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.)

Actually, based upon what you've said, DH wants out and doesn't wantto "get that he is the customer". His counselor isn't getting involved because he's leaving the marriage.

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?

OP here. I never said this

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.)

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?

Anonymous wrote:I don’t know if it is unprofessional but it sounds lazy to me. It’s entirely possible for two therapists to have a conversation about mutual clients, with client consent, without breaching confidence. The therapist just doesn’t want to do it.

Anonymous wrote:I’m a betrayed wife attacked by I’m guessing cheaters or OW a few pages back- it was my husband’s therapist that wanted to speak to me every couple of months to see what he was doing at home and what I was seeing as part of the ongoing evaluation and accountability for this particular mental health diagnosis. And, he was very transparent with everyone during this process. He wanted to get healthy.

Anonymous wrote:

Anonymous wrote:

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.

Having a conversation and trying to come to an agreement is a bad thing? Trying to understand why someone doesn’t want information shared is a bad thing?

I never said I would disclose without a patient’s consent.

No one on this thread knows what’s going on with the OP’s husband, not really. But the fact is that competent healthcare professionals can and do talk with other competent healthcare professionals about patient care *when granted consent to do so*. Mental health is health. Mental healthcare is healthcare.

Anonymous wrote:^^also, thank you, LCSW, for writing out the relevant issues so clearly and thoughtfully. Informed consent is an ongoing process!

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.

Anonymous wrote:

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.