LDS Family Services

[SoCalCoug]

You should consider one very important angle as to why a waiver might be signed ... if there is abuse of any kind involved, by law, a Bishop must inform authorities of said abuse. The Bishop as referrer, and financier of counseling services must be informed of what is going on.

I'm not sure about the legitimacy of that angle. First of all, therapists are mandatory reporters with regard to abuse, and if there is any abuse going on that is revealed to the therapist, then it's the therapist's duty to report it to the authorities.

Secondly, the psychotherapist-patient privilege belongs to the patient, NOT to the referrer or financier of the services. There is no requirement, at least under California law, that the Bishop be informed of what is going on.

[SoCalCoug]

I agree that it would be a strange tactic. Of course we only have one side of the story. However, it would be all the more reason for the referring Bishop to be made aware of what's going on so he can set the counselor straight or insist the person meet with someone else who is less inclined to apply such a tactic!

I'm very uncomfortable with a lay person (the Bishop) being given control over the professional counseling of a patient.

Do your due diligence prior to referral to ensure that you trust the counselor and the counselor's tactics. But I strongly disagree with the Bishop being made privy to what goes on during the counseling.

Nevertheless, if that's the agreement the patient makes to get the counseling paid for with church funds, I guess that's how it is. But I don't think you can justify it as ethical or reasonable. There's a significant amount of duress there, particularly for someone who cannot afford counseling on their own.

[Swimmer]

i'd like to weigh in, but briefly (i'm pretty busy right now).

a. that's among the weirder things i've heard said by a therapist, i think my own reaction would have been stronger than yours, you're very rational

I am one of the least rational people around. I simply handled that situation pretty well because I am so beat down and worn out having been dealing with my current situation for so long. I left the office feeling pretty disappointed and a bit hopeless. Needless to say, it has not been a very good week for me. I will admit I am now quite nervous about trying to find another therapist. Hopefully things start to improve for me and my family pretty soon.

[OhioBlue]

I am one of the least rational people around. I simply handled that situation pretty well because I am so beat down and worn out having been dealing with my current situation for so long. I left the office feeling pretty disappointed and a bit hopeless. Needless to say, it has not been a very good week for me. I will admit I am now quite nervous about trying to find another therapist. Hopefully things start to improve for me and my family pretty soon.

I wish you well. If you're in Utah i could make some suggestions.

[Swimmer]

Thanks

[QUOTE=OhioBlue;43692]I wish you well. If you're in Utah i could make some suggestions.[/QUOTE

I live in Utah County - so any help you can offer would be greatly appreciated.

[tooblue]

I'm not sure about the legitimacy of that angle. First of all, therapists are mandatory reporters with regard to abuse, and if there is any abuse going on that is revealed to the therapist, then it's the therapist's duty to report it to the authorities.

Secondly, the psychotherapist-patient privilege belongs to the patient, NOT to the referrer or financier of the services. There is no requirement, at least under California law, that the Bishop be informed of what is going on.

You have not understood what I have written. The bishop already is aware of what's going -- he was told by the individual and that's why he made the referral! He has to be told first by the individual or he won't make the referral. It's basic logic. Furthermore, if the bishop was told before the therapist was told by law he must report it -- even if the therapist reports it later. This isn't that hard to understand.

[tooblue]

I'm very uncomfortable with a lay person (the Bishop) being given control over the professional counseling of a patient.

Do your due diligence prior to referral to ensure that you trust the counselor and the counselor's tactics. But I strongly disagree with the Bishop being made privy to what goes on during the counseling.

Nevertheless, if that's the agreement the patient makes to get the counseling paid for with church funds, I guess that's how it is. But I don't think you can justify it as ethical or reasonable. There's a significant amount of duress there, particularly for someone who cannot afford counseling on their own.

Read the whole thread. The bishop is NOT given ANY control. Seriously, did you not read what Ohio wrote? Furthermore, the bishop is only privy to the info because the individual told him! This isn't rocket science.

[SoCalCoug]

You assume that the patient limits his/her discussions with the therapist to what was discussed with the Bishop. Yes, the Bishop has some knowledge of what's going on, but presumably the therapist gets into the issues deeper and more comprehensively.

I would ask, if the Bishop already knows everything that's going on between the patient and the therapist, why the need for the therapist to report back to the Bishop?

As for the Bishop controlling the therapy, it's the same way a father might control his son's college education: you go to the school I want you to go to, and I'll pay. Otherwise, you're on your own. Essentially that's how the Bishop is exerting control: go to the LDS Family Services counselor and sign the waiver allowing me to discuss your therapy with the counselor, or you're on your own.

I don't get the reporting thing - in that I guess you're right. I have no idea what you're trying to say about the reporting requirements of the bishop and the counselor. It makes no sense to me.

[tooblue]

You assume that the patient limits his/her discussions with the therapist to what was discussed with the Bishop. Yes, the Bishop has some knowledge of what's going on, but presumably the therapist gets into the issues deeper and more comprehensively.

I would ask, if the Bishop already knows everything that's going on between the patient and the therapist, why the need for the therapist to report back to the Bishop?

