Clinical Psychologist - privacy guidelines around sensitive information clarification please...

[Tweet-Heart]

I have just started seeing a clinical psychologist, he told me about privacy which I understand. However, I want to discuss some sensitive information and provide him with sensitive documents that I don't want other people or third party agencies to know about. I called AHPRA today and they referred me to the APS Code of ethics which is a legally binding document. However, I am still uncertain about whether a clinical psychologist can retain a sensitive file and less sensitive file. I am just concerned about third party agencies like Centrelink, insurers, worksafe etc finding out about sensitive information that is not relevant and then using that against me. I just feel that people should be able to consult with professionals without having to worry about this kind of thing. I also don't want him to keep an electronic file. Maybe I should discuss this with him at our next session, any advice would be appreciated.

[blondguy]

Hi Tweet

Its not off topic at all. Breathing through our nose (slowly) does slow down our breathing which then also helps in avoiding hyperventilation too!

Geoff has mentioned a good point above about doctors and access to your private information.

Your GP cannot divulge any of your records unless you have provided written permission

I hope you had a good weekend Tweet

my kind thoughts

Paul

[Tweet-Heart]

Thanks Paul

I am sure that is why he asked me to breathe in and to look at him as I was having a full on panic attack in front of him.

Also I'm concerned about confidentiality as he started giving me some details of a former patient who was stalking him. I was telling him about someone stalking me and he was giving me advice. I know he didn't mention her name but I don't feel it was necessary or appropriate to go into such details.

[Tweet-Heart]

I also want to add I feel very unsafe going to his practice rooms as he told me the former patient who stalked him walks past his practice and she can do this as the intervention order expired. I am really freaking out I should discuss this with him.

[smallwolf]

Hi,

Regarding your latest posts... my psychologist tells me stories involving herself in order to help me see something in a different light. Admittedly I cannot recall if any of these would include other patients; nor do I know from your description the amount of information provided. But if the matter is concerning to you, you probably should tell them, if only so that you can both maintain a good relationship in a safe environment. Whether you do or not is up to you? This way you are helping to define the boundaries of the sessions?

Tim

[Tweet-Heart]

Hi Tim

Thanks he told me she's harmless but by what he described it is very concerning and I know he was telling me to assist me in gathering evidence against the male who is stalking me but he went into allot of detail and also said she accused him of doing something very bad which I won't repeat. I just don't feel safe Tim and not sure how to tell him and I don't want to bombard him with a call before our session.

I am getting nightmares, flashbacks and I am too scared to leave the house.

Please let me know what he can do to make me safe when we next meet I'm feeling frightened.

[smallwolf]

Tweet-Heart,

Sorry that you do not feel safe anymore because of this situation.

I an not sure that I could really answer "Please let me know what he can do to make me safe" and prefer not to give advice, but I can make the following suggestion to you in relation to "telling" him. I have on the odd occasion sent an email to my psychologist about things. During the week I would not be sure whether my psychologist is in the office, with a client etc. By writing down the problem in an email you get the chance to think about what you want to say, make sure it is in some logical format, and contains everything you want to say. Just make sure you don't shout etc in what you say. In this way, you get to say what you want and when your psychologist is available they can read it and respond appropriately?

Regarding the nightmares... something to talk to your psychologist about? Write down in a journal for your next session? I know these sorts of dreams are bad, but remember they are a dream. Trying to tell us something.

I assume the story you were told triggered the flashbacks and made you scared to leave your house? Has anything else changed to make you scared? Do you have any distraction or coping techniques bring to back to the present moment? Perhaps the nightmares are also making you scared? If you can figure out the whys, wherefores and/or triggers/causes, you might have something to work with. It won't solve the original problem, but help to get through to next week.

For what it is worth, I find writing things down on paper helps to reduce the negative thoughts in my head. And my hope is that it might work for you also.

Tim

[Tweet-Heart]

Hi Tim

That is very useful. I feel he is being quite selfish and inconsiderate. I almost felt like he wanted to off-load by going into detail and he should have known that would trigger things for me.

I am not his counsellor he should find another outlet to express his feelings. At the end of the day he is not the one feeling unsafe I am and when I called him a few days later when I was having a panic attack I felt like he was fobbing me off. He told me it's a social workers job to help me in this sort of crisis situation or to ring WIRE.

I'm going to take him to task on this I'm angry.

[smallwolf]

Tweet-Heart,

Hello again. I hope you dont mind if I tell you a little story... I am not doing any study this term, but am doing a subject by auditing... something was said in the 1st lecture that made me angry, feel judged etc. I was affected (badly) for about a week. In that next week, I brought up the issue with my psychiatrist. I explained what had happened in that first lecture and how I felt. (I wanted to disappear at that time.) My psychiatrist told me that my feelings were natural, and there are people who will make you think/feel that way. She said something else that put me at ease as well.

I think that what my psychiatrist said to me would apply to you as well. The one caveat I would put to you is that if you intend to "take him to task" as you suggest, please try to do it is an assertive manner rather than angry? I agree your counselor should have considered your feelings in telling you that story. He probably misread your body language or ??? Not an excuse, but worth considering?

The other thing I would like to ask relates to when you were having a panic attack... I am not sure what sort of terms you might have in your contract (?) with the organization re contacting them. Now I have my psychologist number on my phone in relation to my safety plan, but I have other number to try before her, such as my own support people, lifeline etc. Do you have similar numbers on your phone? Maybe when you see him next, ask him who you should have called?

Tim

[Tweet-Heart]

Hi Tim

He is being precious and I tell you what I am feeling hormonal and I don't know if I trust him anymore.

He wants me to do Jeffrey Young's scheme questionnaire, he just wants to pathologise and label me.

You wait until I see him next I'm going to blast him.

[romantic_thi3f]

Hi Tweet-Heart,

Thanks for your post and apologies for the late reply.

I'm not sure how many of your questions have really been answered so I might echo some responses!

With the confidentiality concerns, absolutely raise this with your GP. If your GP doesn't know your psychologist will, so if you can be specific with your questions they can be specific with their answers. Once you know what you can disclose I imagine it would be a lot more reassuring.

I was a little bit worried though when you mentioned them discussing a former client. That would raise a big red flag for me. When psychologists make disclosures like that they need to make sure that it's confidential, not going to identify anyone, brief, and relevant to you and your situation. Ultimately though, it's up to you and how comfortable you feel with it.

and finally - there are a couple of reasons why your GP might have asked you to breathe through the nose. One of the reasons it's that it's harder - forcing you to really focus on your breath which helps to ground you. Nose breathing also helps to regulate our 'parasympathetic nervous system' aka our flight/fight response.