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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by toojane on October 30, 2006, at 12:38:07
I discovered this board several months ago and have found a great deal of solace here reading about all of your experiences. You have created a wonderfully supportive community that even touches people who are too timid to participate. I finally found the courage to register after reading Wishingstar's latest post. Her story breaks my heart.
I guess I am finding it very hard to understand how therapists can be so cruel. I've read all the posts here from the very beginning of the board and the variability between therapists is astonishing to me. And frightening. There seems to be no standard level of care that is followed. I realize that professional liscensing bodies set them, but in practice it appears that 'anything goes.' Anne abandoned Wishingstar. Three other therapists are aware of what she did and yet not one of them appears to have done anything to hold her accountable. Instead, Wishingstar is told there is something wrong with her. What normal person wouldn't be upset about this situation? Dismissing her distress as typically 'borderline' is appalling.
I guess I am wondering if the therapists people write about who behave unethically are clinical psychologists or if they are lay counsellors or social workers? I find it hard to comprehend how someone could spend more than a decade earning a PhD in psychology without being weeded out by the people training them.
Posted by Dinah on October 30, 2006, at 13:28:24
In reply to Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 12:38:07
Unfortunately, terminating clients is not considered unethical as long as you give them referrals. In fact I've read therapy books that advise therapists to terminate clients when they don't think they're being helpful.
Also unfortunate, but all too common, is the dismissal of the importance of the therapeutic relationship to clients (perhaps not all clients, but a significant segment). My therapist recently told me that he thought I'd get more and better support here on Babble if I ever lost my long term relationship with him than I would from a good proportion of therapists who wouldn't understand.
I think there are standards of care, but they vary widely by the type of therapy perhaps even more than by the type of degree.
The mental health professional that yelled at me and told me all sorts of unprofessional things was an MD.
My therapist tells me he's learned many things from me and from this board that he didn't learn in therapy school. He has primarily a short term CBT therapy training.
Maybe Babble should be required reading for future therapists.
Posted by Lindenblüte on October 30, 2006, at 13:31:22
In reply to Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 12:38:07
Hi toojane,
I'm so glad you decided to post here.One thing I find interesting about babble is that I tend to participate more and post more about myself when I'm feeling poorly. That's because this is a support website-- so I feel that I need more support when I'm having doubts or struggling. It's impossible to characterize the nuances of a therapy relationship, or even the nature of a session without having been in the room AND having been in both the T's and the client's minds! I write stuff about how my T is crazy or whatever, but a lot of that is colored by my own perceptions of reality, which are distorted, which is why I'm in therapy in the first place! Please note that I speak only of myself, for myself.
I think it's important to understand that therapists are people. They have quirks. Some are good, even genius; while others lack experience or motivation to help their clients. Also, sometimes I (clients) demand a LOT of my therapist, like when I cannot discern reality, or when I cannot express myself. Sometimes it's easy to forget that therapists think of me as "one of the clients", while I think of my therapist as the "one and only (therapist for me, (ever?!?))".In general, someone who has a complicated or difficult condition usually ends up working with a PhD, PsyD or MD (someone who has a doctorate degree). However, there are many very talented people, each with their own unique perspective. I think there are people in all walks of life that have interpersonal skills to provide some benefit to people having a hard time.
Some of the T's are trained as clinical social workers, as psychologists, or as medical doctors, but I guess most of the stuff I've read says that the "fit" between the therapist and the client/patient is the most important factor.
I also wanted to correct one aspect of your post- it's possible (in the USA, at least) to earn a PhD in clinical social work. Such a therapist may have "LCSW PhD" following their name and be licensed to practice psychotherapy. PsyD is a doctoral degree in psychology, which is generally awarded to persons trained to practice clinical psychology. It's also possible to get a PhD in clinical psychology. Maybe it's even possible in some places to get a PhD in English and get a license to practice psychotherapy if one has enough coursework, passes and exam and does an internship? with supervision and evaluation.
I wish only the best, most talented people ended up as therapists or counselors. Alas, it is not so...
