I am a privacy freak. I think everyone has the right to determine who knows what about them. You should have the power to control what, when, if, and how information about you is shared. When you come into my office, that’s what you get.
I have, and have had, a lot of clients who need that level of privacy. Maybe they are, or were, victims of domestic violence. Sometimes it’s a job thing. They could lose their security clearance if certain things were known. Or maybe they have a high profile and don’t want gossip. Maybe they are from a family where going to therapy is stigmatized. Even when clients aren’t concerned about their privacy, they still get that protection in my office. First, because I think it’s just the right thing to do. Second, because the law requires it.
So here are some things that you can expect.
If your partner routinely drops you off, then calls or comes by asking when your next appointment is, I’m not going to tell him/her. It may seem like no big deal. I’ve seen this person. Clearly they know you’re a client here. You live together. What’s the problem?
The issue is that I don’t have your permission in writing to disclose. Let’s say that last night the two of you got into a fight and now your partner is stalking you. I tell him/her when you will be here next and that leads to an ugly confrontation. In hindsight that would’t have been a good move on my part, would it?
Let’s say that a parent wants to pay your bill. They aren’t asking for your appointment times, progress, or anything of the sort. Guess what? I am not going to send them a bill. I have clients whose parents and partners financially control them. I’ve had clients who are ridiculed for coming to counseling. Am I going to give someone your bill without your permission and let this happen? No. Good intentions can lead to poor outcomes.
Let’s say that a medical provider, court officer, or other professional calls and asks for your records. It seems like a request to help you out, but guess what? I am not going to release it! I have no way of knowing who is on the other end or how they plan to use this information. It could be your arch enemy calling to get dirt on you. It could be someone who wants to harm you in some way.
Imagine that you’re a parent who thinks your adult child is out of control and really needs your help. And let’s say that you are right. I agree that it’s in my client’s best interest that you know what’s going on. Guess what? I am still not going to give you information. It’s not mine to give. Everyone has the right to self-determination and if your grown up child doesn’t want you to be a part of his/her healing journey right now, it’s not up to me to include you.
Here’s another example. Let’s say that a friend referred you. You and your friend often talk about your appointments. Then your friend asks about you while you are in my office. I am not having that conversation. It may feel social to you. After all you’re friends. The two of you are friends with each other, but are clients of mine. It’s not appropriate.
I won’t even acknowledge a client outside the office unless acknowledged first. Why? Because some people don’t want others to know that they know a therapist. They don’t want to have to deal with questions or explain how they know me. This usually isn’t an issue as I have a pretty big social circle and I know a lot of people. Saying hi to me doesn’t mean that I know you as a client. However, I am not going to make that assumption. It’s the client’s prerogative to speak or not speak outside the office. I don’t take it personally.
This may sound like I am paranoid. It’s not that. There is an easy way around this. All you have to do is sign a release. A Release of Information form is specific. It says what can be released to whom. It’s dated, so that if you want it to be for one day or one year, your wishes can be honored. If you want to release information about billing, but not treatment, we can do that. Basically what it does is put the client in the driver’s seat, which is where he should be.
If the request is coming from another professional, they should know the drill. In fact, they should have a release in hand and send that with their request for information. Anything less looks unprofessional.
Every client has an opportunity to sign a release the very first day that they see me and every day after. They also have the ability to revoke permission. When I am not voluntarily giving an outside party information, it’s because there is no release on file. I don’t care what other professionals do. I don’t care what I did yesterday. If there is no release on file, no information is going out. I don’t know or need to know why a client isn’t signing a release. All I need to know is “is there are release on file?” If the answer is no, no information is going out.
Lots of delicate things are talked about in a therapist’s office. To reveal yourself like that takes a lot of courage and a feeling of safety. If I were to talk to people about my client’s business – even seemingly innocent things like appointments and billing – it could wreck my professional relationships, ruin my credibility, and threaten my license. It’s more than just a convenience issue or a good idea. Safe guarding client privacy is absolutely essential to my business.