Found Journal - Need Advice

Parent Cafe
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<p>It just doesn’t make any sense at all that ‘confidentiality’ means you disclose all you heard from parent and tell client. Patient confidentiality has to be protected…but what on earth does this have to do with YOUR words going from therapist to patient? It’s nonsensical. Not to mention, why wouldn’t the therapist tell you this before you got into it with her? </p>

<p>As for the stuff you read, I realize you gave just an abbreviated version and of course I don’t know the larger context that drives her to the therapist etc, but as an adult in college, it doesn’t seem that big of a deal to me. Yes of course its illegal to sell her adderall or buy booze for other people but hardly ‘drug pushing’ and quite within the realm of ‘normal’. And smoking pot and drinking is not itself a symptom of some bigger problem. And of course she seems to you like a totally different person- college kids usually are to parents (that is why the statistics show a gigantic percentage of students drink, yet most parents on CC say ‘oh but not my kid’). </p>

<p>I’m not advocating any sort of specific behavior here (and I would not be happy if my child did any of these things), but I’d also not assume some deeper meaning to it either (and I have a really nerdy kid). And to put this in perspective, I drank and smoked pot in college, as did almost all of my current colleagues (all of whom are now successful, happy professors). In fact, in grad school (the very tippy top one), we grad students smoked pot with our professors at the time. </p>

<p>I realize this may be way out of the world to you and most of CC, but I guess i’m just trying to say that if you put it in perspective, you might not have to be so freaked out about your daughter. And if you weren’t so freaked out, she might actually open up to you so you don’t have to discover it in a diary on a table.</p>

<p>It’s also a good reason why most 18 year olds should not be at home but living away from home. 80% of them probably do things that we anxious parents (including me) overanalyze and would like to stop or control or would at least worry about, yet 99% of them turn out perfectly fine in the end. Just sometimes kids problems are more about their parents anxiety and perception of what ‘normal’ is rather than what the kid is actually doing (within very normal bounds of their peer group).</p>

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<p>Okay, I’m looking at this from a therapist’s point of view. It’s complicated. There is no law, at least in my state, that would mandate telling her about the conversation at the very next appointment. However, for the therapist to hold this information indefinitely is going to become a very big problem. The longer she holds it, the bigger the problem, from a clinical standpoint. The bedrock of therapy is trust. In this situation, you’ve stumbled onto a private journal which, regardless of the circumstances of how it happened, may feel like a betrayal to your daughter. If the therapist says nothing week after week and then your daughter discovers that not only did you see the journal and not say anything, but the therapist knew and kept that secret with you, it may well destroy whatever trust she has in the therapist. She could feel that the therapist chose you over her and it can be very messy and ruin the therapeutic alliance. That’s why time becomes an issue and that’s why telling or not telling and how/when to tell becomes an issue. </p>

<p>Some therapists have a “no secrets” policy, but that really only refers to when they are working with families or couples. (The scenario that all family therapists dread is a call from one spouse saying, “I’m having an affair, don’t tell my wife”.) So they might pre-empt that kind of scenario by telling everyone that they don’t keep secrets. The therapist has said she would find out more about her obligations and I assume she will find out she is not obligated to disclose immediately. </p>

<p>I can tell you what I most likely would do. If in doubt as to the law, I would call my professional association (definitely) and speak with legal counsel which is why I pay my association fees. I’d make sure I was clear as to whether or not I had any legal obligation. Assuming I did not, I would then figure out what was best from a clinical standpoint. In all likelihood what I would say would be, “ShakenParent, I understand this is very upsetting and, as you know, I can receive information but I can’t give any since your daughter is 18 and there is no signed release in place. It is a problem for me to keep a secret of this magnitude from her for the following reasons (explanation would follow). I believe it best that this come from you. I would be wiling to facilitate a family session if your daughter was willing to do that. If she is not, then it is your responsibility to tell her you found the journal and it’s best she hear it from you. If you choose not to tell her, then I need to consider whether I can continue the therapy or whether I would need to tell her.” This is a late-at-night first thought on this. </p>