-Li
Posted by toojane on October 30, 2006, at 13:43:56
In reply to Re: Unethical Ts and qualifications » toojane, posted by Dinah on October 30, 2006, at 13:28:24
> Unfortunately, terminating clients is not considered unethical as long as you give them referrals. In fact I've read therapy books that advise therapists to terminate clients when they don't think they're being helpful.
Hi Dinah. I've been reading you for so long it's kinda neat to actually be talking to you.
I didn't mean that being terminated 'properly' was unethical. Of course there are situations where it is necessary. But terminating a patient while she is crisis, in an outpatient treatment program, and having another therapist do the dirty work, not even deigning to meet with the patient to process the loss of the relationship, is terribly, terribly wrong.
I don't understand how someone trained in any school of therapy could do that to a vulnerable patient.
Posted by Dinah on October 30, 2006, at 13:57:04
In reply to Re: Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 13:43:56
Well, I think so too. In fact, I'm not sure how they do it as a human being.
It's just that the ethical standards are sort of fill in the blanks, cya, stuff. Many professional standards seem to be. So she might have technically satisfied the ethical requirements while falling short on less technical measures.
It's a shame there isn't more recognition of the issues in client/therapist relationships. A while back, I was trying to find information on how to handle sexual attraction on the part of a client (it wasn't personal to me - lol) and I was speaking with a group of professionals who were most grateful when I directed them to the APA video on the subject. From even the description of the video they realized that their training was insufficient and that they had misperceptions about the proper course of action. :(
It's very nice to meet you and speak with you as well.
Posted by caraher on October 30, 2006, at 14:03:41
In reply to Re: Unethical Ts and qualifications » toojane, posted by Dinah on October 30, 2006, at 13:57:04
I think it's important to remember that in a forum like this, you're more likely to hear stories of exceptional behavior. The folks with good therapy experiences on average would feel less need to seek out a place to discuss their therapy!
Also, even in psychology earning a doctorate has little to do with the moral fiber of the person with the degree. Perhaps in a clinically-oriented program there might be opportunities to "weed out" the obviously unsuitable, but education and ethics are still very distinct things, unfortunately!
Posted by zazenducky on October 30, 2006, at 14:47:48
In reply to Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 12:38:07
> if they are lay counsellors or social workers? I find it hard to comprehend how someone could spend more than a decade earning a PhD in psychology without being weeded out by the people training them.
Probably because the people training them weren't weeded out by the people training them? It's kind of self perpetuating. There are exceptions but I also believe many many future therapists are drawn to the field because of their own unresolved problems.
Posted by wishingstar on October 30, 2006, at 15:06:22
In reply to Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 12:38:07
Hi toojane, nice to meet you. I guess I have to respond to this one, huh? :) I spend a lot of time censoring my responses, wondering if what I'm thinking makes sense... but I'll type AND post this time!
First, I just wanted to say that I'm surprised and touched that you have been reading my story and have been affected by it.. even if not in a great way. It always surprises me to hear that anyone cares what I have to say, so it's neat to hear. Thank you.
Would you be surprised to hear that I saw Anne pass me driving on the main street in my town today? Of course not. haha! This woman pops up everywhere. Rant aside... her degree is in social work. Shes an LCSW.
I'm still really torn personally about how much of what happened with Anne is about her and how much is about me. Some of what the others said is true.. we're only hearing one side of the story, and we're all in therapy because we have issues, so the story may be skewed in my mind. However, that definitely does not (in my mind) make calling it all "borderline stuff" or abandoning a client okay for any therapist to do, regardless of what the client may have done, assuming it wasnt anything dangerous or obviously inappropriate. I know I was never dangerous or inappropriate with Anne. Of course, there are some more blatent ethics violations that have nothing at all to do with that the client did. So my answer is one great big I dont know. I wish I did.
Sometimes I wonder if therapists dont become a little bit used to, or desensitized, to their work and not realize the effects their actions may have. They have so many clients, and us only one therapist... maybe it's easy for them to forget how much their actions matter for us individually and effect our lives. I dont know.
