Dear Doctor Robert,
I have been with my current therapy for nearly three years. Our
work has been so/so, but I have been able to make some positive changes in my
life. I am writing you because I am seriously afraid to go back to therapy.
Several months ago, I mentioned to my therapist that I did not like when his
receptionist (who also does his billing) used my whole name when calling
upstairs to let him know I was there. Often the small waiting room was
populated with other people and it made me really uncomfortable. I should also
mention that I live in Vermont, which is 97% white and I am a black female. I
am very visible in my community and this adds to my concern about privacy and
confidentiality. At the start of my session I asked my therapist if it was
possible that his assistant say, "Your 4:30 is here." Instead of
announcing my name, a request I felt was reasonable. I didn't focus on the
problem and offered a solution.
The next time I came in for a session his receptionist made a point of
enunciating, "Scott, your 4:00 is here." and gave me a look which
made me feel uncomfortable. In session I asked him if he had offered his
receptionist the feedback anonymously or had he mentioned that I had made the
request. He said he had told it her that I did. I thought this seemed like a
confidentiality breach, as this was something I said to him during our session.
He then explained that she was part of the staff and bound by confidentiality.
I realize that legally he covered his behind, but I feel sick inside thinking
that I don't have any way of controlling what kind of information he discloses
about me. I have brought the issue up several times and (just typing this is
making me cry) and each time he just reminds me that I signed the
confidentiality policy and he has done nothing wrong. I am at a loss as to what
to do. I feel helpless and as though I have no recourse.
Ange
Hello, Ange--
Although your therapist probably is correct technically, as a practical matter has handled this situation
unskillfully to say the least. In the first place, he should have told his
receptionist to announce all patients in the same way, just as you imagined he
would, without specifying to her why she was to do so. The "why" is
none of her business. In the second place, replying to your very real concerns
about your privacy in the legalistic way that he did speaks poorly for
his intentions, sensitivity, and honor as a therapy professional. His chief
concern should have been about you and your feelings, not the legalities of the
situation. Your therapist, having made a mistake, should have admitted
it to you immediately, apologized for his error, and assured you that it would never happen again. Instead, when you repeatedly tried to make him
understand that he injured you by his insensitivity, he beat you back with
legalisms, further injuring the place in you which already feels a bit too
visible. Perhaps if, by some magic, he could be forced to spend a few days
walking around with black skin in Vermont, he would be a bit more able to
understand.
You are absolutely correct in
saying that his receptionist should not know anything about what happens in his
consulting room, and, despite what he told you, she is not bound by confidentiality in the same way that he is.
If she violated your privacy by telling someone, for example, that you are a
patient who likes to complain, she could be fired by him, but that is all. If
he did the same thing, he would have to face the Vermont authorities, could lose his
license to practice, and possibly face a lawsuit. Those two situations are not equal, and he knows it very well.
Since you say that your work has been only "so-so," I would suggest
leaving this second-rate guy behind, and finding a new, better therapist. That
is your recourse. I understand that the
idea of beginning again with someone new could seem daunting, but I imagine that in the event
you will find it not too difficult, that you will not have lost anything already gained in your therapy with your current therapist, and probably, once you connect with a
better practitioner, will find that you should have left this therapist long ago. He is
not worthy of you.
Be well.
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