The first time I sat down to write this commentary, I got so angry I had to stop and stay away from it for a week. Reading over the Agency’s response I see so much blaming-the-victim and cognitive distortion – all just to get the therapist off the hook. The fundamental question is: was that an appropriate message to leave on an ex-client’s work voicemail, and did it risk the ex-client’s confidentiality? The answer is: No, it wasn’t, and yes, it did.
I am certain of my answer because if you asked a random person about this situation, they would agree with me. No one wants to get a message like that at work. No one wants their confidentiality put at risk. Everyone can see that the surest way to maintain confidentiality is not to leave such a message in the first place.
Now, on to my blow-by-blow commentary of the response.
Right away I see that the summary does not contain the full text of the message left by my ex-therapist. The full message was 187 words. The excerpted parts add up to 33 words, just 18% of the original. My concern here is that the committee never saw the text of the full message, that it was edited down by an Agency staff member as they saw fit. Of course that would skew the committee’s interpretation. This message:
touch base and say goodbye
if there were things that have happened that [you] were not pleased with or felt disappointed with in the therapy
someone else who may be a better fit
is a whole lot less invasive and indiscreet that this one:
Hello [client] it’s [therapist], I got your message, thanks for calling. If you have a chance, when you have a chance, I’d like to just touch base with you just to be able to say goodbye, and I’m thinking of you, and thinking well of you, and hoping that your reasons for not wanting to come back are good ones. And I’ve just been thinking about you, and just want a chance to touch base and say goodbye, and if things haven’t gone the way you wanted, or if there were things that have happened that you were not pleased with or feel disappointed with in the therapy, I would be pleased to hear about that and to listen to that. And if there is someone else who might be a better fit, I would be pleased to help you connect with whoever that might be. Give me a call, and let me know when might be best to reach you. I might be able to try you later tonight at home too, but I’ll leave you my work number. Hope to connect with you soon.
[Although the shorter message still gives away “therapy”, anyone listening to either message would know that it wasn’t about massage therapy or a spa treatment. (Note: when spas leave confirmation messages on voicemails, they NEVER say what the appointment is for. Mani-pedi, bikini wax, threading, facials – whatever you are having done, they keep that shit PRIVATE.)]
On page 4 under “Reasons”, the committee says that the therapist did not act in bad faith by leaving the message. I think the therapist’s intentions are irrelevant here. Confidential is CONFIDENTIAL. Once you pee in the swimming pool, you can’t get the pee back out. It doesn’t matter if you didn’t mean for that to happen.
The blaming-the-victim stuff is found where the summary says things like
1) the client didn’t tell the therapist that the daytime number was her work number, (The therapist never asked. I was supposed to know to tell her? Isn’t most people’s daytime number their work number? Plus my outgoing message makes it perfectly clear that it is my work voicemail.), and
2) that there was no indication that anyone else used the line (I was supposed to know to tell her that too? But the therapist is not responsible for asking me that? And technically, it’s not my voicemail, it’s my employer’s, which means my employer can rightfully access it at any time.).
Also, I really do not care for this remark: “both the Member and the Complainant made minor oversights that resulted in this unfortunate series of events.” Grrr. I didn’t make ANY oversights, because it’s NOT MY JOB to teach the therapist about confidentiality. This REALLY vexes me. Aren’t therapists supposed to know how to maintain confidentiality already? Doctors do, banks do, freaking spas do, but therapists don’t need to? (I DARE the Agency to put that on its website.)
I answered the question as it was asked – for a daytime phone number. I was NEVER asked if confidential information could be left at either number. It’s not an oversight not to answer a question that was never asked. The Agency just doesn’t want to acknowledge that its Member fucked up.
Notice on the last page (last two sentences of the second paragraph) that the committee backtracks a little by noting that by saying “the therapy” the therapist exposed her identity (yeah, that’s what makes it a breach of confidentiality, duh), and that in future the therapist should change her intake form, and be as “vague as is reasonable” when leaving messages for clients.
Personally, I think “vague as is reasonable” is still too loose, because “reasonable” can be debated. I think the only sure way to maintain confidentiality in a voicemail message is to say next to nothing, e.g. “This is [therapist’s name]. Please call me.” Even leaving the therapist’s phone number is too risky, since a Google search or reverse-lookup could identify the therapist. The client has the therapist’s phone number anyway, or can look it up themselves. If the client doesn’t call back, that’s the breaks. Life goes on.
After all that, the reasons for the Agency wanting me to keep this secret is pretty clear: The Agency knows that their decision will not hold up to public scrutiny. They want the public to believe in their authority, so that they public will continue to pay for the services of the Agency members, who pay – through membership fees – the salaries of Agency staff. If the public loses confidence in the Agency and it members, and decides to get the same services from other providers or just not to bother with the services at all (since therapy isn’t proven to work anyway, who needs it?), the dollars will cease to flow, and these folks will be out of a job.
So, ask yourself, if you knew at the start that the above was the TRUE level of confidentiality you could expect, would you still have dealings with this Agency or any of its members?