<p>While I understand your desire for privacy as well, you are not her client and not legally entitled to confidentiality (assuming you have not gone in as a family, etc.) My general policy is to let someone know if I get a call from a family member and to do it at the next session, but if I believed there were reasons to wait, I would take the above approach or something like it. And to clarify, confidentiality refers to the therapist not being able to disclose what the client says. This isn’t a confidentiality issue.</p>

<p>One additional thought, I think if I felt a need to disclose after a week or two, I would probably try to not get into the content but say that I received a call and there were concerns from the parent and that in my professional opinion the best thing to do was to have a family session. That way I would tip off the daughter that something was said without getting into the content and I would try to steer her either into a family session or, at the very least, into a situation where she went home and said, “What did you tell my therapist?” I think i would direct her back to the parent for information about what was said in the phone call. Again, I’m kind of thinking aloud here, I could post something else tomorrow!</p>

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<p>To…Post #5 (fireandrain) and any parent that thinks alike. </p>

<p>You really think you have the right just bc they live in your house. You do realize you have to have a level of trust w your kids.
I don’t have secrets and talk openly w my mom. If I knew she was reading my journal behind my back even if bland stuff was written in it I’d be far beyond ****ed at her. I’d never trust her or have any need to communicate w her ever again.
Trust and open communication is important. If you can’t TALK to your kid instead of snooping then that’s just sad and will not lead to any close relationship w your kid(s).</p>

<p>Sent from my iPod touch using CC</p>

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<p>Love how the daughter can lie, cheat, sell drugs, buy minors booze. Not domher school work, and its her parents who are supposed to feel bad about betraying trust.</p>

<p>This young woman has betrayed their trust all over the place and yet they are supposed tom tiptoe around her. She needs to earn their trust again. They cant trust much of what she says apparently, yet they are made to be the ones who have to apologize.</p>

<p>Too bad the daughter doesn’t much care about her parents trusting her. Paper tiger, dpes the young woman have no responsibility for being a liar, a cheat, a drug dealer, not doing her college work? If she wants to be trusted she needs to earn it. Making mom the bad guy here is skewed.</p>

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<p>Confidentiality in a therapeutic relationship refers to the therapists relationship with the client and is about not revealing information about the client to others. There is no requirement that the therapist tell the client about information they have received from other parties, especially if the other party requests that remain confidential. That being said, it can be uncomfortable for the therapist to have information they don’t share with the client and they may feel it would compromise the therapeutic relationship.<br>
It’s very easy to panic about the things you read in the journal but I agree with what starbright said. So bearing that in mind, and realizing there may be other concerns you haven’t shared, if I were in your situation I think the critically important question to ask is - “is my kid’s life in imminent danger” - and if the answer is yes, then I’d pull out all the stops till they’re safe. If not, then you have time to figure things out gradually. It may or may not be a good idea for D to know you read the journal, but there’s time to think about it before you have to make any decisions.</p>

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<p>I agree with mimk. I don’t think the confidentiality is about the law, but about how this particular therapist wants her patient relationships to be. Personally, I would want to know if I had a mother calling my therapist and reporting on me every week. Obviously that isn’t what’s happening, but if the therapist is getting information from somebody that is not the client, that is unusual for therapy, and she may just prefer to have a consistent policy about it.</p>

<p>That said, this could be a time for an exception, but I’d advise just talking to your daughter. As you said, she did leave it out. You weren’t snooping around looking for it.</p>

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<p>OP, you’re not the patient, your D is. That’s why you’re treated differently. If you were the patient, and an outside party (and that’s what you are) called the therapist with information about you, wouldn’t you want to know? What would it do to your level of trust in the therapist if you found out later that they hadn’t told you? </p>

