Leonard —a Ruder awakening

 

 

This is my experience, opinion and part of a complaint I filed with the Ct. Department of Public Health regarding my experience with a therapist in CT.. The case is closed, and it is now public information. The Ct. DPH’s consultant LCSW somehow found that no violation of State Statutes occured. However there was a small success in that the therapist was asked to complete CEU’s in “office and biiling practices” and “client/therapist boundaries”. He was also forced to pay back the money he “overbilled” the insurance company for and to drop himself as a provider. I’ve been told that these are “relative victories” in dealing with a licensing agencies, as they normally dismiss 80% of all complaints up front, and only actually discipline 2% of all therapists that are complained about.

Leonards(timeline) Billing History and “insurance fraud” and “post therapeutic relationship”
2004: Leonard Billed appropriately for 5 sessions that took place in 2004.

2005: Leonard billed appropriately from January of 2005 until September 3, 2005. After this time there are no claims filed through the December 30, 2005. There is no paperwork within the petition file to show claims made, denied or paid for this time period.

However:
In March 2006 Leonard told me that I owe him money from 12 sessions in the fall of 2005 he did not get paid for by A****Insurance. He said, “you owe me some money, your insurance company did not pay me for sessions during that time period. At the time I believed him, and made a payment schedule and paid it off by July 15th of 2006.I asked for but never received an actual bill, nor did I receive receipts In October of 2006 while on the phone with A**** Insurance, regarding separate matter unrelated to this case, I asked the representative why I owed Leonard this money and if and why they denied the claims. I was told by the representative that Leonard did not file paperwork at all for that time period and that by contract I was held harmless and owed him nothing. It was too late and I had already paid Leonard the money he claimed I owed him. I did confront him at our next session but he claimed at the time that he had filed paperwork and that he would check into it. Time went by and I neglected to ask him about it. It was only a few months later that he triple billed for various dates in January 2007 and February 3rd, 2007.

2006: Leonard billed weekly and appropriately from January 7, 2006 to June 3, 2006. Then in “similar fashion” to 2005, he did not submit claims from after June 3, 2006 through December 29, 2006 ….until December 30, 2006.

On December 30, 2006Leonard submitted claims for sessions dating back until June 17, 2006 to December 30, 2006…a total of 23 sessions. Looking at the payments made in the petition file it appears that some of Leonard’s claims were rejected at this time. I do not know exactly why, but I believe it would be either because of A***Insurance “timely filing” requirements, or Leonard may have needed to obtain authorization for “additional sessions” (beyond an automatic 20 per year) and did not attempt to do so.
A client is “held harmless” in both of these situations.

2007: In January 2007 Leonard billed for sessions twice weekly,Tuesdays and Saturdays, for the entire month of January and February 3, 2007, on February 3, 2007.

I saw him 3 times in January of 2007 and ( 1/7, 1/21, 1/28) and on 2/4 as shown on my calendar (I did not see him on February 3, 2007)

I discovered this on 3/3/07 by checking my billing on line on A****Insurance website.

I confronted Leonard regarding this “insurance fraud” and made a deal with him that he was not to bill A***Insurance for my next 7 sessions in order to make up for those he already “got paid for” I was willing to let it go with this arrangement. On May 8, 2007 I received a letter from A***Insurance authorizing an additional 6 sessions. I immediately realized this meant he violated our verbal agreement and billed anyway. I again checked my claims on A**** Insurance website and saw that Leonard had billed once weekly (if we had a session) from 2/4/07 until 4/29/07.

