Your Modern Therapist Ethics Questions Answered: Mail Bag!
Curt and Katie discuss tricky ethics questions we’ve received from listeners and colleagues over the years. We look at dual relationships, documentation, therapists in the public eye, fee setting, and when (and whether) we should report each other to the board. This is a law and ethics continuing education podcourse.
Click here to scroll to the podcast transcript.Transcript
In this podcast episode we answer complex ethics questions from modern therapists
Too often in groups of therapists, you’ll hear confusing situations being described as “unethical” or illegal without any other explanations. Big feelings about complex situations often lead to therapists avoiding them all together. We dug into our listener mail bag (and gathered our own questions) to sort through more complicated and modern questions that don’t often get talked about in grad school or ethics courses. We discuss dual relationships, documentation, therapist performers and influencers, fee-setting, and our responsibility to correct each other. We look at ethics codes and the philosophy behind ethical decision-making to sort through complex situations.
What do therapist ethical codes say around less typical dual relationships?
“When it comes to how ethics committees look at therapists’ behavior in these situations it’s: how foreseeable were any potential boundary crossings or boundary violations in these situations? What did the therapist do to take care of it? …What did you do to manage the potential of harm there? And was there harm actually caused?” – Curt Widhalm, LMFT
- Ethical codes do vary, so it is important to look at your own code
- We must avoid harmful dual relationships
- It is important to address foreseeable concerns
- Concerns related to muddying the mechanism of change (the relationship)
- Therapists must assess the potential boundary crossing and/or pressure for someone to do something in particular (i.e., purchasing a very expensive course)
- Exploring the difference between what is unethical or what is unwise
- What is patriarchal and what is reasonable protection for consumers?
- We look at the question about whether we can or should look up our clients online?
What is actually required in therapist documentation?
- Electronic documentation is recommended, but probably not required
- We need to accurately reflect what is happening in therapy
- Diagnosis may not be required if you’re not using insurance and don’t need to prove medical necessity
How can therapists show up in public spaces?
“I think that it [having other jobs in public] takes on a whole responsibility of other things that makes it to where there’s the potential for your therapeutic work to be influenced by people’s understanding of you outside of what you do.” – Curt Widhalm, LMFT
- Therapists can have public personas and will need to navigate how what is public may impact the therapeutic relationship
- Therapists can be influencers – you want to make sure you’re aware of how it is impacting your brand and relationships with your clients
- How you interact with your clients around your public persona becomes very context dependent
What are the special rules for therapists setting fees?
- You have to come to an agreement with your client on your fee before services start
- Looking at sliding scale, pro bono expectations
- There are so many interpretations on what is expected by your ethics
- We cannot take advantage of clients
- Therapists can only charge for services actually provided
- Discount packages may not be a good idea
What is a therapist’s responsibility when they believe another therapist has done something wrong?
- There is a strong recommendation in most ethics codes to go to the other therapist first
- It is difficult to get proof and/or get actual records and be able to release them
- There are potentials for confidentiality breaches if therapists move forward with concerns
- Supporting clients to report concerns if it comes up in session
Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!
Once you’ve listened to this episode, to get CE credit you just need to go to moderntherapistcommunity.com/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed – you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com.
You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/courses/your-modern-therapist-ethics-questions-answered-digging-into-the-mail-bag-to-identify-how-to-behave-ethically-in-modern-times
Continuing Education Approvals:
When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information including grievance and refund policies.
CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
References mentioned in this continuing education podcast:
Brownlee, K., LeBlanc, H., Halverson, G., Piché, T., & Brazeau, J. (2019). Exploring self-reflection in dual relationship decision-making. Journal of Social Work, 19(5), 629–641. https://doi.org/10.1177/1468017318766423
Haeny AM. Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life. Ethics Behav. 2014 Jul 1;24(4):265-278. doi: 10.1080/10508422.2013.860030. PMID: 25342876; PMCID: PMC4204330.
Luepker, E. T. (2022). Record Keeping in Psychotherapy and Counseling: Ethics, Practice and Supervision. Routledge.
Therapist Related Codes of Ethics:
ACA Code of Ethics Knowledge Center
APA Ethical Principles of Psychologists and Code of Conduct
*The full reference list can be found in the course on our learning platform.
Relevant Episodes of MTSG Podcast:
It’s the Lack of Thought That Counts: Ethical Decision Making in Dual Relationships
Dual Relationships: Pros and Cons
Small Town Sex Therapist: An Interview with Jeanette Tolson, LCSW, CASAC
Make Your Paperwork Meaningful: An Interview with Maelisa Hall, Psy.D.
Noteworthy Documentation: An Interview with Dr. Ben Caldwell, LMFT
How Can You Create an Ethical Faith-Based Practice? An Interview with Whitney Owens, LPC
Teaching Wisdom: Best practices for decision-making to support your clients
The Dividing Line Between Coaching and Therapy
Does Your Social Media Make You Look Like a Bad Therapist?
What Can Therapists Say About Celebrities? The ethics of public statements
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm, and Katie Vernoy.
Curt Widhalm 0:15
Hey, modern therapists, we’re so excited to offer the opportunity for one unit of continuing education for this podcast episode. Once you’ve listened to this episode, to get CE credit, you just need to go to moderntherapistcommunity.com, register for your free profile, purchase this course, pass the post test and complete the evaluation. Once that’s all completed, you’ll get a CE certificate in your profile, where you can download it for your records. For a current list of CE approvals, check out moderntherapistcommunity.com.
Katie Vernoy 0:47
Once again, hop over to moderntherapistcommunity.com for one CE once you’ve listened.
Curt Widhalm 0:55
Welcome back modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about things that go on in our practices, balancing being a therapist and a real person in our off work time. And it’s been a while since we’ve done a little bit of a mailbag sort of episode. And this is kind of a double whammy of both mailbag user feedback, while also be a continuing education eligible episode. So I don’t know if this is just like, we didn’t want to put together a traditional CE episode out of laziness, or just having a lot to kind of put together and take a grouping of, of our audience questions here. So we’re always happy to get feedback, get questions, sometimes you make it on to the podcast. And Katie is going to, she has cultivated a number of ethics related things. So this is a law and ethics eligible CE thing. And she’s going to serve as our reader of audience readings.
Katie Vernoy 2:12
Well, I think reader but also like, the person that’s going to argue a little bit with you, I think, because I think there’s times when there’s times you’re a little rigid. Not, not usually. I think, oftentimes you’re able to push the envelope, but there are times when it’s like, well, wait a second, what about this? So I’m going to do that. But wait a second, what about this as well?