Posted by sunnydays on October 30, 2006, at 16:09:52
In reply to Unethical Ts and qualifications, posted by toojane on October 30, 2006, at 12:38:07
I just wanted to say that I don't think AT ALL that one can characterize whether someone will be a good therapist or not based on their degree. It depends so so much on individual qualities and the fit between therapist and client. My therapist is an LCSW, and I thoroughly believe he would never act like wishingstar's therapist. He is supremely ethical and sensitive to how I might be feeling about the realtionship. In fact, most schools of social work emphasize the relationship more than other schools of therapy because they are focused more on interpersonal relationships in general.
I don't mean this post to sound harsh or anything. I guess I just got really defensive because I felt that you were using social workers as an example of less than ideal therapists. I know that may not be what you intended at all, though, so I'm trying to contain my defensiveness as much as possible. Just please realize that it's impossible to figure out therapist-client fit based on a degree, or ethicalness or anything.
sunnydays
Posted by toojane on October 30, 2006, at 19:59:46
In reply to Re: Unethical Ts and qualifications » toojane, posted by sunnydays on October 30, 2006, at 16:09:52
> I don't mean this post to sound harsh or anything. I guess I just got really defensive because I felt that you were using social workers as an example of less than ideal therapists.
Hi Sunnydays. I am so sorry that my post upset you. It was not my intention in any way to imply that social workers or therapists without PhDs are 'less than ideal.' Only that they have spent less time in training.
The question I struggle with is how do unethical, incompetent and predatory people earn their therapeutic credentials? How come they aren't screened out? The equation I was using was the longer the training, the greater the opportunity for teachers and fellow classmates to assess the person's character. I did not mean to suggest that social workers or counsellors cannot be excellent therapists.
Posted by Phillipa on October 30, 2006, at 20:17:20
In reply to Re: Unethical Ts and qualifications » toojane, posted by Dinah on October 30, 2006, at 13:28:24
Dinah I thought it was just me. But I've tried many therapists and they all want to deal with the now. I'm paying them and I want closure on my past. My Mother's death, my divorce from my Kids father things like that. But they just want to move forward and not delve into the past. So my conclusion is first I save money and then I feel more comfortable with all of you. And you have so much experience in life. Who ever said a degree makes a therapist good? Love Phillipa
Posted by toojane on October 30, 2006, at 21:05:08
In reply to Re: Unethical Ts and qualifications, posted by caraher on October 30, 2006, at 14:03:41
> Also, even in psychology earning a doctorate has little to do with the moral fiber of the person with the degree. Perhaps in a clinically-oriented program there might be opportunities to "weed out" the obviously unsuitable, but education and ethics are still very distinct things, unfortunately!
But I don't understand how education and ethics can be completely different things in the field of therapy. Aren't they intrinsically interrelated? And isn't it unethical to award someone a degree that requires that they act as a fiduciary when they are incapable of fulfilling their responsibilities?Then the question becomes - how do you tell who lacks moral fiber? Which is a troubling question really because how come they aren't able to tell? Shouldn't they be able to?
How come they can diagnose patients but they can't diagnose each other?
Posted by toojane on October 30, 2006, at 21:27:53
In reply to Re: Unethical Ts and qualifications, posted by wishingstar on October 30, 2006, at 15:06:22
> First, I just wanted to say that I'm surprised and touched that you have been reading my story and have been affected by it.. even if not in a great way. It always surprises me to hear that anyone cares what I have to say, so it's neat to hear. Thank you.I care very much. Isn't that strange? Not having met you at all. But reading your posts is heartbreaking at times. I'm not sure exactly why. There are many wrenching stories posted here. I suppose it's like reading a book - some characters you seem to connect with, maybe because their experiences are somewhat familiar.