I immediately confronted him in an email. This was then followed by a phone call from him at 1120 pm. Leonard took an aggressive stance, yelling at me over the phone that my “ expectations were too high” and that I had a “holier than thou attitude”. He also said in a very nasty tone “what would you like me to do about it?!” He also claimed during this phone call that he “was just trying to see how fast A*** Insurance would “turn over benefits” which made absolutely no sense to me. I felt sick after this phone call and my “BS meter was spinning” I followed up with another email the next day.
After a couple emails and a couple phone calls Leonard agreed to meet me at my house to fully discuss the issue on 5/12/07. While here he cried his “crocodile tears” trying to gain my sympathy. He claimed his “son was suicidal” and that he and his wife had made some “poor investment choices”, that they were close to bankruptcy, and might have to sell their house. He managed to gain my empathy, but certainly not my trust. Leonard wanted the opportunity to earn my trust again so I agreed to meet with him on a weekly basis, not as a therapist, but only as a human being who wanted to prove he was trustworthy. I was feeling extremely conflicting emotions, and it is then I said to him “you can no longer be my therapist, but you’re not my friend either, I do not know what to call it”. This was a phrase I said to him at least 3 times in separate discussions in the next few months.

Please see the attached schedule for info regarding the times we met, as well as my calendar included in this letter. (There are major inconsistencies with his scheduling of clients in his “billing grid” at times when I saw him other clients are listed)
I also made it very clear to Leonard that I wanted him to pay back A*** Insurance for the sessions he “stole”, and did not particularly care how he did this.

I also asked for the money he had taken from me back in 2006. He said he would write a check to a charity in my name, but did not offer to write a check directly to me.

I continued to meet with Leonard for several months in a relationship I still do not have a name for other than “former therapist and former client”. These meetings were highly unproductive, we would take a walk, and talk, it was mostly what Leonard calls in his notes, “chit-chat”, although Leonard still tried at times to play the “therapist role”.

The trust was never rebuilt. I would ask him at times if he thought of how to pay back the insurance company and he either would not respond, change the subject or say that he couldn’t do that as it would “open up a whole can of worms” and he would not do that.

Over time, these sessions became further between and nothing was being accomplished. I strongly believe that Leonard had no intent to pay the insurance company back and that the only reason he was meeting with me was to ensure that I was not going to turn him in.

Obviously “this game” could not go on forever.

The New Year was coming around and I was quite tired of carrying this “burden”. On December 31,2007 I anonymously reported an “insurance fraud” claim to A*** Insurance’s SIU unit.

Leonard was contacted by A**** Insurance and by early February.

At the end of my morning session on 2/2/08 Leonard told me he was being audited by A**** Insurance. (but he did not know I was the one who turned him in as the complaint I made was originally anonymous.). He said this was his “worst nightmare”, and asked me to consider changing the dates that I saw him. I emailed Leonard later in the week and said “no” and that I would not lie for him.

On 2/9/08, at the end of my session Leonardtold me he had spoken to an attorney regarding the audit and that the attorney told him “someone probably turned him in” and asked me if I was the one who did. Feeling absolutely terrified I said “yes”. I do not recall the conversation immediately following. I could not stay at his office to further discuss it as I had an event to attend that I needed to arrive at by at 1130 am in town. I do not recall how we got in contact later in the day, email or phone, but Leonard wanted to further discuss the situation.

In retrospect, I never would do this again! I went back to his home office for 430 pm and we talked until 930 pm. I was fearful enough going there that I asked a couple of friends to call and check to make sure I was ok.
Leonard asked me to bring along my calendars for the previous two years so that I could give him the dates I actually saw him. This is the very first thing that occurred after I arrived at 430 pm.
During the course of this meeting Leonard said the following:
Leonard said “I could go to jail for this” (speaking about himself)
Leonard made a big deal and said “I forgive you for what you’ve done”
Leonard said to me “you went outside the relationship”
Leonard said “My son was suicidal before this might put him over the edge”
Leonard said “I will never be with a man as long as I deal with issues this way.”
Leonard said “He will feel very sorry for me when I realize what I’ve done”. (by turning him in)
Leonard called me self righteous and said I had a” holier than thou” attitude.
As I was leaving his office Leonard last words he said astonishingly were “too bad I can’t get paid for this”
It was an extremely emotionally draining experience to say the least. I felt “beat up” and had a bad headache afterward.

