"What the Therapist Thinks About You"--NY Times article

[Dr. Richard Grossman]

Hi everybody,

Here's an interesting article in The New York Times:  "What the Therapist Thinks About You"
By JAN HOFFMAN  JULY 7, 2014 4:03 PM 346 Comments

http://well.blogs.nytimes.com/2014/07/07/what-the-therapist-thinks-about-you/?_php=true&_type=blogs&_r=0

The primary question:  Should patients/clients have access to their therapist's notes?  Thoughts anyone?

Richard

P.S.  L.O.L !  Only in New York (and maybe Boston) would there be 346 reader comments about such an article!

[Ales2]

I think we should have a legal right to see our notes, but that said, Im sure there are many instances when if the therapist knows their notes can/will be read, it will change how/what they decide to record.  That would be a problem and defeat the purpose. I would love to see my therapists notes, but he never took any in my presence. Some update things on a card, or 5 minutes after the sessions.

There are probably some cases of severe mental illnesses, schizophrenia and paranoia, where seeing the notes might cause problems or they may misinterpret what the therapist said, possibly eroding trust and interfering with treatment.

In some offices in various settings, Ive seen files coded in green (public) yellow (admin use only) and red (confidential, requires a court order) to allow certain documents to be viewed. Something like a yellow/red file would possibly work for these situations. Yellow for patients/red for practitioners (to avoid misinterpretation and protect privacy).

just my .02

[Gaining Strength]

I love this article and the concept. Without going to the bigger picture, I have to say that I, for one, would not want to see my file. I would forego the possible boost from reading encouraging positive remarks to avoid the risk of having the rug pulled out from underneath me by the only person who understands and cares about where I have been and where I am going. BUT, on principle, I think people should have access to their files.

I'm so glad I don't have to way out the costs and benefits. I see strengths for and against. But how nice it would be if you wanted to read your file and your therapist allowed it.

Now I'm retreating to my turtle shell.

[Twoapenny]

In the UK you do have a right to see your notes.  Written records are held under the terms of The Data Protection Act, which means everyone has a legal right to see what's been written about them, unless there's evidence that seeing them would cause exceptional harm (and even in those circumstances I think it ultimately comes down to a judge to decide whether that's the case or not).

What's written varies, though, depending on whether you are dealing with private or public sector.  Two private therapists I've seen went to great lengths to explain note keeping to me, and said that they don't write what they think about you, it's just notes about what you discuss to jog their memory for the next session and to help them plan for future sessions (exercises or techniques to suggest or work on, for example).

Public sector, though, and I've had all manner of things written about me - I'm a drama queen, manipulative, I lie and exaggerate to get attention, you name it, it's all there.  The public sector is well known in the UK for demonising patients to disguise the massive short comings in help and support - instead of focusing on making you well they can just say you're making it all up and wash their hands of you.  Arseholes.