August 2, 2012
I heard a story recently. Here it is, more or less:
My friend (let’s call her Bianca) has been seeing a therapist for a while now, maybe a year or so, and as far as I know has been having a rewarding experience. The therapist is a little out there, from what my friend says, and sometimes will go into side stories about herself and her somewhat dysfunctional family. Questionable boundaries, it seems…
A couple of weeks ago I was having dinner with Bianca and another friend and Bianca mentioned that she is having some issues with her therapist. She told us that Dr. X, without asking, had given her e-mail address to another patient who is also a musician. Right after a session, Dr. X informed Bianca of this and told her that she was going to receive an e-mail from this other patient, giving Bianca very little time to figure out an appropriate response before having to leave.
It bothered my friend substantially. She eventually did receive an e-mail from the other patient, who was harmless, and over the next couple of weeks, she worked up the courage to confront her therapist.
This past week, she did. She told her how it made her feel, and how she felt her privacy was violated. Dr. X apologized, but then explained that many other her patients network with one another, and if Bianca had a problem with that she should have said something earlier. Bianca was in disbelief. She reminded her therapist that she was not asked about the e-mail situation – she was told, presumably after Dr. X had already given the other patient her e-mail address (which includes her full first and last name – hello HIPAA!?!?).
This went on and on during their session, and as far as I know, Dr. X just. did. not. get. it. Things really weren’t resolved – at least for Bianca. Dr. X did not give her an opportunity to express her concern about their relationship, and instead tried to move on from the conversation with her non-apology, not taking appropriate responsibility for her lack of judgment and nonexistent patient confidentiality policy.
This woman has been practicing for over 20 years and used that as an excuse in justifying her behavior.
I am so disturbed by this story. I asked my friend if I could write a post about it, because I think it’s important for us to remember what the rules are, and that there are professionals among us who probably needed to take a refresher course somewhere along the line. We are not to share our clients names. How hard is that to remember? And that’s obviously just one piece of the puzzle. It may have even been inappropriate for Dr. X to ask Bianca if she could pass her e-mail address along to another patient of hers – therapy is not an opportunity for networking – but she didn’t even do that!
What are the requirements to remain a practicing counselor? Does a therapist have to take professional development courses or periodic ethics exams? Should they? It seems like we, as music therapists, have to do an awful lot in order to remain certified. Because of the courses I’ve taken and feedback I’ve received, I have been constantly reminded of what my standards of practice should be, and while sometimes there are questions, I ask them before anything goes awry.
I told my friend that if her therapist, in response to confrontation about the matter, had said, “Oh my god. I am SO sorry. I don’t know what I was thinking – It will never happen again,” then things might be different. We all make mistakes. We are all human. BUT, she didn’t. She had the prideful arrogance to turn the problem back on my friend, as if it was Bianca’s responsibility to keep her therapist in check.
My conclusion, is that we need to actually read the HIPAA guidelines we sign. We need to read and live by the standards of practice and the code of ethics. Not very interesting, I must admit, but I know I really wouldn’t want to be responsible for one of my patients feeling violated and unsafe.
Doesn’t that defeat the purpose of therapy?