As for the Bishop controlling the therapy, it's the same way a father might control his son's college education: you go to the school I want you to go to, and I'll pay. Otherwise, you're on your own. Essentially that's how the Bishop is exerting control: go to the LDS Family Services counselor and sign the waiver allowing me to discuss your therapy with the counselor, or you're on your own.

I don't get the reporting thing - in that I guess you're right. I have no idea what you're trying to say about the reporting requirements of the bishop and the counselor. It makes no sense to me.

I'm not making any assumptions. In order for the bishop to use FO funds he must be given more than vague reasons by the individual in order to be referred. There is nothing unethical or wrong with seeking out an ecclesiastical leader for counseling and then having that leader refer the person to a professional. There is nothing unethical about a professional working with the bishop to ensure all needs are met as Ohio outlines below, especially in regards to the repentance process as per LDS doctrine ...

d. the intersection between the ethics of confidentiality and the use of other available resources is a tricky one, to say the least. Especially when parties involved may see eternal salvation as part of the issues. we have this issue come up not infrequently at byu, and bishops get mad at times because we aren't able to communicate back to them (we don't have clients sign anything like lds services does). i don't advocate ignoring bishops either though, that won't help anyone. my experience varies based on the bishop, but i like to believe that i can be helpful in general ways while still respecting confidentiality, at least when no waiver/release has been signed. At the same time, (can i say this?) some bishops scare me with their thinking about what's going to be helpful, and so i find myself less inclined to exchange a lot of information even when a release HAS been signed. clients, therapists, bishops--despite our experiences, training, and mantels of authority--are all inevitably human, with all the glorious fallibility that being human includes. i have no better answers for how to manage this dance than the next guy--make sure the welfare of the client is the driving force, try to be on the same team, and employ basic respect/decency.

As far as reporting to authorities, a bishop is legally bound to report abuse etc. What is so hard to understand?

[tooblue]

As far as reporting to authorities, a bishop is legally bound to report abuse etc. What is so hard to understand?

The abuse cases in the states from several years ago are what happens when Bishops don't report abuse to authorities. If the Bishop doesn't report abuse the church can be held legally responsible for not protecting children from a pedophile posing as a Home Teacher ... protecting people from abuse is more important than confidentiality.

[Swimmer]

Just to clarify

Not that anyone is necessarily thinking anything bad about me, but I just want to make absolutely certain that everyone understands that in my situation THERE IS NO ABUSE INVOLVED! My issues are personal and quite overwhelming, but have nothing to do with anything like what is being discussed in the most recent posts.

[tooblue]

Not that anyone is necessarily thinking anything bad about me, but I just want to make absolutely certain that everyone understands that in my situation THERE IS NO ABUSE INVOLVED! My issues are personal and quite overwhelming, but have nothing to do with anything like what is being discussed in the most recent posts.

Sorry to have hi-jacked your thread. The most recent posts have nothing to do with you. Many of us have sought counseling for a variety of reasons including myself. I really enjoyed my experience with a non LDS counselor. I think I speak for everyone here when I say we hope you find a counselor who you are comfortable with -- contact OhioBlue via boardmail. I'm certain he will have a great recommendation.

[Mormon Red Death]

Here is the skinny folks. The counselor may not give information to a bishop unless the patient agrees to it the (the waiver). Its not hard to see that the counselor and bishop could work together for treatment and the waiver makes sense. However, If the signing of the waiver is required to get funding it is not only unethical it is also against the law. Bishops are not Medical personnel. If they are financing the sessions they become like the insurer and cannot create mandatory filings of personal information. I don't know about Canada but in the US we take HIPAA compliance VERY seriously. As anyone who has worked in the medical industry can tell you.

Who gets to see my confidential health information?

Anyone directly involved in your care would have access to your information. Doctors, nurses, other medical personnel, billing offices and secretarial might all have legal access to it. Any specialists, personnel who perform lab tests and diagnostic tests, or any procedures either outpatient or inpatient may also have access to your records for the time that you are in their care. Basically anyone who is necessary to provide the best medical care that you can receive.

Like I said if your part of your treatment is working with the bishop (which you agree too) then the waiver is totally justified. If not there is ZERO accountability to the bishop.

Personal Story:

After My first child was born the wife and I went through a rough patch brought on by several things. We talked to our bishop and simply said we would like to go to counseling. We saw a great guy I think 12 times. I did have insurance but we wanted to see an LDS therapist. Our bishop said: "Ok you pay your normal copay" and the ward will pay the rest. After it was over we met with the bishop and he had no knowledge of what was said in our counseling. IE I did not have to sign waiver and our therapist told us flat out that the bishop would not know anything about our sessions.

[Solon]

So the waiver is not mandatory. Good to know.

I wonder why they don't accept insurance.

[Mormon Red Death]

So the waiver is not mandatory. Good to know.

I wonder why they don't accept insurance.

Much easier to keep billing costs down when you only have one payer. Insurance companies are famous for making providers jump through hoops just to pay a $60 claim.