10 things your therapist won’t tell you.

There’s an interesting post from Psych Central about 10 things your therapist won’t tell you about therapy.  If you have any questions about this after reading it, let me know.

The only one I’d really differ on is about client access to records.  Yes, there will be hemming and hawing, but it is more to make sure that there is nothing in the chart that violates another person’s confidentiality.  Generally, I prefer to go over the chart materials with the client present.

It is a real shame that people have to have a mental health diagnosis even if they don’t want one.  Luckily, there are some generic diagnoses out there that can be used, like “Adjustment disorder”, “Mood disorder, not otherwise specified”, etc.  However, the problem is, you won’t get more than about 8 sessions from your insurance company with a diagnosis like this.  Just because you have 20 sessions on your plan doesn’t mean that you will get all 20 sessions.  Insurance reserves the right to say that you don’t need it, medically speaking.  Any questions, let me know.

About Nate Prentice, MSW, LCSW, CAS-PC

Nate Prentice, MSW, LCSW is a Licensed Clinical Social Worker and Pastoral Counselor who maintains a private psychotherapy practice in Drexel Hill, PA.
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4 Responses to 10 things your therapist won’t tell you.

  1. Frank Kautz says:

    Interesting. Much of it will also work for lawyers. The only issue I have is the issue with the chart. If it is in the chart, it is no longer someone’s confidence, it is now part of the chart. It is discoverable in a lawsuit, and under HIPAA, must be given to the client, without charge, upon request. A lot of health professionals forget this, some because they never knew it, and some intentionally because they want some compensation for the file or they feel it is their file not the patients. The old politicians maxim comes to mind: Never put it in writing if you can say it, never say it if you can get it across with a nod, never nod if you can wink, …”

  2. nateprentice says:

    Let me give you a hypothetical. A couple comes to me for therapy. Joe eventually divorces Anne. Anne wants something Joe says in couples therapy released to the courts, thereby stepping on Joe’s rights. Of course, I would hesitate to release all of the info to the court without checking with a lawyer first.

    What do you think?

  3. Anxious 1 says:

    I’m seeing a therapist right now.She is young and is helping me with a.d.d.,depression and anxiety. I asked her about confidentiality and her reply was only a judge could get a hold of my file. I told her that if I wanted a job in a national lab involving national security they do an extensive background check which includes ones like ones she keeps. I don’t believe her for 1.Two I’m gonna check around on this to verify if what she says is true. She told me someone could dig and dig and dig and never find my records.Their not stored in her office she says. 3) I overheard this subhuman,bottom feeding,bigoted boss in Livermore,CAL. say he had a way to get around HIPAA. He’ll be sued soon & I’ll leave a letter in his wifes mail box so she’ll know why in case he has extra streams of income.4) The transmission of private records from one place to another gives me grave concern regardless of safe guards especially after getting a new a.t.m. card because of compromised a.t.m. card no.#s at a major super market.
    I also wonder if those records are used without a clients knowledge for research or development of college texts and so forth.

  4. Nate Prentice says:

    In general, I’m no lawyer, I’m a psychotherapist. My understanding is that yes, someone can subpoena records. However, all a subpoena requires is that a response be given. That is where the lawyer for the client and the therapist come in In terms of deciding what is released. I am aware of three automatic exclusions to confidentiality–danger to self, homicidality, and abuse of a vulnerable person, e.g. A child. For specific questions such as yours, I would suggest consulting a lawyer. Hope this helps.

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