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NHS therapy and confidentiality - childhood abuse(15 Posts)
I have posted a few times about this under this name change.
Short history - I have four kids, two with Sen so been quite involved ( on my request - which in hindsight was utterly stupid of me) SS as I was trying to secure respite for my ASD toddler.
I have a tendency to hoard so I'm a hoarder. You possibly would not know if you came too my house. Yes it's cluttered, yes it quite full but it's clean it's tidy there is zero issues with accessing anywhere in the house. There's no paths through crap or things pilled to the ceiling.
So anyway I have issues with getting rid of things like toys, clothes etc but also opening mail, emails. I open what looks important and ignore the rest.
I went to the dr at the beginning of the year. I had cbt but now I have moved into therapy as I hoarded as a child, grew up with a hoarder. It's not something cbt could dent.
Now I'm under a phyc or similar Dr ( not sure what her PhD is ).
If I'm totally honest my hoarding stems from childhood abuse but it's got worse or not resolved due to the extreme stress of my Sen kids.
As part of my SS assesment ( which I didn't meet criteria for respite or anything ) my hoarding was discussed at lenght in a meeting. I was told that anything personal could be kept out of the meeting (TAC) but my wishes not to discus my house was ignored. I had no idea they would ignore my wishes and sat in the meeting in a cold sweat as my personal details was shared. I have never felt so ashamed. I haven't been diagnosed as a hoarder and if I had not asked for help with it no one would be able to say "your a hoarder".
So now I'm under this dr. I told her about my confidential info being shared before, that I was worried to trust her.
She told me that she can't gaurantee that my case details will not be discussed outside of the therapy room. I have decided to keep my abuse to myself.
I don't know what I want from this thread. Will therapy help me with stress and procrastination if I don't discuss where and why it started? It was physical and mental abuse from my for over 20 years. She denies it ever happened. SS was called by neighbours but they only came once and never investigated.
I possibly need therapy at some point for her. I just need to control this hoarding before it does become a bigger issue. Physically looking at the house it's under control. In my head I struggle with it every day. Right now it defines me. I feel that I am a hoarder. That's one word to sum me up. But I didn't feel like this 12 months ago. I was just a clutter collector. A bit behind with sorting things
Can you ask her to clarify the boundaries of confidentiality. It's usually only related to risk. It's a real shame to not be able to work openly with a therapist - trust is key. Best wishes to you
Usual confidentiality is maintained unless you disclose that there is harm to self or others, particularly children. I'd also question the therapist's conduct and adherence to agreed confidentiality.
I spent most of my first session talking about the confidentiality thing. She said what I expected - it's only shared on risk after you are informed that they will share it ( so twice this year that has not happened with me - been a bizarre year so far!). Do I was ready to tell her at my second session but we covered it again as she wasn't sure I wanted to continue.
Her words was "you need to have realistic expectations of what will and won't be shared" so I couldn't then say "mum used to beat me - will that be shared?"
I'm thinking that needs to stay private. At all costs. It feels very very personal. I don't want everyone to know. There is emense shame that comes with abuse. I would feel totally violated if that was shared with my kids school and LA as my hoarding was (how its relavent to their Sen I don't know) mum hoards do the kid has asd, mum was abused so that why the kid has asd
But more than anything. Mum was abused, abused kids grow up to abuse which is so so not true. I never ever hit my kids.
Wow. No way should this therapist have shared that. Clear breach of confidentiality. It's appalling. Realistic expectations?!
I mean if you disclosed you were planning on suicide or beat your kids or your home was so dirty it was a health risk...OK...but slight hoarding is nothing like that.
Is she private? If so I would find another one. If NHS I would complain about her.
I am worried that some one will make that leap - was abused so kids are at risk.
The services in my children's care have done worse than that so far this year.
SS childrens disabilty team said they could see I was struggling to cope and needed respite, but I didn't meet criteria so no respite was granted. That week my LA had a consultation on respite and was asking for feedback. I went to the meeting and asked what the criteria was - sitting on a bridge waiting to jump. The next day SS phoned my husband up saying she was thinking of sectioning me! No warning from the person who reported me to her. Over a flippant comment.
If she had said - is that how you feel? Like jumping off a bridge? If so I need to raise this. But no, I unaware and at toddler group when everyone was trying to get hold of me urgently to get me sectioned. Which of course didn't happen - I don't have any MH history. I would say I don't have MH issues but I know hoarding is a MH condition.
So with that incident and the incident where they asked me what I didn't want discussed at my TAC meeting but again without warning discussed in lenght anyway ( I had no idea until they just raised it at the TAC) that's twice my confidentiality has been breached
I want the help but I am more scared that every time I share information it is made public
This therapist hasnt broken confidentiality. I'm just not sure she won't. But two other teams in the past few months have. I just don't want a repeat with her as I have never told anyone about my mum.