<p>Is there any chance you could go with your D to the next session?</p>

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<p>I just don’t understand why on earth the therapist would be willing to let the parent talk as she did…and only after the parent spills everything, informs her that she has to tell her daughter. While the therapist is entitled to whatever clinical approach she thinks is best for her client, it seems quite wrong and unprofessional to me that this therapist would allow this mess to unfold as it is. Why not tell the mom at the outset her policy? </p>

<p>Obviously if the mom had been informed from the therapist that everything she says is going to the daughter, the mom would have made a different choice and not create these risks between mom and daughter or between therapist and daughter. </p>

<p>She doesn’t sound like a good therapist to me.</p>

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<p>I agree with post #22 and have a no secrets policy, although I use my discretion with regard to how information is shared. Keeping that kind of secret could easily interfere with progress, and finding a way to use the information could easily move the process along. I would have no problem with someone choosing someone who worked differently, but would wonder why that was more important than what was happening in the therapy. I would be concerned that the person paying would feel free to terminate therapy if they didn’t like something I did or said. But hey; it happens… Reminds me of the controversy over not paying for a major or a school you don’t like. This is a reminder to me to bring it up early, rather than after I get a call. I try to quickly say don’t tell me anything you want kept a secret, and I always say I want you to tell so and so we spoke. </p>

<p>By the way; even if you are an adult, if you are living at home, i think parents should be involved in treatment on some level, and always have them sign the financial paperwork.</p>

<p>I am not “working” now, but I am having a hard time wrapping my head around the idea of why a young adult would write all that down.</p>

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<p>Seahorsesrock rocks. Also, I agree with: “I am having a hard time wrapping my head around the idea of why a young adult would write all that down.”</p>

<p>Because she’s begging for serious help?</p>

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<p>It’s not clear how the conversation happened. Sometimes people spill information in the first sentence and sometimes they leave it on voicemail.</p>

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<p>Papertiger #23 – Yes, I do have that right. If I feel it is in the best interest of my son to violate his privacy because he is participating in behavior OP mentioned, damn straight I will be in his room violating his privacy all up and down. His anger will subside, but to turn a blind eye to a problem because as a parent you don’t want to violate their privacy by looking in their bedroom? I think back to Columbine. If only a parent had gone into the bedrooms and saw the massive array of weaponry those boys had.</p>

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<p>A perspective that I presented may not have been clear to all(re post 19).
It may be that the student say -“thank you, I trust you now”- to the parent for snooping in the journal the very minute the student learns of it. But I don’t think so. I suspect the student will be angry that once the parent found that it was a journal, the parent kept reading. I suspect the student will feel the parent went too far snooping, and violated student’s privacy. I think the student is far more likely to say- “I can’t trust you!”. In keeping with that feeling, that is how the parent will need to regain student’s trust. All feelings may not be justified, but they can still exist. I have not addressed the legitimacy of the feelings. Was this snooping justified? I have not addressed that.
Other posters that read my earlier post carefully will see that I did not say such a feeling was justified. Careful readers will see I did not say reading such a journal from a troubled student was wrong. But I believe the idea that the student will not feel violated is laughable. While other posters here may laugh at my opinion, I believe the student will feel the parent overstepped her bounds and that student will feel parent has to re-gain trust.</p>

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<p>Agree with shrinkrap and mimk6. Communication and confidentiality policies should be addressed at the beginning of a therapeutic relationship, and appropriate releases signed at that time. I also agree that there are 2 issues at play with respect to the communication: confidentiality (between therapist and patient) and secrets. I also have a “no secrets” policy, and address that up front. Often the unhealthy communication issues are part of the problem that brings them in.</p>

