Seeing A Psychologist

[gregftl]

First of all I want to say I get all mental health services thru the Ryan White program down here in Ft Lauderdale, FL. Ok, I've been seeing a Psychiatrist now for around 5yrs for anxiety/panic disorder. She prescribes me Xanax. Basically at my appointment I go in and talk to her for about 20 minutes then she writes out my prescription. She gives me 1 refill so I only have to go in to see her once every 2 months.

Well, a few weeks ago I went in to see her and I was informed in order to continue seeing her I MUST also see a Psychologist. First of all I have to say I think this is ridiculous considering I chat with my psychiatrist before she writes out my prescription. Second I find it very odd with the financial crisis Florida is having and having over 2500 people on the ADAP waiting list they are making me see two people (that are being paid)........for a job that could be done by just the one person (the psychiatrist---the way it has been done for the last 5yrs). Oh but no they wait til they are in financial crisis to waste more money.

So I go in to see the psychologist last week and she tells me before we start that if I say anything that I'm going to do illegal that she cannot keep that confidential. All the regular bla bla bla before u start. Then she hits this button on an electronic box on her desk ...it lights up and we start talking. Now i'm just gonna assume that was a recording device but she never told me our conversation would be recorded. Plus the fact she was doodling the whole time on a visible notepad also tells me she was recording the conversation. Kinda unprofessional eh..... a psychologist who doodles circles and triangles on a notepad while u are trying to talk to her. Isnt she obligated to tell me before we start talking that she will be recording my conversations? Or is this just normal practice and it's not law that they have to inform u? Personally I really dont feel comfortable with my conversation being recorded I think she could spend the time writing down what i'm actually saying to her instead of doodling circles and triangles on a notepad! I only say that b/c with the invent of technology as u know these days once something is recorded anyone can get their hands on it. Plus the fact the other woman i see (the psychiatrist) says the state of florida comes in and checks over her notes on me......that makes me feel really uncomfortable. I dont think it's proper for the state (just b/c i'm getting my services thru a state/federal program) to be able to be snoopy and i'm pretty sure these recordings are going to be listened to by more people other than my psychologist (state officials).

What are my options here? Can I refuse to have my conversations recorded without being booted out of her office....or.....?

Greg

[mecch]

I never heard of a psychologist nor a psychiatrist recording sessions.
I also never heard of any therapist saying that "illegal" activities were not confidential.  Just what level of illegality by the way - it would be interesting to know?  For example what if someone were in a state where not disclosing HIV before sex was a crime?  What is someone said they shoplifted a sweater? etc etc.
I hope you get some good answers here, and if you don't I hope at least someone can put you on the right track to get some answers.
Pity about the wasted money, too!

[GSOgymrat]

Hi Greg,

I can't address the Ryan White requirements but I can tell you something about the counseling process. The reason your clinic is requiring you to see a counselor/psychologist is because evidence shows that for most problems counseling and medication management is more effective than counseling or medication alone. Psychiatrists typically just address the medication component because they often are not as extensively trained in counseling techniques and because they are much more expensive than a counselor. In our clinic a 50-minute session with one of our psychiatrists in around $350, a 50-minute session with a counselor is $90.

The psychologist is obligated to inform you before you start about the limits on confidentiality. She is not obligated to break confidentiality if you "do anything illegal" but is required to break confidentiality if you are a danger to yourself, a danger to other people or suspected of abusing a minor, the elderly or someone who is disabled. I'm not sure about the device on the desk you describe but it is probably a timer. If she was recording the session she should have informed you and had you sign an acknowledgment. She also needs your written approval to discuss anything about your sessions with anyone unless her records are subpoenaed. Because she apparently is contracted with Ryan White you may need to get details regarding what information is being communicated. I would encourage you to discuss all your concerns with her at the beginning of your next appointment. If you don't trust this particular psychologist or have concerns about confidentiality I would take it up with the director of the program.

It sounds like you think that the counseling is unnecessary or that it will not be helpful. I would encourage you to give it a try once your concerns regarding confidentiality are resolved to your satisfaction. Therapy has helped me and other people and if your clinic is offering this service for free I would take advantage of it.

Ford

[Miss Philicia]

If you want free sedatives paid by taxpayers you need to sit and bullshit with a chatty shrink for an hour session, that's how it works where I live and I'm surprised you've managed not to encounter this for as long as you have in Florida.  Otherwise you sound a bit paranoid about the whole situation.  What are you telling this person that you think is going to be forked over to the state police?

