Tuesday, August 23, 2022

Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? Talking about confidentiality and neutrality


Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? This has come up a few times recently and it’s a great question. 
 
There isn’t a standard answer because there are no rules. Mental health practitioners can see members of the same family, people who work together, sleep together, who know each other on social media etc etc.
What’s key is 1) confidentiality and 2) neutrality. 
 
Confidentiality. Some therapists share their notes in their office with colleagues or staff. I work alone and I prefer to maintain strict confidentiality. 
 
If you see me, I talk to you and to you only. Between sessions, I forget I know you. 
 
If your best friend, cousin, work colleague, or neighbour also sees me, I act as if I don’t know you in therapy sessions. In fact, I won’t even confirm or deny that you’re my client if anyone asks. 
 
So, I won’t talk but if you and your friend want to discuss your sessions, that’s your decision. You know what’s good for you.
 
Neutrality. The therapist helps the client reach their goals. That’s the job in a nutshell. In the session, it’s all about you. 
 
But with cross connections, I often hear the same story from different perspectives. Like if there’s a product launch, I may hear about the event management side from one client and from the product side from another. 
 
Confidentiality means that I can’t let information I hear in one session bleed over into another.
What’s said in a session, stays in that session.
 
This can be a problem when secrets are involved. 
 
For example, client X owns a restaurant chain and client Y works as a chef. Client X tells me that the chain will be firing 10% of all staff. In another session, client Y hopes for a big bonus and plans a long holiday. 
 
Confidentiality means I can’t talk out of session. So when client Y is talking away about holidays, I have to shut off and not warn them the company is actually in trouble. Which is awesome confidentiality but poor client Y, right? 
 
When it comes to dating, divorce and so on, secrets and confidentiality can really complicate matters.
 
So, I have this approach for taking on new clients:
If you know each other, that’s fine by me. Work colleagues, cousins, neighbours… it’s all fine.
If you think the relationship is very close and you’re thinking about neutrality or confidentiality, tell me and we talk it over. 
 
Generally speaking, if you are happy together and want help for two different things, like one wants to talk about anxiety and the other wants to talk about career happiness, I’m fine with that. 
 
If you’re close family or in a relationship and both of you want individual sessions to talk about your relationship, that may be tricky.
With two new clients, especially those living together, I usually suggest they see a family or couples therapist.
If one is an existing client and the one is new to me, I usually suggest the new one sees someone else. It’s just easier.
Should that not be an option for some reason, we can discuss it. Depending on what’s going on, I may say yes or no. 
 
(Hint: if you have options, like lots of other professionals around, I usually say no. If you have few options, like you’re LGBTQ in the Middle East, or poly in the West, then I may say yes)
Of course, this is when all the info is out there and up front. 
 
Sometimes relationships aren’t clear at the beginning or they change. 
 
For example, I learn once we have started sessions that client A is the ex that client B is telling me about, or that client Q works in the same company as client P. Sometimes, client J is delighted with a new friend and I discover the new hottie is my client L.
 
Usually, it’s all good. I listen, hold the session and then forget until the next time.
 
The one curiously tricky situation is when I discover that two clients who I thought were individual one-off clients are actually partners. 
 
If I’m lucky, they tell me in session and then we can talk it over. But if they don’t, and I don’t know if they know their partner is in therapy, it’s an issue because I can’t ask without breaking confidentiality. But that’s a discussion for another day 😊

Image by Pretty Sleepy Art from Pixabay