NHS therapist sharing details with team

[Chuggachops]

I’m really struggling at the moment and called CMHT duty for support.

I got a call back from a team member who basically reiterated verbatim what I am working on in therapy from the computer system.

Totally get and appreciate sharing of best practice but I just feel really pressured and not heard, especially as the team member put her own twist on things and suggested thinks that weren’t appropriate.

It’s not the first time and it’s affecting how much I share in sessions and my willingness to reach out for support. Is it normal?

*things

I sound ungrateful but I’m not - just genuinely worried about it

Speak to your therapist at the beginning of the next session, it may be that the team member should not have been able to access those notes. Explain your concerns and your feelings around that.

From this you will find out if it is the procedure or unacceptable, if you don't get an answer, write or email the team leader to complain.

The processes of the 'institutional NHS' often feels violating. Occasionally they do things for good reasons to do with your care, sometimes they do things due to the habits of an organisation that fails to truly appreciate the importance of privacy and trust, while sometimes they happen because someone who really shouldn't be in a profession has never really soaked up the principles of a trusting relationship.

I think that if I were in your position, for now I would simply try to ignore the signals that tell me to think about this. Then, the next time I speak to my therapist, I would raise it as a way of my therapist getting to know me better - what hurts and why is important. I would ask if there are any aspects of my life that I will be safe to air without others becoming aware.

Maybe I would also ask the therapist if they would mind outlining what goes in the notes and why. If the therapist says, "everything", then that isn't really therapy because as you have said, it would make the process feel less safe. I feel sure that an experienced therapist would be keen to address your concern and come to an agreement that leaves a safe space to talk. Be prepared to compromise your ideal if the team feel really concerned about your safety. Good luck.

@Chuggachops the practitioner should have explained confidentiality and it's limitations to you during your initial assessment appointment.

The practitioner needs to complete notes after every session for a variety of reasons. For example it is a requirement of their profession. Or for example, If you rang in (as you did) and your keyworker was not available, another practitioner would not know anything about you. Notes are accessible by all members of that team for obvious reasons.

They will be practicing team confidentiality. For (hopefully) obvious safety reasons, they cannot keep secrets from the team but it's a tricky balance. They should have discussed this with you in your first meeting. They will need to be communicating with the team how you are but they could write down general themes of discussing instead of unnecessary details.can you bring it up with them?

The problem with putting notes on the system is that whoever reads them will have their own 'take' on things & interpreting whats going on for you. The relationship between you & your therapist is unique in that you will both have developed a dialogue that is individual. So what I'm saying is that in this situation- someone reading it will naturally not 'get it' because they haven't been part of your process or have the dialogue with you.
I think talk to your therapist about the difficulties you have experienced with this & ask that you can agree an alternative for other workers to draw upon instead of reinterpreting the notes on the system.

It may be that you can agree that she could write 'in the event of an out of hours emergency the following procedure would be helpful to X' & then list what you need at that point.

Excellent advice given - thank you.

I know I need to raise it as it’s affecting my willingness to both call up when I need to and share things in the sessions.

I knew about the notes going on the computer system but I wasn’t aware of how others would use it. I have a WRAP plan (which is rarely used ) when it should but they are encouraging me to use the ‘soothe box’ I’ve put together. If I’m ringing then. I’m well past the soothe box and it feels very personal and private - I don’t want everyone to know what is in there. I feel self-conscious.

Yes you would feel like its too private I'm sure & if the advice isn't relevant because you're past that stage then there needs to be a proactive plan to meet your needs in a crisis. Seek advice from your therapist first off to see if you can solve this between you. Its not going to work if you don't 100% trust the process & the therapist. You are vulnerable in this & its insensitive to use your info like that