Request for Professional Review

As most of you know, I’ve been going back and forth about the decision to file a formal complaint against my former therapist for her highly unethical behavior. If you’d like to know more about the specifics, you can read about it here or here.

(Short version: she abruptly terminated treatment with me after 10 months of twice-weekly therapy. I walked in to session one day and it was over. No transition and no new therapist in place. And to top it off, she blamed it all on me.)

I’ve been agonizing over this because I think I always knew that what she did was very wrong. But in the aftermath of losing her, I was still intent on preserving the relationship and trying to stay connected with her somehow. I loved her and she was important to me. Thus I was afraid of doing anything that might provoke her and push her further away from me. Now that all ties have been officially cut, I’ve had more clarity and the chance to think about this objectively. With my new perspective, it is clearer than ever that what she did was unethical.

Still, though, I’ve been doubting myself and whether or not filing such a complaint would be an act of retaliation or some attempt for me to remain connected to her somehow. I don’t want to be punitive. And I don’t want to get myself into some long drawn-out process that will be emotionally draining.

I’ve been debating over whether to not to bring this up with the therapist I’m seeing now. Since she is also a social worker, I felt that this might be a strange topic to discuss. I also admittedly don’t want her to think I’m the type of client who just files arbitrary complaints left and right when things don’t go the way I want them to. (She would probably never think that, but I don’t want to risk it. Or, more importantly, I don’t to risk that I will perceive her reaction as some version of the aforementioned opinion.)

Luckily, Wife and I have a friend who is also a therapist. Even better, she’s a therapist who’s not a social worker. So when Wife and I went to visit her and her husband this weekend, I used the opportunity to pick her brain a LOT. I’d sent her the link to this blog, so she was already aware of what happened with Zooey. And let’s just say she was not impressed.

Goodbye, Zooey

Here is the final email that I wrote to Zooey. I sent it last night after I got home from classes. I spent about an hour drafting and editing before coming up with this:

Clarification

After reading Zooey’s email response, it seemed like she was trying to set a boundary, but was simultaneously refusing to be explicitly clear with me about it. I felt like her email was a cop-out and that she was STILL not taking responsibility for her own actions and decisions. I also knew that if I didn’t ask for clarification, I’d agonize over what, exactly, she meant.

So, true to form, I wrote her back and simply asked for clarification:

Thank you for responding, Zooey.

This may be redundant for you, but I do want to be perfectly clear on this: are you telling me to not ever communicate with you again in any way?

I understand the restrictions on personal relationships post-termination. In person and in a previous email, you said that you welcomed updates about my life. It would seem you are perhaps backtracking on that, so now I am admittedly confused.

I think it would be best if we were both explicitly clear on the boundary you are setting. Otherwise, it will probably drive me crazy to try and guess what is or is not okay.

Thank you,

Andi

This was her response, which made me both laugh very loudly and cry a bit:

NOW You Care About Ethics?

Zooey responded to my voicemail by emailing me. Here is what she said:

Andi,
I received the voicemail you left on Friday. In response to your questions regarding contact between us now that we have terminated, I want you to know that my profession’s code of ethics prohibits personal relationships with current or former patients. Please be respectful of this. I encourage you to explore and work through your feelings with your current therapist.
Sincerely,
Zooey

I am admittedly emotional about this. She initially said that she “welcomed updates about my life”. She emailed me back last month. She didnt give me any parameters to follow. And as I’ve already pointed out here and here, she was certainly unethical in her termination process.

But I think I am actually relieved. Now I can really begin to let her go. It will continue to be painful and awful and messy. But at least she has given me the gift of FINALLY setting a boundary on this. And although it’s irritating that she just now figured out that her profession has an ethics code, at least this wil give me a chance at closure. 

Better letter than never?

Termination & Ethics, part 2

Last week I posted about the NASW’s ethical guidelines for Social Workers, particularly in regards to termination practices.

Since then, I’ve been reading Treating Complex Traumatic Stress Disorders, by Christine A. Courtois and Julian D. Ford. Chapter 4, entitled “Best Practices in Psychotherapy for Adults”, outlines the best evidence-based practices for helping patients with C-PTSD and related disorders. They essentially highlight the same 3-phase model that Zooey’s DID “expert” supervisor advised her to use and that many trauma specialists accept as the best approach for trauma. I read the “expert”‘s book as well and I liked the model, so Zooey and I agreed to try that. It is also very similar to how they approach treatment in the residential trauma program I attended in the Fall. I’ll write more about that treatment and the phases in future posts, but here’s a basic rundown:

• PHASE 1: Safety and Stabilization
• PHASE 2: The Processing of Traumatic Memories
• PHASE 3: Reintegration

My understanding is that the idea is to get the patient stable and in a safe place so that they are able to engage with their traumatic memories without resorting and/or regressing to unsafe/destructive coping skills. Then, once the memories have been processed, phase 3 is essentially a culmination of the previous two phases. The client is able to use their new skills and information to analyze themselves and move beyond the effects of abuse. Or something like that.

Ethics

My bestie is getting her MSW (Master’s in Social Work) right now, so when she learned what happened with Zooey…let’s just say she was not impressed. In fact, one of her first reactions was to reassure me that this was most definitely NOT an acceptable way for Social Workers to behave. Zooey is an LCSW (Licensed Clinical Social Worker) and since I’ve been learning about medical ethics in my own studies, I was curious if Bestie had been learning something similar in her MSW program. I not-so-discretely asked her about the ethics surrounding social work practice. She sent me a link to the NASW (National Association for Social Workers) Code of Ethics. Here is what is listed under “Termination of Services”:

1.16 Termination of Services

(a) Social workers should terminate services to clients and professional relationships with them when such services and relationships are no longer required or no longer serve the clients’ needs or interests. 

(b) Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary. 

(c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client.

(d) Social workers should not terminate services to pursue a social, financial, or sexual relationship with a client.

(e) Social workers who anticipate the termination or interruption of services to clients should notify clients promptly and seek the transfer, referral, or continuation of services in relation to the clients’ needs and preferences. 

(f) Social workers who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options.

Okay, so here’s my response to various parts of this: