

m

Our therapist told us this is what she said.

Oops. Your story is changing.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is there to coordinate, though? Marriage therapy uses a different muscle, and has a different focus, than individual therapy. I wouldn’t necessarily think to have a marriage counselor consult with my individual therapist. I imagine you have specific circumstances that makes it more of a necessity?

Interdisciplinary healthcare is standard of practice. I don’t even consider couples therapy and individual therapy different disciplines, so this example is even more egregious; imagine if, say, someone’s PCP refused to talk to their ophthalmologist because it’s their “policy.” This situation is no different. As a therapist (I’m the psychologist PP), you’re darn right I want information from other healthcare professionals treating my patients, if there’s consent. It only improves my care - I’m one person and I only see this person in one context. When I worked inpatient, we had interdisciplinary rounds daily and at every single one of those, someone in one discipline, e.g., occupational therapy, shared information that a healthcare provider in a different discipline, e.g., psychiatry, hadn’t known about the patient and which was *relevant to their care*. Refusing to talk to any other healthcare professionals about anything is unethical care.

And what would you do if your long-time client cane to you with a consent to discuss his treatment with a marriage counselor, but told you that he signed it to placate his wife and he really didn't want you to have any discussions with the counselor?

Generally, I think it’s helpful in those cases to (1) examine why someone doesn’t want information shared and (2) see if we can come to an agreement on sharing some information. Some people seem to have a misunderstanding about what this kind of information sharing looks like. No one’s handing over audio recordings of any session or even progress notes from every session. It’s about two healthcare professionals having a phone/video call to discuss general issues of relevance, e.g., differential diagnosis, areas of treatment focus, etc.

To the PP who appreciated my earlier post about therapy being healthcare: thank you for your response. I’m glad you understood the point I was trying to make.

To the PP who thinks therapy isn’t healthcare: you’re wrong. Mental health is health. Licensed therapists are healthcare professionals just as much as are physicians, nurses, physical therapists, occupational therapists, audiologists, speech therapists, etc. Societal stigma around mental illness is problematic, but it doesn’t dictate, legally, what healthcare is, thank goodness.

Wow, you are really clueless. OP said her husband has a history of childhood trauma. Insisting, suggesting, coercing, or pestering a client to share confidential information is awful. Your stance shows you cannot be an effective therapist if you are incapable of understanding.

I hope you disclose your stance to your clients before they start seeing you. I would rather see the therapist who was adamant they won’t ever share. Which therapist are people with childhood trauma going to be more comfortable trusting and disclosing information?

100% agree. Op, read up on the effects of childhood trauma and give dh some grace.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is there to coordinate, though? Marriage therapy uses a different muscle, and has a different focus, than individual therapy. I wouldn’t necessarily think to have a marriage counselor consult with my individual therapist. I imagine you have specific circumstances that makes it more of a necessity?

Interdisciplinary healthcare is standard of practice. I don’t even consider couples therapy and individual therapy different disciplines, so this example is even more egregious; imagine if, say, someone’s PCP refused to talk to their ophthalmologist because it’s their “policy.” This situation is no different. As a therapist (I’m the psychologist PP), you’re darn right I want information from other healthcare professionals treating my patients, if there’s consent. It only improves my care - I’m one person and I only see this person in one context. When I worked inpatient, we had interdisciplinary rounds daily and at every single one of those, someone in one discipline, e.g., occupational therapy, shared information that a healthcare provider in a different discipline, e.g., psychiatry, hadn’t known about the patient and which was *relevant to their care*. Refusing to talk to any other healthcare professionals about anything is unethical care.

DP, not the OP, but: Thank you for posting here and pointing out the importance of healthcare professionals actually communicating with each other! I think some PPs are agitated about some idea of "a therapist must never tell the spouse/another therapist anything, ever" but they are not seeing therapy as healthcare in the way you can. It really is not uncommon for this type of sharing to take place, despite what some PPs insist. Sadly for OP and the marriage, it sounds as if the DH and his therapist are going to be a united front against any sharing.