Curt Widhalm 2:32
Okay.
Katie Vernoy 2:33
So the first segment, I think, really is in response to an episode that I think everyone should listen to. It’s on dual relationships. And there’s the famous now 17 part ethical decision making process that we go through. And honestly, I think we actually ended up doing the second half with the ethical decision making process twice. What got published was around a dual relationship in taking a client that knows a current clients. For our Patreon, folks, we actually did one on can we sell our therapy clients, our coaching products and services. And so we got feedback on both really, which is nice. But I think the first one is one that I already know the answer to this, but I think the the way that it’s brought forward, oftentimes, whether it’s in Facebook groups, or the things that we’ve we’ve gotten from our listeners, is this idea that we can’t have these deeper relationships with our clients. We can’t be friends, we can’t do therapy with colleagues, stuff like that. And that is clearly not true. That’s overly rigid. But beyond the like you cannot have sex with your clients, it seems like therapists hold this notion that we cannot have any other relationship with our therapy clients, except for the small town therapy, folks, they they understand that they’re going to know pretty much all of their clients, but but most attorneys can can work with their friends, obviously, there’s there’s some, you know, I’m not going to go into their ethics codes and their conduct, codes of conduct. But but what actually is true here, what kind of a relationship can we have with our therapy clients? Where do the ethics fall on this?
Curt Widhalm 4:24
So I’m gonna frame this with the codes of ethics are in place first and foremost, to kind of set an expectation that professionals can kind of set an expectation to the public of what to expect from most of us in most situations. And from the get go, I’m saying that there’s going to be a lot of “it depends” in these kinds of things. But there’s also some pretty significant differences from one code of ethics to another. So part of this is looking at the code of ethics for the profession in which you belong. The history of our podcast we’ve gotten into, the psychiatrists have a different code of ethics than the psychologist and the LCSW is than the MFTs than the PCs, and so on and so forth. So, use whichever code of ethics applies to you and go through a wonderful 17 step process.
Katie Vernoy 5:20
Don’t worry, folks, we’re not going to do the 17 step process on this episode.
Curt Widhalm 5:24
Yes. But I think most of the codes of ethics say something to the effect of, we need to avoid harmful dual relationships. Some of the codes do a better job of explaining that: here’s a definition of what dual relationships are. Which is any relationship that you have with somebody who is that’s in addition to your therapeutic relationship with them. And as you bring up, you know, kind of the small town sorts of things where some of them are going to be unavoidable. We’ve talked at length in past about how sometimes even in urban settings that dual relationships can sometimes even be helpful to clients. But I think as a profession, we tend to have a problem with: but even though this is an “it depends” contextual question, I want a really black and white answer that applies to everything, all of the time. So that way, I don’t have to continuously think about these things. And dear listeners, I’m breaking the news to you that you got to keep thinking. Because ultimately, what’s underneath harmful dual relationships is being able to foresee and foreseeably avoid boundary crossings, harmful things that happen between clients and therapists that can really impacts the therapists ability in their role as therapists that might end up putting too much power into the therapist part of the relationship, whether it be knowledge of things that a client isn’t ready to talk about in therapy, or things that can be manipulated by the therapist. When it comes to how ethics committees look at therapists behavior in these situations it’s how foreseeable was any potential boundary crossings or boundary violations in these situations? What did the therapist do to take care of it? And that kind of guides like, Alright, were you smart enough to look at could there be harm here? What did you do to manage the potential of harm there? And was there harm actually caused? So it’s still kind of, you know, maybe not a concrete enough answer here. There’s nothing that’s preventing you from having a dual relationship or a deeper relationship with clients. It’s how smart are you about it? And what are you doing in those situations where you’re like, anybody else in the profession would be like, yeah, that’s something that you shouldn’t have gotten into?
Katie Vernoy 8:06
Well, I think the challenge, though, is the what would a similarly situated therapist have done? Because I think a lot of therapists are very rigid about this. And so there are folks who aren’t able to get therapy, for example, because of the relationships they have with therapists, or because of, of some of these things, or people are very cautious about entering into these relationships. And so to me, I feel like the biggest part of what you’re talking about, is looking at the particular person, that you’re thinking about embarking on either therapy, you know, or the reverse, joining a committee they’re on or going to an event where they might be or those types of things, it seems like it’s specific to the client and the relationship that you have with that client…
Curt Widhalm 8:56
Yes.
Katie Vernoy 8:57
…or prospective client.
Curt Widhalm 8:58
Yes.
Katie Vernoy 8:58
And I think that’s hard, because a lot of times, and this is something I’ve actually talked about with my own therapist is, therapy seems to be clearer on those relationships versus consulting or coaching clients. Because coaching and consulting clients, it’s very messy. And it can feel very bad when you go to like a lunch with a coaching client. And either it feels imbalanced one way where they’re constantly asking to just pick your brain real quick things that they would normally pay for their wanting to get over coffee, or the reverse. You’re sitting there selling to this coaching client because you need more revenue or something. And I think that we kind of address it and remove it as therapists because we don’t quickly go to I can just be friends or interact socially with my therapy clients. Because there’s nothing that is said about it. We can but it’s it’s a more thoughtful process. Does that make sense I feel like you’ve got kind of a confused expression on your face.
Curt Widhalm 10:02
Well, I’m trying to hone in on what your question is here and why other professionals can do this kind of stuff and therapists can’t. And here’s, here’s kind of my off the cuff sort of answer to this is, as a profession that prides itself on the working mechanism of what happens, of why change happens, if it’s about ‘the relationship,’ and we’re muddying the waters of what ‘the relationship’ is without clearly defining it. That’s what separates it. Like, if I can be friends with my attorney, and my attorney can go in and do whatever it is that I need my attorney to do. There are certain laws and stuff that I expect them to be able to do the legal things that they do for me, it’s my attorney, I’m not friends with my attorney, my attorney probably is very annoyed with me about a lot of things. But, but that is something that it doesn’t muddy the waters of what their task as my attorney is. If, you know, I’m friends with my doctor, and we go out for dinner, and my doctor would probably be like, Sure you want to order that? Like, alright, you know, that might, you know, muddy how I feel about them overall, but it’s not necessarily going to change how well that, you know, they draw blood from me. You know, these are the kinds of things that our mechanism of change as a profession is entirely around the relationship that we have with people. When we don’t clearly look at how that affects people, when we’re not directly sitting in front of people in our office or in front of our telehealth sessions or out in the community or wherever you serve your clients. When there’s that additional piece to it, this is the professional responsibility that’s different for therapists here.