I only saw Leonard one time after that and that was so I could put closure on the relationship. On or about August 14, 2008 I met with Leonard and (finally) officially “fired” him as my therapist. Through his self disclosure and my experience with Leonard, he does not appear to like to put closure on relationships and likes to leave things “open ended”. While this is good in theory, I find a final closing (at least of “a phase” of any relationship) necessary to move forward.

To Summarize:

During the investigation of my original petition it was found that there was “no pattern indicating Leoanrd intentionally committed fraud” and that fraud could not be proven. While it could not be proven that Leonard “wrongfully billed” more than myself and my ex husband…there was a pattern in his billing on my account as can be seen from the previous writing here.

It appears to me that in January 2007, upon rejection of his claims from 2006 for timely filing ( for my sessions) or other reasons, perhaps Leonard sat down and “intentionally” tried to recover monies he essentially ( for lack of better terms)“screwed himself out of”, through his “lack of billing”…. I would call this Insurance Fraud”.

This is not “sloppy record keeping or sloppy billing” it is just not billing, then willingly and intentionally filling out paperwork for the sessions in January 2007 that did not occur “to recover the funds”. “Being Busy” and not having time does not seem to be an issue to me either as in reviewing Leonard’s (highly inaccurate) “psychotherapy notes” of me in the petition file, he apparently had time to write 6 to 12 page “rants” allegedly about me (these notes showed clearly the counter-transferrence he was experiencing)….and the content of the notes is certainly questionable as to it’s factual nature. ( really many enteries are falsified) I do not believe these notes were all written right after sessions, but no matter when they were written, I think Leonard’s time would have been better spent working on his billing.

There was an apparent pattern here as Leonard had a pattern of “not billing” and then later trying to recover money from me.Then, when he knew that wouldn’t work again, he tried to recover the money from A**** Insurance, but I discovered that as well. While he did not steal money from me in 2007 as he did in 2006, he stole sessions, which have a monetary value for me. These can be limited in number by A*** insurance as they have to approve sessions beyond an automatic 20 per year. For additional sessions it is my understanding that proper documentation must be provided and/or authorization given. Perhaps Leonard did not want to do the work to file this information. From what I see paperwork does not exist in the petition file to show that he at least attempted to get additional coverage.

In conclusion, Leonard lied to me in 2006 regarding not getting paid by A****Insurance for sessions in the Fall of 2005, and lied to A**** Insurance in January of 2007 by triple billing for sessions that month. Did he do this to recover the money from claims “rejected” in 2006? It would appear so to me. Had he not lied to me previously in 2006, I would not have had reason to track his billing to A**** for my sessions, but I had reason to believe that Leonard might “do it again”.

necessary loss of a therapist

 
On this day three years ago my former therapist found out that I reported him for insurance fraud …Wow was that an uncomfortable discussion, starting at 430pm in the evening and lasting  5 hours into the night!
  Leonard R. morphed into a  worm….visibly wriggling and contorting himself to convince me I was the “bad guy” who needed forgiveness for my “grievous error”  in reporting him to the insurance company for insurance fraud! 
That he attempted to make this “grist for the mill” in a therapeutic sense boggled my brain! I was no longer a client of his in the first place….second, he did something illegal, not just unethical! Yet he went forth that night proclaiming that he was the person wronged….that I should have told him the detailed consequences of what would happen if he did not pay back the insurance company and have my sessions reinstated….( he had failed to fulfill his end of a deal we had made after I caught the insurance fraud in February 2007 that he would not place claims with the insurance company for the next 7 sessions until we caught up  with the number of sessions he had already billed for….sounded like a easy, clear deal to me! The dumbass went ahead and put the claims in anyway) He had had almost a year, 8 months in which he was no longer considered to be “my therapist” to do this,
After considering my options for a several months, and realizing that Leonard R was a “man of many words”…..but not a “man of his word” I turned the issue over to the insurance company….and later to the State of Connecticut Department of Public health. (there is no Licensing Board in Ct.)
 