The lines between "your or kids life are at risk" seems extremely low so far
Confidentially will be breached if a risk, but they should tell you first if they can. The other thing that may happen is that they may discuss your experiences with other team members. This allows them to seek support for themselves, ensures quality as they are checking they are doing the most helpful thing for you and means they can all learn from each other. However this should not be done in a way that means you are not identifiable so personal details left out, it's more about you getting a decent service. I would assume this later discussion of your case is what the person was talking about when you asked about it.
firstly dont not discuss your abuse , as you say it may be reason for your hoarding and you said you want help with that .
It doesnt sound like confidentiality has been broken , your hoarding has been discussed which may be affecting your children ?
you say "my house" yes but its your childrens home too so it has to be discussed.ss work to the common assessment framework ( google it) so when people think they are only interested in the children you will see they have to look at everything to do with the child . you cant pick and choose. you have asked for respite , they will look at what could be done to help you cope at home first, respite for a toddler is very unusual to be granted due to their age. they will be looking at how to work with you to improve your coping ability so your children can be with you , not be away from you .
a word of caution , dont suggest anything like " jumping from a bridge" everything is written in the minutes , they cant assume you are joking , its a serious meeting so treat it as one. for every person that says it in joke 1 may actually do it . They have to take it seriously.
please continue with the therapy , tell them about the abuse , there isnt the judgement of abusers always abuse. i was abused , i work in services and i have been assessed and approved to adopt . being abused is not your fault why dont you want proffessionals to know ( i understand about the school thing , but they shouldnt go into detail anyway)
i hope it all works out for you and most importantly your children
Most of the advice on this thread is unfortunately incorrect. The NHS therapist is only incorrect to say that she would tell you before breaking confidentiality - it isn't always possible or allowable to do that. If social care are involved they can, under certain circumstances, request notes without the authorisation of the patient, where there are serious concerns about the well-being and safety of children, for example.
I am so sorry that you were abused and that you feel so worried about talking about it. I feel strongly that you cannot really seek help until you can tackle what you know is at the heart of your problems. I do not believe that by facing your problems head on, that you will be risking your children. Many, many parents have suicidal thoughts and would not act on them. The therapist will be able to understand the difference and assess risk properly. Seeking appropiate support for yourself should reflect well on you as a parent.
It's sad and understandable that you are so afraid. You need a safe place to open up. Hopefully you can work this out with your current therapist. If not maybe finding counselling through a voluntary organisation would give you more privacy.
I wish you luck. I think it's time for you to stop hiding the hurt that was done to you. It's not your fault.
Medway I couldn't read your post and not reply. To hear you voice your dilemma about whether you can trust your therapist and get the help you need is very sad to read. However Kitty's post is the one to read. You are right to fear the potential breach of confidentiality when ss are involved and there is any concern over a child's safety.
A voluntary organisation such as Mind might offer you more privacy. I really hope you get the help that you need.
Thanks. SS are no longer involved. The case was closed after my son didn't meet threshold and the TAC was held. I would never approach them again after their behaviour. But as my son will be at school soon and his needs are so severe I might end up dealing with them again at some point.
I think I should keep this to myself for now. The hoarding doesn't place the kids at risk ( SS confirmed this during assessment) but obviously it impacts them to a extent. If they loose something then it takes a while to find it if it's gone into the toy pile etc. Plus they learning unhealthy habits watching me. I'm more aware of that as they get older.
If I could just get back enough control to keep on top of it ( like regular trips to charity shop and to stop buying things for the rest of this year except uniforms and shoes) then I could take a mental breath of air before pursuing therapy outside of the NHS
Or is that unrealistic do I need to look into mind now during the NHS and declutterring?
I guess I'm ok with it being discussed within the MH team and going on my health records.
I am not ok with it being known to education. Tbh that kind of stress triggers my hoarding. I comfort buy and avoid discarding when I'm stressed. It's like comfort eating or drinking. My stress just gets dealt with in this format
Your fear and distress is really strong in your posts. I'm so sorry you're feeling this way .
Therapists have to have watertight reasons for breaking confidentiality - risk of harm to you, your children mainly. If this wasn't the case, then she acted unprofessionally. If it was the case, then she was just doing her job. It would have been best practice for her to tell you that she was going to have to share details of your sessions with SS, though.
Were the children classed as Children in Need or was there a child protection order? If SS want to access confidential records where children are at risk, they can do that under law.
In terms of sharing information with their team, this is common practice in health and social care. I work in a social care/education environment and discuss cases in my supervision and team meetings, although I anonymise them where possible.
Have you thought about contacting a specialist voluntary organisation to talk about the abuse you suffered? It sounds like you have a good awareness that your hoarding is rooted in things that happened to you as a child, which is a great start. It sounds like you do want help with exploring this, so I think you should seek it out.
If SS have closed the case and no further concerns arise, they are unlikely to seek any further information from health professionals regarding you. It sounds like you could really do with a safe space to talk about the abuse and start to make sense of it all.
The kids are classed as in need. Both have statement / EHCP. One in Sen school
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