That’s because therapy actually isn’t “healthcare” the same as if the patient has diabetic eye problems and the ophthalmologist has to talk to the endocrinologist. In some cases it might be for severe mental illness - the individual therapist might have useful information about that to share with the marriage therapist. But I get the vibe from OP that she just doesn’t think her DH has the right to confidentiality with his therapist, or there’s some secret the individual therapist knows that she wants to force out. Regular healthcare doesn’t really deal with confidences in the same way.

I have a lot of physical medical issues and I have to consent for my doctors to talk to each other.

I had surgery last fall, and I had to sign paperwork at three different offices so they could share notes, labs, x-rays, medicinal history, etc (surgeon, referring specialist, and the concierge PCP I pay $2000 per year to coordinate care).

Everytime I get labwork done, I need to sign a form that says who, besides the ordering physician, can get the results.

I agree that this sounds like a case of the husband telling his provider he didn’t actually consent to sharing info. Or the husband’s provider has this policy because she knows how many of her clients are coerced into signing consent forms by spouses who NEED to know things.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is there to coordinate, though? Marriage therapy uses a different muscle, and has a different focus, than individual therapy. I wouldn’t necessarily think to have a marriage counselor consult with my individual therapist. I imagine you have specific circumstances that makes it more of a necessity?

Interdisciplinary healthcare is standard of practice. I don’t even consider couples therapy and individual therapy different disciplines, so this example is even more egregious; imagine if, say, someone’s PCP refused to talk to their ophthalmologist because it’s their “policy.” This situation is no different. As a therapist (I’m the psychologist PP), you’re darn right I want information from other healthcare professionals treating my patients, if there’s consent. It only improves my care - I’m one person and I only see this person in one context. When I worked inpatient, we had interdisciplinary rounds daily and at every single one of those, someone in one discipline, e.g., occupational therapy, shared information that a healthcare provider in a different discipline, e.g., psychiatry, hadn’t known about the patient and which was *relevant to their care*. Refusing to talk to any other healthcare professionals about anything is unethical care.

And what would you do if your long-time client cane to you with a consent to discuss his treatment with a marriage counselor, but told you that he signed it to placate his wife and he really didn't want you to have any discussions with the counselor?

Generally, I think it’s helpful in those cases to (1) examine why someone doesn’t want information shared and (2) see if we can come to an agreement on sharing some information. Some people seem to have a misunderstanding about what this kind of information sharing looks like. No one’s handing over audio recordings of any session or even progress notes from every session. It’s about two healthcare professionals having a phone/video call to discuss general issues of relevance, e.g., differential diagnosis, areas of treatment focus, etc.

To the PP who appreciated my earlier post about therapy being healthcare: thank you for your response. I’m glad you understood the point I was trying to make.

To the PP who thinks therapy isn’t healthcare: you’re wrong. Mental health is health. Licensed therapists are healthcare professionals just as much as are physicians, nurses, physical therapists, occupational therapists, audiologists, speech therapists, etc. Societal stigma around mental illness is problematic, but it doesn’t dictate, legally, what healthcare is, thank goodness.

Wow, you are really clueless. OP said her husband has a history of childhood trauma. Insisting, suggesting, coercing, or pestering a client to share confidential information is awful. Your stance shows you cannot be an effective therapist if you are incapable of understanding.

I hope you disclose your stance to your clients before they start seeing you. I would rather see the therapist who was adamant they won’t ever share. Which therapist are people with childhood trauma going to be more comfortable trusting and disclosing information?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes he signed a release.

He did it for show. He doesn't want his therapist talking to the joint therapist. His therapist is being the "bad guy" by refusing, but is doing so at your dh's request.

If the therapist says it's her policy not to speak to other therapists, but that's not actually her policy and she is covering for a client, that would be dishonest and wrong.

Does OP actually know this is her stated policy? Or is she just hearing this from her husband?

m

Our therapist told us this is what she said.

To add, in fact, she said she has never had this happen in her career.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes he signed a release.

He did it for show. He doesn't want his therapist talking to the joint therapist. His therapist is being the "bad guy" by refusing, but is doing so at your dh's request.

If the therapist says it's her policy not to speak to other therapists, but that's not actually her policy and she is covering for a client, that would be dishonest and wrong.

Does OP actually know this is her stated policy? Or is she just hearing this from her husband?

m

Our therapist told us this is what she said.