Katie Vernoy 10:16
That makes a lot of sense. I think that helps me more than than any of the other pieces. Because to me, you say Well, avoid boundary crossings or avoid violations. And it’s like, okay, violations feel a little bit clearer. You know, those things become clearer whether they’re legal or ethical violations, but boundaries are personal. People determine where their boundaries are. And I think the challenge is determining what boundaries need to be present in the relationship that you’re in. And that’s a dynamic boundaries are set and navigated negotiated between two or more people, right. I can set my boundaries, you can set your boundaries. But if we’re actually in relationship, those boundaries need to be negotiated and talked about between the two of us because you may have different boundaries with me than you do with someone else who you work with. Right?
Curt Widhalm 12:11
Right.
Katie Vernoy 12:23
And so, so talking about how the relationship is the mechanism of action for therapy or one of the most important parts of that, and how protective we are, I think that feels very, very clear. Because there are some some of my colleagues, for example, who I think could navigate a therapeutic relationship in some ways, and some that absolutely could not. And so I think being able to determine, Okay, what does that look like? How does this impact this particular relationship? And am I thinking about whether I’m going to harm the client, or prospective client. And is there a potential good that will come from making this step?
Curt Widhalm 13:33
Yeah, I think you got it totally.
Katie Vernoy 13:35
Okay. So this is similar. And this speaks to the Patreon version of our dual relationship episode. But, but we, you know, spoiler alert, we got to, I was not going to sell my coaching program to my therapy clients. But it’s not necessarily completely against the ethical codes to do so. Right?
Curt Widhalm 14:01
Right.
Katie Vernoy 14:02
So what is the potential for harm in selling additional services to our therapy clients, or having a therapist and de facto coaching relationship with the same client? What do we have to look for there?
Curt Widhalm 14:23
I mean, a lot of this is going to come back down to does it foreseeably put people in a position where they are feeling obligated or pressured? Is it something that goes against those boundaries that creates boundary violations to a client. Does it set expectations to these kinds of things? If you know your course costs 5% of what a session fee is, I wouldn’t worry about it. Unless you make there be reasons to worry about it. If you’re providing extreme sliding scale, you know, services on a week by week session and your coaching course costs, you know, the equivalent of a year’s worth of therapy sessions like, again, this is a very context dependent sort of thing. I think that a lot of these kinds of questions, very much stem from every situation needs to be treated as an exact equal situation. But there’s a lot of context dependency in these kinds of things. And it’s a lot safer, and especially the way that laws and ethics get taught to early career clinicians is, if you made this mistake with everybody, would it create harm? And in a lot of cases, at that point in your career the answer is: Yes. So, it’s something where getting to some of the nuance and some of the experience and why part of looking at ethics is talking with other professionals about this and getting multiple viewpoints on things to help you come to a decision on this is really important. Like you said, there’s nothing in the ethics codes, as far as I’m aware of that says, You can’t sell things to your clients, you can’t have other businesses, none of the ethics codes are gonna say that. And in fact, if the ethics codes do say that, then those ethics, you know, overseeing bodies are probably going to run into like antitrust sort of issues. Is it unwise in some situations? Absolutely. Is it unethical because it creates a situation in those dual relationships sometimes, because that power influence in the relationship is there? Yeah, that can make it unethical at times. But like I said, there’s a big difference in like, alright, if you have a client that just won the lottery, and is now ready to take your how to be wealthy coaching course, it makes total sense. If it’s somebody that, like I said, You’ve been seeing on sliding scale, who’s you know, working with poverty issues? Might be an entirely different conversation there. So, maybe frustratingly, through a lot of this episode just going to be like, the answer is really, it depends. And part of going through an ethical decision making model should help clarify a lot of these, it depends questions for you.
Katie Vernoy 17:27
I think the thing that, for me, muddies this a little bit, is that there are what are good business practices. I, I also consulted with CAMFT, the California Association of Marriage and Family Therapists on a program I was doing, and was told your therapy clients can’t sign up for this one day workshop, and was given a very definitive answer that I can’t do this very thing that we’re saying probably would not cause harm. I mean, there’s, there’s a lot to think about with this. And I do recommend, even though I make fun of it, I do recommend the 17 step process here. Because how you’re going to show up in these courses, what your what that relationship looks like, those are all very much it depends. So I get that. So so there’s that element with, which is what you’re talking about. But then there’s this other part, which is ethical codes feel a little bit patriarchal here. You know, we’re saying our clients are weak, and we can’t challenge them in this way. Or we can’t, we can’t become this powerful being that we’re going to force them to buy stuff from us. We have to, it’s infantilizing, to a certain extent, there’s an element of this where it’s like, these are consumers who who are able to make decisions. And it’s assuming that when they become our therapy client, that power differential is such that we have to protect them from dual relationships. And and I think there is some truth there. But I also I’m trying to look at other professions don’t worry about this this much. And so it feels a little bit like you know, kind of, we have a whole episode on, you know, kind of the racist patriarchal origins of our ethics. It’s like, how do we determine if this is leftover from that? And we’re unnecessarily infantilizing our clients and how do we determine if this is just the right thing to do?
… 19:23
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Curt Widhalm 19:27
You know, I used to feel the way that you describe this.
Katie Vernoy 19:30
Okay.
Curt Widhalm 19:31
I used to feel that our ethics codes both treated clients as extremely weak, but also the most capable people altogether. And it took kind of a while for me to see that, at least is an ethics committee would look at something is that we should treat people as equal as possible, as as capable as possible in making some of these decisions. But for those clients who do need that extra consideration, that is why those pieces are still in the ethics codes. You know, the clients who are going to, you know, have a dependency on somebody who’s in a power position do need to be looked at differently than people who are coming in for phase of life c-codes. That there’s needing to be some room for both that helps to guide people in a number of different situations and a number of different things. You know, it’s like saying that all clients from a certain, you know, racial or immigration group are going to behave exactly the same. Well, people from first generation, second generation out of that group are going to be looking very differently than somebody who’s, you know, only been in the country for a handful of weeks. So…
Katie Vernoy 21:01
I mean, and each person within each of those things that you described are going to be different.