<p>If a parent were to contact me about an adult child, and there was not an imminent risk of harm to self or others, I might listen to what they had to say (though without a signed release it is sometimes not appropriate to even acknowledge that the person is a patient in the office) and then let them know that you would want to advise their daughter that you had contacted them with some concerns. I would not disclose the specifics of the conversation to the patient, but would use the fact that the parents called as an opportunity to get the patient to talk about things that might prompt such a call. I have never heard of any requirement anywhere that requires the treating Dr to disclose the contents of a conversation other than Tarasoff rules (threat of harm to another requires a duty to warn), abuse/neglect of a child or older adult, and imminent harm to self or a general threat to others (without a specific target identified that triggers the Tarasoff rule).</p>

<p>I might encourage the patient to allow some family therapy sessions to begin to address the trust and communication issues. Personally, I feel that family therapy should not be handled by the individual patients treating doctor. That just sets up all sorts of problems. But a session or two for an identified issue can be appropriate.</p>

<p>I agree that this is an opportunity for the parents to sit down with the child and address concerns, even if it causes a riff. If everything was ok within the home and the daughter was not having issues, we wouldnt be having this discussion. So expect a reaction. To avoid a scene, consider taking her out to dinner and having the conversation in a public place. It is important to open the dialogue and then hopefully have continued family therapy sessions separate from her individual treatment to address the home issues.</p>

<p>As for selling her meds, that is not ok. While its unfortunately not uncommon on college campuses, selling a class 2 drug is, I believe, a felony. That needs to be addressed ASAP. It is not ok. Identify the highest priority and address first things first.</p>

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<p>

I’m so glad you mentioned that. It’s what has been screaming out at me. I’m personally aware of a couple of cases where young people from good families made that mistake and actually did end up being prosecuted. Which has a cascade of consequences. I wouuldn’t give a rat’s butt if my daughter “trusted” me if she was breaking the law as well as endangering herself and others.</p>

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<p>Yes, only I would say, “herself OR others.” If and when the OP’s daughter matures and grows beyond this stage of her life, she will understand why the OP took the steps she took to protect her daughter. Kids do grow up. The goal is to keep them alive and out of jail long enough to get to that point.</p>

<p>I wish the OP the best. She clearly loves her daughter and is looking out for her. I agree with those that feel she and her husband should let her daughter know what she found immediately, and if it means that work or other family obligations have to take a back seat to this issue, so be it. If this were my kid, I’d cancel all of my obligations and have a family meeting asap. This is an 18 year old, but she’s living with the parents, which means that her actions directly impact the entire family. Get this out in the open and deal with it. Her therapist can help her work through the anger that is sure to result, but the parents deserve to know what’s going on under their roof and deserve to be able to sleep at night without worrying that the child they love will land herself in jail, or worse, for doing something stupid.</p>

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<p>And for the record, I think the MD prescribing deserves to know as well. I would be VERY unhappy if a family knew a family member was selling the drugs I was prescribing, and didn’t tell me or address it.</p>

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<p>^ Not just unhappy. The prescribing MD can be in very hot water with the DEA if he/she is prescribing drugs and is aware they are being diverted. Prosecutions so far have focused on opiates but this is a serious issue for any adults involved especially the OP’s daughter.</p>

<p>“If I feel it is in the best interest of my son to violate his privacy because he is participating in behavior OP mentioned, damn straight I will be in his room violating his privacy all up and down.” – me too!!</p>

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<p>There have been some very good posts here. I think that all of the other therapists have given a good description about the various legalities v.s. a therapist’s own policies.
The one thing that I want to add is that if your daughter began her treatment in November and this is jus the beginning of Febuary…well that is just not that long of a time to built trust and make progress when there was a crises that led to treatment and drug and alcohol involment. If your daughter is willing to show up for the appointments reguarily and not complaining then it may be best to not try to switch therapists yet. That said–yes, it could be very helpful to have a few sessions with family to put everything on the table. This could also help you decide if you value the work being done and for therapy to move forward. This sounds like it will blow up before it dies down but that is just not always a bad thing.</p>

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<p>One comment on whether the OP should find another therapist, etc. The daughter is 18. There have been many threads on CC lamenting the fact that you can’t force adults to get help. Yanking this therapist could result in no therapy.</p>