 I most had to answer to myself as to why I even agreed to have this discussion with him! Why had  I placed myself in this sort of situation?
 It wouldn’t even be a brief consideration today!   I wouldn’t make it through the first session with a therapist like Leonard R…perhaps not even the first phone call…the red flags were flying then and there!

To Reap Psychotherapy’s Benefits, Get a Good Fit

http://www.nytimes.com/2007/08/21/health/21beha.html?_r=1

A slightly dated, but informative article on the therapeutic relationship from the new York Times (2007)

Americans seem to like psychotherapy. Whether it’s for the mundane conflicts of everyday life or life-threatening illnesses like major depression, psychotherapy is widely viewed as a healthy, if not harmless, pursuit.

Yet unlike most other medical treatments, psychotherapy can take considerable time. An infection can be cured in days, but remission of severe depression or anxiety disorder usually takes weeks or months, and a personality disorder typically requires years of intensive psychotherapy.

So if the outcome may be months or years away, how can a person tell whether his psychotherapy is any good?

It’s harder than you’d think. For one thing, people… (to read more click the above link)

Connecticut Department of Public Health Quarterly Action Reports

Here’s a link to a report on some  “select”  Licensed Health Professionals in Connecticut.

http://www.ct.gov/dph/lib/dph/communications/rar/pdf/qu_3_10.pdf

The volume of hairdressers, and nurses still amazes me! So does the very low count of Mental Health Professionals…one LPC, and one Psychologist, who was mentioned as he “completed his probation” for incompetance/negligence…feel safe?
….and I still wonder what an embalmer can do wrong!

More on choosing a therapist…

This article has some information I find very useful! It is very important to ask many questions when choosing a therapist…remember… you are the boss and are Hiring this person to work for you!

http://www.wikihow.com/Choose-a-Therapist

It can be difficult to choose a therapist. The times we feel our best, smartest, and most discerning will usually not be the times we find ourselves wanting to get some counseling. And when we’re not feeling our best, it can be frustrating to sift through the names and counseling styles to find someone who is understanding, experienced, and in possession of a good range of skills. The following is a procedure which should make the process easier and the results more reliable.

Steps:
1. Determine what part of your problem can be helped by a therapist, and write a brief (two or three sentences) summary of this. Use What a Therapist Can Do and What a Therapist Cannot Do in the Tips section below.
2. Obtain the names of therapists from sources that you trust. These can be family members or friends, favorite teachers, school counselors, your family doctor, your pastor or rabbi, and any other person whose opinion you value. Use online referral listings too, as there is a wealth of resources available online, often with an informative blurb about how each therapist works, their fees, etc.
3. Call each of the recommended therapists: ask lots of questions and take notes. You could ask the therapist about his/her training, or about whatever else feels important to you to know (for example, does s/he have experience working with people of your ethnicity/sexual orientation, etc.) You might also ask the therapist about how s/he handles conflict: therapists who are able to repair the rupture in the relationship when there is a conflict tend to have better outcomes than their conflict-avoidant colleagues. You’re essentially acting as an employer who is giving a job interview, and you’re going to determine whether you want to hire this therapist as a consultant. Keep this idea in mind during each call.
4. Try to call several therapists before you make a decision. Compare your findings to the tips and warnings below. Does s/he return your phone call in a timely manner? Do you like the way that s/he talks to you? Do you feel relatively comfortable talking to him/her about what is going on with you? When a therapist seems warm, personable, intelligent, and knowledgeable, and doesn’t display any of the warning signs below, consider hiring that person. Once you have interviewed all the prospective therapists, take some time to think about the best choice. If you plan on using insurance, call your insurance company to be sure that the therapist you like is covered, or if that therapist will provide ‘out of network provider’ statements to you.
5. Remember that your therapist is someone you have hired.(!) It’s important to bear in mind that some problems will take longer to resolve than others, so treatment duration can vary considerably. But if you notice absolutely no change in your problem after the first couple of months, hire a different therapist.