Curt Widhalm 21:05
Exactly. And so as an ethics committee would look at these kinds of things, what they’re looking for is, What is your thought process when it comes to this particular client? If there are things that are very obvious that this client has relational trauma issues, then you’re going to be expected as a professional to have more foresight, and not have the expectations to treat them in the exact same way as, you know, here’s a colleague of yours who’s generally, you know, upstanding within the community and is coming in and dealing with a, you know, should I close my practice? You know, I’m kind of looking at, you know, do I want to keep doing this anymore? It’s, again, it’s going to be a very context dependent sort of discussion, depending on who’s there. I think in the way that you’re describing it, the way that I admit that I had looked at this before, is, we’re trying to look for our ethics codes to apply to every single situation and give us the exact answer of what to do. When really, I think a lot of the codes end up being more in a place that’s like, we can’t predict everything, not everything is going to be outlined. And if we did Curt’s six hour courses would be dreadfully boring, because they’re going to end up, you know, just trying to get into the nitty gritty of every single situation and define them. But I think that it really is kind of that middle path of both. Like for the clients that you should treat as being fully independent in making informed decisions about everything. On the other end of things, there’s going to be clients who are in the middle of, let’s say, a psychotic episode that aren’t going to be able to have the same wherewithal to make those same kinds of decisions. I think our codes for the most part, helped to look at both of those situations. I think, you know, Whitney said this in a in our episode on kind of religious sort of stuff is that, or maybe it was on the one that we did with her, but like, people don’t always read the entirety of the ethics code. And so we kind of tried to create this, like, well, here’s this one size fits all for everything. But there’s parts of the code that they’re obviously not referring to.
Katie Vernoy 23:30
What happens with that is, when we’re able to go client by client, we can make those decisions and be more nuanced and identify when we’re protecting our clients purposefully, or if it’s unnecessary, right?
Curt Widhalm 23:45
Yeah.
Katie Vernoy 23:46
When we’re looking at putting together a course or, or some sort of coaching program, we may need to go to a more overarching plan where clients can’t purchase this. And so then we’re stuck with the same thing. Where we’re, we’re going to the most protected versus being able to be more flexible. And I think the listener who reached out on this was was about this limits our ability to grow our income, and it limits our ability to to have sustainable practices and it feels harmful to us as professionals. And I see that and I think you and I at points get to a place where we we disagree on how much therapists should take care of themselves versus focus on their clients. And we’ll probably get into that again later in this episode. But to me, it feels like following the structure of the ethics codes, and having a policy that goes to a protective place, and then looking for exceptions on a case by case basis, I think becomes is something that we can do as professionals. Or is there something that that that would, that that could also be harmful? If we don’t consistently apply policies on some of these things
Curt Widhalm 25:12
I come from the standpoint that anything could be harmful. You know, I see you drinking your water there, Katie, you drink too much water that could be harmful. Like, there’s there’s the potential for harm. The part that we look for is, how well did you foresee things that should have been foreseeable?
Katie Vernoy 25:34
Okay. Okay. So I think we, we’ve addressed that pretty well. I think the last one, and this is actually my question, I’m going to claim it. But can or should we Google our clients? Or follow or read their social media profiles? What are the pros and cons of knowing more about what is out there about our clients?
Curt Widhalm 25:55
Depending on your code of ethics, I talked about this at the beginning, the ACA Code of Ethics says absolutely not.
Katie Vernoy 26:02
It’s a breach of privacy, right?
Curt Widhalm 26:03
Yeah. Without client permission, don’t do it. Other ethics codes are varying degrees of that all the way down to not stating anything at all. So…
Katie Vernoy 26:16
A little out of date, huh?
Curt Widhalm 26:19
Yeah, the aspects of this, and I hear different, you know, theoretical arguments on this, from all sides. You know, on one hand, it’s, you know, very much like the therapy relationship is what the client brings into the room. And if they want you to have adjunctive information about them, they need to give you the permission to look at those kinds of things. Other well meaning people are like, I should do as much homework as possible to understand what is going on with my clients before they come in. I think that, personally, that approach can lead to some opportunistic bias, whether it’s intentional or not, as far as how you interpret things that are not necessarily within the context of how the client wants to be understood. I think it can be something that, you know, I made mention before, you know, people who are like, Oh, I’m on the phone with you, and I’m Googling your phone number to see what your house value is to know that if I can charge you more than what my listed fee is, you know, as of 15 minutes ago, my fee just went up to $9,000 per session. So is it something that therapists should do? Or shouldn’t do? You follow the ACA code of ethics: absolutely not. Is it something that has the potential to bias your relationship with your clients? Absolutely. I think that it’s being able to kind of frame things in ways like you, you’ve had a situation recently, where a client had something that was happening in the news, I’ve had these situations before, you know, being in LA for both of us. There’s…
Katie Vernoy 28:12
Yeah.
Curt Widhalm 28:13
…celebrity news kinds of things that seep into sessions. Are they things that we should be aware of? Eh. I don’t have a strong opinion on those kinds of things? Is it something that you might come across just in your day to day life? Totally. Is it how you handle that information the most important thing? Totally. Is your own personal curiosity, diving into things. That’s pretty bad. Is that unethical? Depends on your ethics code.
Katie Vernoy 28:50
Yeah, I think for me, the, the piece, and we had a little bit of a conversation on this prior to recording and so you addressed some of the questions I had already. But I think the piece for me is as a consultant, I do want to understand the public perception of my client, as it as a coach, consultant and coach, like I want to have that information so that I am prepared for the conversation. The frame of that relationship is different. They’re asking for…
Curt Widhalm 29:18
Totally different. Get out of here with your coaching nonsense.
Katie Vernoy 29:18
Hang on, hang on.
Curt Widhalm 29:21
This is a therapy podcast.
Katie Vernoy 29:23
All right, but but the the frame of it is based on wanting some sort of strategy or executive coaching or something like that, right. So there’s, there’s or business coaching and so there’s an element of I need to show that I’ve done a little bit of homework and when I network I Google folks or I Google their companies, right? I look at their their websites before I meet with them to show I’ve done my due diligence. And what I’m hearing here from you is that therapy clients may not expect that and may not want that. And and what I came to and I’ll just I’ll cut to the chase that we can get to the next question is: if I have clients that are sitting in that field, because I often do career and executive therapy, that I can add a question to my intake saying, are there things you’d like me to know, feel free to add links and/or additional context here. Right. And I do have, “Is there anything else you’d like me to know?” on my therapy questionnaire. But I haven’t said feel free to add links, because I think some folks may want you to have some background that they don’t want to have to explain. And so that’s permission. And I don’t know that that’s, you know, I wouldn’t highlight it, it would be the last question that’s more of a throwaway question. But there may be folks that actually want a little bit more homework on the therapist’s part because they’re so tired of having to explain everything.