I remember reading about the time you drove two hours to see Laurie only to find that she had mixed up your appointment and you watched her call someone else in for your session. That happened to me too! Not the driving two hours part but the rest. You were certain you had the appointment card at home. Mine was right there in my purse. She had me mistakenly written in her book for the next day. Reading your post, I felt like I knew exactly what you were feeling.
Posted by toojane on October 30, 2006, at 21:45:14
In reply to Re: Unethical Ts and qualifications » toojane, posted by Lindenblüte on October 30, 2006, at 13:31:22
> Hi toojane,
> I'm so glad you decided to post here.Thank you for the warm welcome, Lindenblute. It feels very awkward posting. A bit like trying to join in a conversation with the popular girls in the middle of a highschool corridor. There's a lot of uncertainty and trepidation mixed in with a smidge of gee I hope they like me
Posted by Daisym on October 31, 2006, at 0:14:21
In reply to Re: Unethical Ts and qualifications » caraher, posted by toojane on October 30, 2006, at 21:05:08
Perhaps we need to think about how inexperience mixes in here. I'm not sure I believe most, or even many, therapists are callous and uncaring. I think their training actually sets them up to see pathology instead of pain and in an effort to be "professional" they lose their ability to individualize treatment. The flip side is therapists who have lost their compassion. They suffer from burn out and are jaded, expecting the worst out of people. Everything they do becomes about cya and no risks are taken. They really don't like what they do anymore so their ability to care is diminished. And not caring is very damaging to fragile clients.
I totally agree with everyone else who believes that the degree or license have little to do with the skill of the therapist.
Posted by Lindenblüte on October 31, 2006, at 6:21:24
In reply to Re: Unethical Ts and qualifications » Lindenblüte, posted by toojane on October 30, 2006, at 21:45:14
> > Hi toojane,
> > I'm so glad you decided to post here.
>
> Thank you for the warm welcome, Lindenblute. It feels very awkward posting. A bit like trying to join in a conversation with the popular girls in the middle of a highschool corridor. There's a lot of uncertainty and trepidation mixed in with a smidge of gee I hope they like me
Yeah, well, I still feel awkward posting. Sometimes I'm in a groove and post stuff about myself a lot. Sometimes, I just feel like a complete moron, but I don't even care.Popular girls... ha! not quite! The great thing about this place is that it doesn't matter if we LIKE eachother. We all deserve support, even when we're feeling unlikeable. Lots of different ways to hang out on p-babble. Lots of different people. If you're feeling like being silly, go to social. Silliness has a happy home there. Or, if you're having self-esteem issues, the self-esteem board is a friendly board too. I think they're all friendly, actually. Sometimes I feel like talking chemistry, and sometimes I like talking about movies, and sometimes I feel like talking about my relationships.
See you around :)
-Li
Posted by wishingstar on October 31, 2006, at 22:29:39
In reply to Re: Unethical Ts and qualifications » wishingstar, posted by toojane on October 30, 2006, at 21:27:53
> I care very much. Isn't that strange? Not having met you at all. But reading your posts is heartbreaking at times. I'm not sure exactly why. There are many wrenching stories posted here. I suppose it's like reading a book - some characters you seem to connect with, maybe because their experiences are somewhat familiar.
>*** I really appreciate that. It means a lot to me that you care and connect to me exeriences.. although I would never want anyone to connect because theyre been somewhere similar. I wish no one here would hurt anymore.
> I remember reading about the time you drove two hours to see Laurie only to find that she had mixed up your appointment and you watched her call someone else in for your session. That happened to me too! Not the driving two hours part but the rest. You were certain you had the appointment card at home. Mine was right there in my purse. She had me mistakenly written in her book for the next day. Reading your post, I felt like I knew exactly what you were feeling.
>
>***Oh gosh.. I'm sorry you went through that too. I havent thought about it recently, but even now, it still hurts when I do. That is a very painful thing to go through. And it really wasnt even about having driven 2 hours at all. But thank you for telling me you can relate. It makes me feel not quite so alone.
(I have no idea how this became about me.. I didnt mean for that to happen. Sorry!)
This is the end of the thread.
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