[phildinftlaudy]

Years ago when I saw a psychiatrist the shrink also had me see a psychologist.  As Ford said, this is because the two go hand and hand.  This is actually a good use of money.  Just being handed a Xanax and being sent on one's way is not good medical practice --- almost comparable to being able to walk into a pill dispensary and walk out with painkillers with no physical exam.

Seems you have a lot of ongoing complaints about every part of a system that you are deriving taxpayer benefits from.  Having you see a psychologist in addition to a psychiatrist is actually giving you the best possible care.  Something similar to seeing a general practitioner, but also being able to see an ID doctor, dermatologist, etc.

As far as recording - as a person who is a social worker, I can tell you that you would only be taped if you were informed and gave consent.  Just as Ford said.  Also, reportable criminal acts are those that can cause harm to you, others or active child abuse.  As far as others having access to your records - this is done to ensure that the services being received are relevant to diagnosis and that treatment plans and protocols are being adhered to --- any funding entity has the right to do this (not just services paid for by government, but those paid for by private insurance or worker's comp).

[gregftl]

First of all I want to say I get all mental health services thru the Ryan White program down here in Ft Lauderdale, FL. Ok, I've been seeing a Psychiatrist now for around 5yrs for anxiety/panic disorder. She prescribes me Xanax. Basically at my appointment I go in and talk to her for about 20 minutes then she writes out my prescription. She gives me 1 refill so I only have to go in to see her once every 2 months.

Well, a few weeks ago I went in to see her and I was informed in order to continue seeing her I MUST also see a Psychologist. First of all I have to say I think this is ridiculous considering I chat with my psychiatrist before she writes out my prescription. Second I find it very odd with the financial crisis Florida is having and having over 2500 people on the ADAP waiting list they are making me see two people (that are being paid)........for a job that could be done by just the one person (the psychiatrist---the way it has been done for the last 5yrs). Oh but no they wait til they are in financial crisis to waste more money.

So I go in to see the psychologist last week and she tells me before we start that if I say anything that I'm going to do illegal that she cannot keep that confidential. All the regular bla bla bla before u start. Then she hits this button on an electronic box on her desk ...it lights up and we start talking. Now i'm just gonna assume that was a recording device but she never told me our conversation would be recorded. Plus the fact she was doodling the whole time on a visible notepad also tells me she was recording the conversation. Kinda unprofessional eh..... a psychologist who doodles circles and triangles on a notepad while u are trying to talk to her. Isnt she obligated to tell me before we start talking that she will be recording my conversations? Or is this just normal practice and it's not law that they have to inform u? Personally I really dont feel comfortable with my conversation being recorded I think she could spend the time writing down what i'm actually saying to her instead of doodling circles and triangles on a notepad! I only say that b/c with the invent of technology as u know these days once something is recorded anyone can get their hands on it. Plus the fact the other woman i see (the psychiatrist) says the state of florida comes in and checks over her notes on me......that makes me feel really uncomfortable. I dont think it's proper for the state (just b/c i'm getting my services thru a state/federal program) to be able to be snoopy and i'm pretty sure these recordings are going to be listened to by more people other than my psychologist (state officials).

What are my options here? Can I refuse to have my conversations recorded without being booted out of her office....or.....?

Greg

[Rev. Moon]

Greg,

May I ask why you start multiple threads about the same subject (this one is just a copy-pasta of the same issue you posted in the Mental Health Forum).  You've already been given several responses on the other one, all of them valid and good. 

[David Evans]

Greg,

Please post in one thread.

David
Moderator

[WillyWump]

So I go in to see the psychologist last week and she tells me before we start that if I say anything that I'm going to do illegal that she cannot keep that confidential. All the regular bla bla bla before u start. Then she hits this button on an electronic box on her desk ...it lights up and we start talking. Now i'm just gonna assume that was a recording device but she never told me our conversation would be recorded.

If it were me I would be asking more questions.

"What is that button you just pushed?" "Are you recording me or is that just a timer?" "If you are recording me dont you have to have my permission to do so?" "Can you explain to me in detail the discosure requirement regarding illegal activities?"

-W

[Miss Philicia]

I just switched to a new therapist, but it was my choice because there's a new person on their staff and they though I was a "stable" person that could handle any transition.  I've had two sessions with her thus far, and they've been recorded because she's technically still under supervision of my original therapist, so he is evaluating her abilities.  I also had the choice to decline being recorded, and once I agreed to it I had to sign a document stating such agreement.  This is all 100% Ryan White type organization and it's always massively audited by the Higher Powers that be, etc.

Oh, and this new therapist is actually really good -- she's only 29 but lived in London for 7 years and married an English guy.  She's equally comfortable exchanging make up tips, discussing anal sex, and pondering the sisterhood of large cocks.