Curt Widhalm 30:48
I’m thinking of that therapy meme, where it’s like, I’m switching therapists so often that I’ve just created a PowerPoint of my entire history.
Katie Vernoy 30:57
Yes. So, so, maybe that’s, you know, you can also attach your therapy PowerPoint here. So okay, so that’s, that’s the ones that are specifically dual relationships. I think there’s some other ones that will come up about dual relationships as we go forward. But the next one I got, which was really, really interesting was about documentation. And this is a series of questions that I think are very interesting. It boils down to what is the minimum required documentation? But part of it is do we need to do digital documentation? Do we need to have documentation for all clients, and this came from someone that they’re niche is, frankly, billionaires. So folks are cautious, very high profile, they have a fear about their information either being obtained through hacking or legal means, and and not wanting information to be present. And so what is the minimum requirement? And how do we make sure that we’re following laws and ethics around documentation, while also understanding that we have clients who have different needs?
Curt Widhalm 32:02
The right amount of documentation is to do the right amount of documentation.
Katie Vernoy 32:08
Oh, my gosh, you said this was gonna be frustrating, but that is especially frustrating. What is the right amount of documentation?
Curt Widhalm 32:17
The simple question and I guess simpler answer to this, first and foremost is that you are not required to do things electronically. I think some of the updates around HIPAA and high tech laws and those kinds of things, provided a lot of guidance towards encouraging most things to be done electronically, but there’s no requirement that you have to put things into an electronic device.
Katie Vernoy 32:43
Okay, so that part’s easy. How about the you said the right amount of documentation: That is the most frustrating answer so far.
Curt Widhalm 32:52
Yes. The records that we have to keep need to accurately reflect what is going on in our therapeutic work with clients. And so it needs to not necessarily over describe and be a word for word transcript of things, but it does need to kind of state like, here’s what’s happened in sessions. Do you need to get into absolute details and quotes on things? I think you’re gonna get a wide variety of answers from a lot of different people. But regardless of the medium, this is straight out of the ACA Codes of Ethics, regardless of the medium. Counselors include sufficient and timely documentation to facilitate the delivery and continuity of services. Counselors take reasonable steps to ensure that documentation accurately reflects client progress and services provided, however much that you’d need to do in order to do that is the standard whether you’re an ACA Code of Ethics person or not, that’s a pretty good description across all of the fields that we do. So the answer to this is, even if people don’t want stuff written down, you still need to write stuff down.
Katie Vernoy 34:16
Sure. Demographic information, I think there’s a certain amount and we don’t need to make this into a documentation episode. But there’s the diagnosis issue, do they have to have a diagnosis? Do we have to explain medical necessity like, like if I have bare bones documentation that talks about my interventions and a vague client response, I put a Z code down or I have no diagnosis, just say client is in, in therapy to for life transitions. Like, like, at what point is it just like, I can’t do therapy for this person because I can’t sufficiently document therapy.
Curt Widhalm 35:03
Diagnostic is a interesting question, because I think you and I are both Marriage and Family Therapists. One of us I know for sure does family therapy, the other? Possibly?
Katie Vernoy 35:15
I do sometimes, I do sometimes.
Curt Widhalm 35:17
Okay. If it’s a family system, there’s not a diagnostic there. Like, as a, as a true thing, you know, if you’re, I see the question on your face, you’re going to IP somebody, you’re gonna identify patients, somebody and you’re gonna.
Katie Vernoy 35:31
I have to, I had to when I was doing it. It was it was under insurance. So I had to have an IP, I had to have a diagnosis. So. So there’s different parameters, but I’m talking about, we’re not using insurance and sure family. So that that theoretically goes for anyone, right? Anybody can come into therapy for any reason, and they don’t have to have a diagnosis, they just have to have a presenting problem.
Curt Widhalm 35:54
So you bring up the term medical necessity, which is a term out of third party reimburses, insurance companies, those kinds of things in order to justify paying you for the services that you’re providing. So, can people come into therapy without a diagnosis? Sure, there’s situations that call for that. Are you going to get reimbursed for those services by a third party thing? Probably not. So part of that medical necessity documentation aspect thing might be for a third party provider. What you are expected to do, though, is: have goals, have a treatment plan, and have your documentation reflect your work on that thing together.
Katie Vernoy 36:41
Okay. That makes sense. I think there’s a whole other conversation we go into about what is therapy and that, you know, the diagnosis thing. I think we talked about that there too. So I’ll link to that in the show notes. But I think, to me, there’s that element of if someone wants nothing written, not even their full name. And they’re, they’re wanting to do something different. I think they’re not seeking therapy, they’re seeking a different type of support, and we should not engage in a therapeutic relationship with them.
Curt Widhalm 37:12
Correct. And there’s nothing that precludes you from doing that kind of work with somebody outside of your therapy practice. Just run it as a different business sort of thing that does not, like don’t call something therapy, and then do something that’s not therapy. It’s just kind of like, if what you’re doing is not therapy, then make it very obvious that it’s not therapy.
Katie Vernoy 37:40
I think the challenge though, is if it’s very close to therapy, but it’s not therapy, because this is a person that doesn’t want their information anywhere, and they’re traveling around the country or the world. Like I think it’s something where we’ve got a therapy versus coaching one, we probably we’ll end up having to do more therapy versus coaching episodes, but it’s really how do you distinguish the service from therapy? Right?
Curt Widhalm 38:03
Yeah, you need to have that be in your descriptors and your agreements of what you’re doing very much up front. What you’re describing is the Impossible Burger of therapy, which is it’s close. It’s not the same thing.
Katie Vernoy 38:20
All right. All right. Okay, so another another area. This is one that I think we might really struggle with, is therapists that have some sort of a public persona. We have the influencer question. We have the therapists, as performers, actors and musicians question. Where do we want to start?
Curt Widhalm 38:42
I want to start with you asking a question because I know that I’m not going to give credence unless it’s a response to something.
Katie Vernoy 38:51
As we are recording, we’ve got a couple of strikes going on with the Writers Guild and sag AFTRA. So it makes me think can therapists be performers, can they be actors and musicians? Can they have an only fans account? Like? Can therapists have other jobs that are very public?
Curt Widhalm 39:11
There’s nothing that says that they can’t.
Katie Vernoy 39:14
Okay.