What a Therapist Can Do:
Can be an understanding and supportive listener.
Can help you develop your ability to cope with life’s difficulties.
Can help you develop some of your life-skills: more effective communication, better problem-solving, better impulse-control, etc.
Can help you look at your problems in different ways and with a different perspective.
Can help you gain more insight into your behaviors and emotions.
May be able to help you make changes in how you function and feel. (This may require a lot of hard work on your part, though!)
Can offer advice on how to find services which s/he isn’t able to provide.

What a Therapist Cannot Do:
Cannot remove hurt feelings and unhappy events.
Cannot change other people in your life, and cannot tell you how to change them, either.
Cannot create instantaneous change in you. Personal change requires hard and dedicated work.

WARNINGS!
Here are some warning signs to watch out for. A therapist who exhibits any of these behaviors should be viewed with caution or even avoided altogether.
The therapist doesn’t seem interested in allowing you to explain your problem; s/he seems to be more interested in fulfilling an agenda.
The therapist takes a ‘one size fits all’ approach. That is, s/he seems to have a ‘rigid program’ that everybody needs to follow.
The therapist advertises or claims ‘sure cures’ or ‘spiritual transformations’.
The therapist seems bossy or confrontational in a way that makes you feel intimidated or uncomfortable.
The therapist tries to get you to commit to a set number of sessions, or tries to get you to sign a contract for a ‘program’.
The therapist claims to have some radical new way of living or looking at life, which s/he is going to teach you about.
The therapist tends to cultivate a ‘cult of personality’ or mystique around who s/he is or what s/he does.
The therapist responds to some of your questions with “You won’t be able to understand what this is all about until you’ve made enough progress.”
The therapist offers ‘insights’ about your past which don’t seem to add up — which don’t seem to be true.
***The therapist makes any kind of sexual advance towards you.
***I’ll also add if the therapist commits insurance fraud!
ex. billing for sessions you did not have or billing more than an insurance copayment amount

These last two should be followed up by reporting the therapist to your State Licensing Agency and if fraud, your insurance company!

Choosing a therapist is a “buyer beware” activity. Be picky, and take your time choosing. Go with he person you intuitively FEEL will help you…not necessarily who you THINK will help you. If your encounters with a therapist feel wrong…they almost surely are wrong, or at least the therapist is not the “best” therapist for you!

“License to harm” Mental health Standards from Seattle

 

….and I thought Mental Health Care standards were low in Connecticut! These from Washington are staggering!

http://seattletimes.nwsource.com/html/licensetoharm/2002949517_sexmed24.html

NASW Ethics Code “wishy-washy”

How strong can the NASW ethics code be when the words “should”/”should not” appear 70+ times in just section 1!

you can count for yourself here or below…

http://www.naswdc.org/pubs/code/code.asp …or below….

The only act expressly prohibited by the code is having sexual relations with a client.(Sec1.09)

Even section 1.11 on Sexual Harassment only states that “Social workers should not sexually harass clients. Sexual harassment includes sexual advances, sexual solicitation, requests for sexual favors, and other verbal or physical conduct of a sexual nature.”

So what gives folks! You have an ethics code that a LCSW can run circles around and violate all but one aspect of that code without recourse or being concerned as to the outcome of unethical actions. “Should’s” and “should nots” are wide open to interpretation and do not serve to enhance the professions credibility or protect the interests of a client.

