After
years of ongoing issues with our relationship, my wife started therapy about
six months ago. She was really pushing me to start seeing her
psychotherapist as well, to deal with my personal issues (which she believes
is the root of our problems) After about 5-6 sessions into to her therapy,
I began to accompany her for a few couples sessions. I then called to set
up ongoing individual sessions. He told me that he didn’t feel comfortable
seeing me because he didn’t think he could be impartial. He encouraged
me to start seeing his wife (also a psychotherapist) instead. He explained
that each person needs to feel as though he or she has someone “in his
corner.” I understood that, but thought that he should be professional
enough to avoid becoming impartial. . . . My overall concern
about this issue was how he could effectively counsel a couple without seeing
and understanding both people. He assured me that he and his wife would compare
notes, but it’s hard for me to trust in that process. I also thought
about how common it is for couples and families to share the same therapist.
To make this more stressful, I now felt trapped into having to see his wife,
who may or may not be the right therapist for me. Then what? Would I have
to see someone else, and would they then be expected to visit with my wifes
therapist to compare notes?! It just didn’t seem to make sense. Since
then, I’ve had about 10 sessions with his wife, and am at the point
where I don’t feel as though she’s right for me. Even is she was,
I wouldn’t feel comfortable with having to pay double ($290 per hour)to
see her and her husband, when other couples are paying for one therapist.
I’m stuck and am not sure where to go with this. I would like to be
able to find another therapist, but am not sure how to best handle the couples
counseling.
In answer to one previous
question, I say that the function of marriage counseling is to create
a safe and respected environment in which the husband and wife can communicate
with each other without hostility. If, after understanding the needs and
desires of the other, one person refuses to accommodate the other, then
individual psychotherapy can be prescribed, so as to uncover and heal the
cause of the resistance to fair and charitable
cooperation.
Similarly,
in answer to another question, I say that sometimes,
when a husband and wife are being seen in marriage counseling, the counselor
may occasionally arrange to see one or both individuals in individual sessions.
Usually, to avoid clinical disaster, these individual sessions are conducted
under the rule that there will be no secrets, and that anything spoken in
the individual sessions must be brought into the joint counseling. If either
person has the sort of psychological problems that would warrant individual
psychotherapy under strictly
confidential
conditions, the individual(s) should be referred to a separate psychotherapist,
someone who has no connection to the marriage counseling.
Now, in your
case, your wife began her own individual psychotherapy, you joined her for
some sessions of marriage counseling, and then you requested your own individual
psychotherapy. Ultimately, then, you were asking for three forms of
treatment, not two: your wife’s individual psychotherapy, marriage
counseling, and your own individual psychotherapy.
In all of this,
though, the concern should not be about impartiality because marriage
counseling must be a cooperative process, not an adversarial process. The
real concern must be for
confidentiality,
in any treatment modality.
• |
If one
psychotherapist were to see you and your wife individually in addition to
seeing you both as a couple, steps have to be taken to make sure that
“secrets” emerging from the individual psychotherapy do not obstruct
the couples sessions. Everything must come out into the open in the marriage
counseling. There has to be an open agreement here about a waiver of
confidentiality regarding information obtained in individual sessions. If
either you or your wife do not feel comfortable with this, then you should
be seeing a marriage counselor with no connection whatsoever to any of the
individual psychotherapy. |
• |
If one
psychotherapist were to see both you and your wife, each in individual
psychotherapy, information obtained from your wife in her sessions cannot
be revealed to you without her written permission, and vice
versa. |
Under these
conditions, your wife’s psychotherapist chose to refer you for individual
psychotherapy to someone else. Even though, technically, he gave you the
wrong reasons, he made a clinically acceptable decision—at least, to
a point. By referring you to his wife, however, rather than to some other
person with no intimate connection to him, he opened the possibility of a
breach of your confidentiality. If he and his wife “compare
notes”—even casually—without your written authorization,
they will make an ethical violation that, with your formal complaint to their
licensing boards, could cause them to lose their licenses.
As for the referral
itself, no client is bound to accept treatment from anyone referred by a
psychotherapist. In fact, if a psychotherapist makes a referral, several
names should be provided so that the client has a
choice. If only
one name is provided, that, too (if it can be shown to have a coercive quality)
could be construed as a violation of professional ethics.
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