Curt Widhalm 39:15
I think that it takes on a whole responsibility of other things that makes it to where there’s the potential for your therapeutic work to be influenced by people’s understanding of you outside of what you do. I mean you and I are both in the Los Angeles area. You and I both know people who have been on the the big screen, the little screens, the that that was a part of their former life, and depending on you know, who we run into those might have been very prominent in a previous part of their life. Some of them didn’t make it in those industries and became therapists. So there is definitely that potential for people to be like, Oh, don’t I know you from being murdered in a Saw movie. And that’s going to be something that, yeah, you’re allowed to have a past life on things. Nothing is going to prevent you from having side hustles as far as our ethics codes go. It’s how you manage those situations when it comes up that really does influence things. Now, you bring up, you know, the question about having a only fans sort of thing. Unethical? Absolutely not. Unwise? Potentially. And I’m even gonna give this a pretty big, you know, kind of space here is that, you know, we talk a lot about the importance of like, lived experience when it comes to being able to work with people from different backgrounds. If somebody’s lived experience of being an only fans content creator allows for them to work from a better position with sex workers, I see that there’s potential benefits to those kinds of things. But really, the pearl clutching will come around. What if people find you with your concurrent only fans account and what happens with that? You know, you can’t like, I don’t I don’t know how onlyfans works. I have clients who do it. I don’t know the the nitty gritty of it. But if you can’t stop people from seeking you out on these sites, even if there’s a, you know, hidden user name sort of thing, does that have the potential to really shift how clients see you? Yeah. How you handle that information, how that impacts the therapy sort of thing: this comes into how well you hold yourself as a professional in those situations. It’s knowing that this is a potential as you create that kind of content. You know, some people call Katie and me influencers, I think ours is substantially different. I mean…
Katie Vernoy 42:12
Sure.
Curt Widhalm 42:12
I will say, I don’t have an only fans account. I make sure that a lot of the stuff that I put out into the world is largely therapy related. And I’m not intentionally doing this to be a therapy influencer, by any means. But people have called us this. So I mean, I’m granting a lot of people to be like, yeah, you can go out and you can do things. And you can be an influencer and that kind of stuff. Understand that, that could add to your brand. That could detract from your brand depending on who’s looking at the content that you’re putting out there. Unethical? No. Unwise? Some situations. Helpful? Yeah, definitely, for some people, if it’s done thoughtfully.
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Katie Vernoy 43:05
A question that comes up for me is that when you have these things, whether it’s an only fans or you’re an actor, or a musician, or you’re a social media influencer or something, right, there’s something that is in the public sphere. Do and I know that this is context dependent, but I want to open the question to discuss the context. Do you inform your clients about it? Do you talk about how we might interact in the public sphere? And if there are things that you find out about me that you want to talk about, bing them back? And of course, that means your clients going to Google you right away. But I think there’s that element of how far ahead of it do you get, and how do you determine what the conversation is with your client? And I’ll give you an example of how I’ve done this. I’ve had therapists who reach out to me for therapy. And depending on the presenting problem, depending on how all of that plays out, I let them know about the podcast, or when I was president of CAMFT. I would let them know those things and talk about, you know, or if they were a local therapist, I’m the person who runs the local therapists Facebook group. I talked about those things and said, would these be a problem to you? And how would you take that in? It was it was within the context of the conversation. But I think there’s that element of is this person putting themselves in an uncomfortable situation by becoming your client if they don’t know where you sit in the world and other places publicly?
Curt Widhalm 44:39
What you’re describing is some of the forsight that I was referring to earlier in the episode. You know, do I need to tell every seven year old who comes into my practice that I have a podcast for therapists and that I do these other public things? Absolutely not. So I think you know, this is again, one of those very much ‘it depends’ sorts of situations. If this is somebody who’s likely going to run into you at events. Yeah, you should probably bring that up and be like, here’s generally how I’m going to handle these kinds of situations. If that takes the surprise out of those kinds of situations, yeah, that’s one of the ways of handling dual relationships. If it’s something that movie that you were in 25 years ago, as an actor is getting a reboot, and it’s, you know, all abuzz and you’re being, you know, brought back up onto like Comic Con panels and that kind of stuff. And you have a practice that works with therapy geeks, and those kinds of things. Yeah, you might bring up those kinds of things. Your skill is to then bring things back to why your client is actually there and not making it about yourself.
Katie Vernoy 45:12
Yeah, yeah, exactly.
Curt Widhalm 45:30
But I think you know, as far as our ethics goes, it leaves a lot of your life outside of being a therapist, really open to doing a lot of things. It’s the skill of how you handle when that shows up in therapy, and not making it necessarily about you ends up being something that if you need specific guidance on I’d encourage you to consult with other people. But there’s nothing that absolutely forbids any of this kind of stuff.
Katie Vernoy 46:34
In our episode around is your social media making you look bad as a therapist. I’ll link that in the show notes as well. Towards the end, there was an element of our conversation where you kind of went to a place of therapists shouldn’t be influencers. And I disagreed, and we kind of went back and forth. And I don’t think we got to an answer there. And if if we’re not going to get to the answer here, that’s fine, too. But I feel like there are a lot of ethics codes, how we look at things, those things were written prior to social media, they were written prior to a lot of this technology. As you’ve stated, some of those have been updated. But I think that there’s mechanism of thought that we have to have very high standards, we have to be beyond reproach. And there’s a lot of that that just doesn’t fly when there’s cellphone cameras and social media and all of those things. And so what do we really need to pay attention to whether it’s in our own just social media, but also if we’re wanting to be influencers, especially within our niche and use it as therapists marketing; What are the things that we can do in a positive way? Not just like, hey, you shouldn’t do it. But how can we be effective in social media, if especially if that’s a mechanism of us marketing our practices?
Curt Widhalm 48:00
I want to clarify that my point isn’t, don’t be an influencer. My point is, have the foresight to know that what you’re putting out and influencing might detract from how your clients or potential clients see your ability to work with them. I mean, look at how many people throughout the pandemic had very strong 30% informed viewpoints about the ways that the world should operate things that completely detracted or influenced how much you liked the person as far as their art and artistry someplace else. So we run the same risks of that. We might not have a bajillion Instagram followers or something like that. But my caution is that you want to show consistency with who you are. And veering too much into too many things, being only partially informed about things really has the potential to make you not be seen in the way that you want to be seen. And, you know, going back to that episode, as opposed to this episode, ethically, when you make public statements as a professional, people are going to grasp on to those. And people are going to say well, this therapist spoke out about this thing, therefore the entire industry is you know, crumbling down sort of thing, you know, propping somebody up just because they have credentials and an opinion that doesn’t necessarily fit within the status quo. That might be what you want to do but you do have a responsibility to speak truthfully, as a professional in those situations. Now, if you’re out influencing something else, I don’t know. Herbalife is you test the credibility when you put your credentials in that sphere, you know. So, it’s something we’re very much like is there anything that forbids you from that? No. Are you going to be held accountable when you use your professional status to influence those kinds of things? Absolutely. If there’s a complaint.