Sure, living life is hazardous in itself… and there is no guaranteed “safety” contract anywhere, but an ethics code of a professional organization must support the ideals of the organization in order to maintain it’s integrity…”should’s and should nots” are weak, unstable and to say it simply….”wishy-washy”

Section one of the NASE Code of Ethics
1. SOCIAL WORKERS’ ETHICAL RESPONSIBILITIES TO CLIENTS
1.01 Commitment to Clients
Social workers’ primary responsibility is to promote the well­being of clients. In general, clients’ interests are primary. However, social workers’ responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be so advised. (Examples include when a social worker is required by law to report that a client has abused a child or has threatened to harm self or others.)

1.02 Self­Determination
Social workers respect and promote the right of clients to self­determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self­determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

1.03 Informed Consent
(a) Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third­party payer, relevant costs, reasonable alternatives, clients’ right to refuse or withdraw consent, and the time frame covered by the consent. Social workers should provide clients with an opportunity to ask questions.

(b) In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients’ comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.

(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.

(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.

(e) Social workers who provide services via electronic media (such as computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services.

(f) Social workers should obtain clients’ informed consent before audiotaping or videotaping clients or permitting observation of services to clients by a third party.

1.04 Competence
(a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.

(b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.

(c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm.

1.05 Cultural Competence and Social Diversity
(a) Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

(b) Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups.

(c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.

1.06 Conflicts of Interest
(a) Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment. Social workers should inform clients when a real or potential conflict of interest arises and take reasonable steps to resolve the issue in a manner that makes the clients’ interests primary and protects clients’ interests to the greatest extent possible. In some cases, protecting clients’ interests may require termination of the professional relationship with proper referral of the client.

(b) Social workers should not take unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests.

(c) Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)

(d) When social workers provide services to two or more people who have a relationship with each other (for example, couples, family members), social workers should clarify with all parties which individuals will be considered clients and the nature of social workers’ professional obligations to the various individuals who are receiving services. Social workers who anticipate a conflict of interest among the individuals receiving services or who anticipate having to perform in potentially conflicting roles (for example, when a social worker is asked to testify in a child custody dispute or divorce proceedings involving clients) should clarify their role with the parties involved and take appropriate action to minimize any conflict of interest.

1.07 Privacy and Confidentiality
(a) Social workers should respect clients’ right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research. Once private information is shared, standards of confidentiality apply.

(b) Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client.

(c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed.

(d) Social workers should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies whether social workers disclose confidential information on the basis of a legal requirement or client consent.

(e) Social workers should discuss with clients and other interested parties the nature of confidentiality and limitations of clients’ right to confidentiality. Social workers should review with clients circumstances where confidential information may be requested and where disclosure of confidential information may be legally required. This discussion should occur as soon as possible in the social worker­client relationship and as needed throughout the course of the relationship.

(f) When social workers provide counseling services to families, couples, or groups, social workers should seek agreement among the parties involved concerning each individual’s right to confidentiality and obligation to preserve the confidentiality of information shared by others. Social workers should inform participants in family, couples, or group counseling that social workers cannot guarantee that all participants will honor such agreements.

(g) Social workers should inform clients involved in family, couples, marital, or group counseling of the social worker’s, employer’s, and agency’s policy concerning the social worker’s disclosure of confidential information among the parties involved in the counseling.

(h) Social workers should not disclose confidential information to third­party payers unless clients have authorized such disclosure.

(i) Social workers should not discuss confidential information in any setting unless privacy can be ensured. Social workers should not discuss confidential information in public or semipublic areas such as hallways, waiting rooms, elevators, and restaurants.

(j) Social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. When a court of law or other legally authorized body orders social workers to disclose confidential or privileged information without a client’s consent and such disclosure could cause harm to the client, social workers should request that the court withdraw the order or limit the order as narrowly as possible or maintain the records under seal, unavailable for public inspection.

(k) Social workers should protect the confidentiality of clients when responding to requests from members of the media.

(l) Social workers should protect the confidentiality of clients’ written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients’ records are stored in a secure location and that clients’ records are not available to others who are not authorized to have access.