Katie Vernoy 50:25
I think there’s probably more of an episode on this. And maybe we need to find a cool therapist influencer that will come on and talk about this and how they’re ethically being a, a, an effective influencer, because I feel like there’s, there’s more guidance to be here. But we don’t have time for that level of conversation. But I think we got to a reasonable spot with that question. The next section of questions are on fees and payment. Are we ready to move to fees and payments? So what are the minimum standards for fees setting for therapists? How do they differ from legal business practices? It feels like therapists hold that a lot as ethical or not ethical, but it doesn’t seem to align with traditional business practices. So sliding scale, or what we charge or, and this is one that I’ve come across with folks who do like DBT, or trying to, you know, set up things differently. Why can’t therapists keep money for unused services if clients pay in advance for a reduced rate? And I think this goes back to power differentials, and, and all of that, but it’s it’s this higher standard around how we set fees, how we enforce these fees, and what we have to do if we put together like packages.
Curt Widhalm 51:50
So there’s a lot in this question.
Katie Vernoy 51:55
I know I’ve kind of combined them. So maybe we parse them out, where do you want to start?
Curt Widhalm 51:59
Okay, so ethically, what do you have to do with fees, you have to come to an agreement with clients about your fees before starting services. They have to know what they’re going to be charged. That’s ethically, that’s legally, you know, no surprise billing sorts of things. They have to know what they’re paying and what that’s based on. Can you set that to be one cent per session? Totally. They just need to have that be the expectation, and it’s agreed upon before services start. And nobody’s forcing you to charge a bajillion dollars per session. But if that’s what’s agreed upon, you better have some standards that you can do better therapy than the people around you. But the usual other end of this conversation is more pushing for fees to be on the downward side of things, and that you must have sliding scale options, or those kinds of things, or how do you figure out what sliding scale options are? Or do you just ask people at the beginning of everything, How much you want to pay for therapy? Oh, $9 per session? Great, that’s what you say. The bare bones of this is there has to be a fee that you agree upon, even if that’s $0 that that is understood at the beginning. Now, some ethics codes, say that you should do free work. Some ethics code, say that you should do work that is not expecting or charging very little for some of the work that you do. It does not say that that has to be therapeutic sessions. And so that can be serving as board members for your therapist organization. That can be putting out an award winning podcast, or a not award winning podcast. That is something where you are giving back with your therapeutic skills to a community of people without the expectation of a regular fee, or sometimes any fee at all. So I think that some people take that as a very literal, like the ethics code, say that you need to do pro bono work or reduced fee work. And they interpret that as the only way that you are doing work is by seeing clients. And I think that that’s kind of become just one of those things that sits in the background. But there’s a lot of interpretation, like, you know, have you done some pro bono work today? Yeah, I wrote some blogs that I put out to a, you know, a number of parenting groups on, you know, family systems kinds of things. Great, that’s pro bono work.
Katie Vernoy 54:39
On the other end, there are those folks who say that people are charging too much. And so is there an upper limit of what we can charge and how do we ethically follow rules around that?
Curt Widhalm 54:54
So this is where it’s not taking advantage of clients. And that is going to vary wildly. And, you know, as much as many people in our profession are going to hate what I’m about to say next: privileged and wealthy people need therapy too. And if your fees are not taking advantage of them, if your fee is solidly providing services, it’s doing good work. I was approached by someone several years ago that is, within the realm of household names across the US. And they said, you know, we don’t really want to bring our child to the therapy office, what would your fee be to come to our location of Los Angeles placement? Um…
Katie Vernoy 55:59
That’s a very weird way to say that.
Curt Widhalm 56:01
They have places all over the world.
Katie Vernoy 56:03
I’m just saying, Come Come to come to us, you could have just come to us those words.
Curt Widhalm 56:09
How much would, how much would it cost to come to us to do a therapy session here? And I said, Well, your location is about x distance from me, plus the therapy time plus me to travel back to my office, that would realistically be, you know, three sessions worth because I’m not able to book somebody immediately before or immediately after you. And they said, that’s fine. You know, who we are. Is that taking advantage of somebody? No, it’s an agreed upon fee, the rationale of it’s explained, they, you know, stated that it was okay. Am I upselling them because I have heard of them? No, this is all within the realm of this is my fee, this is how I apply it.
Katie Vernoy 56:57
Sure.
Curt Widhalm 56:58
Now…
Katie Vernoy 56:58
And I think you probably could also have gone and there’s wear and tear on the car, and there’s this and there’s that and so the fee is x.
Curt Widhalm 57:04
Right. Now…
Katie Vernoy 57:05
And they probably still would have said fine.
Curt Widhalm 57:07
Now is my fee and my specialty in a very, you know, privileged and wealthy part of Los Angeles, something that is going to seem astronomical to somebody who’s beginning out their career in a lower cost of living area that’s a lot more surrounded by poverty sorts of things? Absolutely. I accept that. Can you tell me how to run my business? You can have your opinions on it. But there’s nothing within our ethics codes where our laws that say, we all have to follow the exact same income strategies.
Katie Vernoy 57:46
Okay, so we can follow basic legal business practices, except where they differ from that our ethical codes. So I want to get back to someone telling you what to do. So put a pin in that let me finish the fees, and then we’ll we’ll get we’ll get to the other therapists questions on ethics. But I’ve heard and maybe this was just from CAMFT, and it’s something where it’s a little bit more cautious than it needs to be. If I say, if you pay ahead for six months worth of treatment, this is what it would cost. And then if they don’t complete it, I have to give back at least a certain portion of that amount. Is this an ethics code? Or is this just…
Curt Widhalm 58:31
This is an ethics code and a legal thing.
Katie Vernoy 58:34
Okay, so explain that to me.
Curt Widhalm 58:36
You can only charge for services actually provided. And so if you say, you pay ahead for X number of sessions, and they don’t use that number of sessions, you have to give them that money back. Because that fee that you agreed with them upon at the beginning, you’re now charging them for services that you didn’t provide.
Katie Vernoy 58:56
I think attorneys have this too, right. Like you can be on retainer, but they, you, you. They can’t charge for services they don’t provide.
Curt Widhalm 59:05
Right. So…
Katie Vernoy 59:08
That’s pretty similar.
Curt Widhalm 59:09
And then a couple of minutes ago, you said, Well, if you give a discount on this, there’s a article from Ben Caldwell that we’ll put in our show notes over at mtsgpodcast.com. But it basically describes that if you’re giving a discount for services based on kind of a package deal, you’re kind of de facto serving as an insurance company. And you don’t want to be acting as an insurance company. But…
Katie Vernoy 59:38
Well, for moral reasons, right?
Curt Widhalm 59:42
Of course, that was…
Katie Vernoy 59:44
That was a given.
Curt Widhalm 59:44
I want that to be on your part of the transcript, not mine. Find out transcripts over at mtsgpodcast.com. And but what you’re offering as far as a package deal if they’re not taking, you know, full advantage of all of the sessions. Are you going back to them and being like, well, since you didn’t do it, that changes what our agreement was on a per session basis. You know, are you, you know, the government like, Hey, we’ve been taking taxes all year, but it’s April 15, we need a little more money. Like.
Katie Vernoy 1:00:23
I think those things get confusing. And I think that’s probably beyond the scope of this this episode, especially because we’re getting real close on time. But to me, it seems like there, there are business practices that we need to pay attention to, there are some ethics around, you can’t charge for services that are not provided. And there’s also you can’t change from what was agreed upon.
Curt Widhalm 1:00:44
Right.
Katie Vernoy 1:00:45
Okay. All right. So with respect to other therapists, the questions I see a lot or that come up for me when I’m in some of these Facebook groups is Do we have to go to other therapists first, before reporting to them to the board? Do we actually need to report anyone to the board? And are there confidentiality issues, if we go either to another therapist or to the board? We did a whole episode on impaired therapist, so we go into more depth about that. But this is something I continue to see over and over again, you need to report them to the board, or you need to do this. And this, I think comes from like, you know, sometimes it’s doxxing, sometimes it’s canceling, like, there’s a lot of stuff that happens. But what do we actually need to do if we’re concerned that that one of our colleagues or potentially another therapist in a different, with a different license is doing something wrong?
Curt Widhalm 1:01:39
So our ethics codes largely encourage us to go to those other therapists first. And part of this is, when we’re talking about harm to clients, we have to look at who actually has the right to release the record that somebody was in therapy with this person in the first place. And a lot of times that comes down to the client themselves. You know, if, you know, let’s, let’s say that there’s a therapist that you and I both know, in the community, let’s called the therapist, John Doe. The I hear, you know, from somebody, Hey, my therapist, John Doe, did something, you know, that, you know, was a sexual pass at me and tried to, you know, encourage sex with me in session. I, as another therapists don’t have any proof in going to an ethics committee, or to a licensing board that there was actually even a therapeutic relationship there. You know, there’s kind of like, Yeah, I heard from somebody they seem credible within what they’re describing sort of thing here. But knowing that as part of the investigation, the licensing board, or the ethics committee is going to be like, Okay, do we have the clients permission to actually talk about them being in therapy in the first place?
Katie Vernoy 1:03:03
Yeah.
Curt Widhalm 1:03:04
So as an ethics code, and holding our selves to a higher thing, our mechanism of action is to actually encourage to approach the John Doe’s in these situations to say, Hey, this is something that is being reported about you within the community, that you are kind of limited in your ability to actually report anybody to a licensing board without client permission.
Katie Vernoy 1:03:35
Well, can I even go to John Doe if my client says no, don’t talk to them?
Curt Widhalm 1:03:37
I would respect the client’s wishes in that case, because if that is your client in this situation, you know, I think we’re I was describing it as, hey, I’m just somebody and…
Katie Vernoy 1:03:50
Sure.
Curt Widhalm 1:03:51
You know, I’m at a dinner party, and somebody is like this. But if it’s my client, and they say, Don’t do that, you can’t do that, because they’re not giving you permission to break confidentiality. What you can do is inform them on, here’s how you as a client can file this report, and here’s how I can support you in that process. But if they say don’t go to John Doe, you are not legally allowed to go to John Doe.
Katie Vernoy 1:04:14
So it’s the professional therapy never includes sex. There’s you know, that that brochure, there’s that kind of stuff, but if it’s just something that’s in the in the therapists community and you hear or your social setting, and you hear something, Do you have to go to the other clinician, do you have to do anything with that information?
Curt Widhalm 1:04:36
Lazily, you don’t have to. We would hope as a profession, that you’re able to use your skills of helping shape other people’s behaviors to help shape the behavior of those other people who are representing you and your license.
Katie Vernoy 1:04:54
So it’s a you should but you don’t have to.
Curt Widhalm 1:04:57
Pretty much, yeah.
Katie Vernoy 1:04:59
Okay. Because I think people feel like they need to. And I think there are times when it may be hard for someone to approach a colleague in the community. There’s there are times when it may feel like it’s just so nebulous, it feels premature. I mean, I think there’s, there’s several pieces to this where, I mean, that’s a pretty hard decision.
Curt Widhalm 1:05:24
Yeah. And depending on how unhinged, John Doe, is, in these situations, I understand why some people might not want to spend their non working with clients time, exuding that kind of energy, especially if it brings you within the targeted sights of somebody who’s acting and behaving in this kind of way.
Katie Vernoy 1:05:47
Okay, so we’re low on time, I think we’ve gotten through most of the questions that I think we’re most important on kind of our ethics mailbag. Are there any other questions that you have received that you want to make sure we address before we close up?
Curt Widhalm 1:06:04
I think this is good for this ethics mailbag. I think, if you do have more questions, make sure that you send them into us. If it’s on our social media, or by email, send it to us at podcast @ therapyreimagined.com. And, you know, follow us on our social media, that kind of stuff. Reach out to us, let us know your questions. We’ll collect them. We’ll probably do another mailbag in the future. And if you want to continue to support us, you know, get your Ces through us and follow the directions at the beginning and the end of the episode, consider supporting us on Patreon where you get some extra content from time to time or Buy Me a Coffee. And until next time, I’m Curt Widhalm with Katie Vernoy.
… 1:06:49
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Katie Vernoy 1:06:50
Just a quick reminder, if you’d like one unit of continuing education for listening to this episode, go to moderntherapistcommunity.com, purchase this course and pass the post test. A CE certificate will appear in your profile once you’ve successfully completed the steps.
Curt Widhalm 1:07:05
Once again, that’s moderntherapistcommunity.com
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