(m) Social workers should take precautions to ensure and maintain the confidentiality of information transmitted to other parties through the use of computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology. Disclosure of identifying information should be avoided whenever possible.

(n) Social workers should transfer or dispose of clients’ records in a manner that protects clients’ confidentiality and is consistent with state statutes governing records and social work licensure.

(o) Social workers should take reasonable precautions to protect client confidentiality in the event of the social worker’s termination of practice, incapacitation, or death.

(p) Social workers should not disclose identifying information when discussing clients for teaching or training purposes unless the client has consented to disclosure of confidential information.

(q) Social workers should not disclose identifying information when discussing clients with consultants unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure.

(r) Social workers should protect the confidentiality of deceased clients consistent with the preceding standards.

1.08 Access to Records
(a) Social workers should provide clients with reasonable access to records concerning the clients. Social workers who are concerned that clients’ access to their records could cause serious misunderstanding or harm to the client should provide assistance in interpreting the records and consultation with the client regarding the records. Social workers should limit clients’ access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client. Both clients’ requests and the rationale for withholding some or all of the record should be documented in clients’ files.

(b) When providing clients with access to their records, social workers should take steps to protect the confidentiality of other individuals identified or discussed in such records.

1.09 Sexual Relationships
(a) Social workers should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced.

(b) Social workers should not engage in sexual activities or sexual contact with clients’ relatives or other individuals with whom clients maintain a close personal relationship when there is a risk of exploitation or potential harm to the client. Sexual activity or sexual contact with clients’ relatives or other individuals with whom clients maintain a personal relationship has the potential to be harmful to the client and may make it difficult for the social worker and client to maintain appropriate professional boundaries. Social workers—not their clients, their clients’ relatives, or other individuals with whom the client maintains a personal relationship—assume the full burden for setting clear, appropriate, and culturally sensitive boundaries.

(c) Social workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client. If social workers engage in conduct contrary to this prohibition or claim that an exception to this prohibition is warranted because of extraordinary circumstances, it is social workers—not their clients—who assume the full burden of demonstrating that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally.

(d) Social workers should not provide clinical services to individuals with whom they have had a prior sexual relationship. Providing clinical services to a former sexual partner has the potential to be harmful to the individual and is likely to make it difficult for the social worker and individual to maintain appropriate professional boundaries.

1.10 Physical Contact
Social workers should not engage in physical contact with clients when there is a possibility of psychological harm to the client as a result of the contact (such as cradling or caressing clients). Social workers who engage in appropriate physical contact with clients are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact.

1.11 Sexual Harassment
Social workers should not sexually harass clients. Sexual harassment includes sexual advances, sexual solicitation, requests for sexual favors, and other verbal or physical conduct of a sexual nature.

1.12 Derogatory Language
Social workers should not use derogatory language in their written or verbal communications to or about clients. Social workers should use accurate and respectful language in all communications to and about clients.

1.13 Payment for Services
(a) When setting fees, social workers should ensure that the fees are fair, reasonable, and commensurate with the services performed. Consideration should be given to clients’ ability to pay.

(b) Social workers should avoid accepting goods or services from clients as payment for professional services. Bartering arrangements, particularly involving services, create the potential for conflicts of interest, exploitation, and inappropriate boundaries in social workers’ relationships with clients. Social workers should explore and may participate in bartering only in very limited circumstances when it can be demonstrated that such arrangements are an accepted practice among professionals in the local community, considered to be essential for the provision of services, negotiated without coercion, and entered into at the client’s initiative and with the client’s informed consent. Social workers who accept goods or services from clients as payment for professional services assume the full burden of demonstrating that this arrangement will not be detrimental to the client or the professional relationship.

(c) Social workers should not solicit a private fee or other remuneration for providing services to clients who are entitled to such available services through the social workers’ employer or agency.

1.14 Clients Who Lack Decision­Making Capacity
When social workers act on behalf of clients who lack the capacity to make informed decisions, social workers should take reasonable steps to safeguard the interests and rights of those clients.

1.15 Interruption of Services
Social workers should make reasonable efforts to ensure continuity of services in the event that services are interrupted by factors such as unavailability, relocation, illness, disability, or death.

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 fee­for­service 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.

LCSW, LMFT, LADC, LPC… and what is a psychotherapist?

The below list is that of Credentialed professionals that are Licensed Mental Health Practitioners. Most States use similar titles, but the actual License Title may change. For example, in Connecticut a Licensed Clinical Social Worker is an LCSW…in Massachusetts a similar Title is LICSW….Licensed Independent Clinical Social Worker. The key word is “Licensed” . Ph.d, Psy.D and MD are Licensed Credentials recognized nationwide by each State. See your States Mental health Regulatory Agency for exact info.

(General) Licensed Mental Health Professional Titles:

Psychiatrist MD
Psychologist Ph.D.
Licensed Clinical Social worker LCSW
Licensed Professional Counselor LPC
Licensed Marriage and Family Therapist LMFT
Licensed Alcohol and Drug counselor LADC
Advanced Practice Registered Nurse APRN

Some States do have registries for unlicensed Mental Health and Alternative Health Practitioners, Connecticut does not. As a matter of fact, as I have mentioned in other blog posts, Connecticut does not even have a Licensing Board for LCSW’s, LMFT’s, LPC’s or LADC’s…the only “regulation” is directly through the Department of Public Health Office of Licensing.

All others are not regulated in any way!
Credentials/Titles such as those below are not Licensed Professions: I inserted blanks, as these titles will usually have a descriptive word or two before ( sometimes after) the title.ie…. “Spiritual” Counselor, “Mental Health” Advisor, “Life” Coach, “Career” Consultant

Mental Health Counselor
Hypnotherapist
Psychotherapist
Allied health Professional
Certified __________***Certifications*** are not licenses
___________Counselor (except as above…LADC, LPC)
___________ Therapist ( except as above…LMFT)
___________Consultant
___________ Coach
___________ Advisor
___________ Analyst

Anyone, without so much as a High School Diploma, can legally proclaim and use these titles!
….and there are others! People can be rather creative when coming up with titles that sound “professional”!
Nationwide, the Mental Health Profession is very poorly regulated! However you are taking a huge risk by using the services of an Unlicensed Practitioner. There is little recourse against unethical acts for the client of a Licensed Professional, there is zero recourse against unethical acts of an unlicensed practitioner!

Bad Therapy Red Flag #10 (Therapist sales pitches you to join an MLM)

Bad therapy Red Flag #10 Therapist “Sales Pitches” you to get involved in a MLM (Multi Level Marketing) Group he and his wife just “bought into”

Not much explanation needed here. My former therapist, L.Ruder, did attempt this not only with me but also with my ex-husband during his weekly session.

Fresh back from a trip to Canada and Niagara Falls, the therapist and his wife had attended a “seminar” that he “had” to tell me about. The seminar was a MLM seminar to sell cell phone EMF (electromagnetic frequency) protective devices….they came in the form of pendants, etc. I shut Mr Ruder immediately down in the middle of his sales “pitch”and told him I had no interest in MLM organizations regardless of what they were selling…to which I immediately got accused of being “closed minded”!. I had to reaffirm that this was not something I had any interest in….period… and was rather “put off” that he would start my session with this BS!

My “reaction” to being sales pitched by a therapist should not have become “grist for the mill” for the #therapy session and I was quite perturbed!
He did however “promise” to never bring up the subject again, but if I was to change my mind about this “awesome” opportunity I could contact his wife.

…and btw…when this was reviwed as part of the Licensing Complaint I filed with the Ct DPH…the Consultant didn’t see anything unethical about it…yeesh!