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Posted
20 hours ago, JulieM said:

This is what my friend was told too.

She was pretty upset when confidential details were shared from her counseling appointments.  She talked to the counselor who told her she’d signed that these could be shared with the Bishop and he was in regular contact with her about their appointments.  My friend told her she wanted to tear that form up or submit one stating details could no longer be shared, and the therapist said “ok, but then you will have to start paying for your sessions.”  The therapist told her as long as the church was paying, she was required to have that form on file from her.

I really wish they'd do away with that form.  I'm not sure why they feel it's ok to share information from the sessions with the Bishop, but I honestly believe that mos therapists are still very careful and most Bishops very much respect the member's privacy.  We've had at least one disastrous result from the therapist giving information to a Bishop and he betrayed that confidence.  It was an abuse situation and luckily an isolated case.

Posted

I appreciate everyone's input/info on this subject.  I have learned so much.  But you know...confidentiality is important in my view...so I would rather any family of mine to take care of costs with having this stipulation.  That all being said though...the initial post of mine was because this woman's mother was easier to find.

Posted

Signed up here just to address this issue.  I've been a private practice therapist for 10 years, temple recommend holding.  LDS services cannot accomodate demand in our state, so I get some overflow.  Bishops like working with me because I'm cheaper than LDS services and I'm good at what I do.  LDS services has a reputation in my field as hiring anyone with a degret and a recommend, so quality is not always a characteristic of an LDS services employee. That said, I'm sure there are good ones out there.

When a bishop calls me, I explain that if he is paying for therapy, I always suggest he require the client to kick in any percent amount so that there is some financial skin in the game.  Often,  a bishop will employ that plan.

Then I tell the new client, that I will need a release signed.  It is a release I have created.  Legally I have to have a release so that I can infor the bishop that I have met with this client and need to be paid for these dates.  I will also infirm the new client that the check requires 2 signatures, that means anyone in the bishopric and ANY of the secretaries will potentially know that "you are in therapy."  Also, I cannot guarantee privacy regarding what and to whom bishop will share info.  

I make it clear that bishop and client that will not share any info, other than dates and general progress. 

I have had two very bad experiences early on and am very careful with this process.  Bishops serve a spiritual purpose but are grossly under trained to handle much of what hits them. 

Posted

I think it's important to mention that professional therapy is a regulated service in all 50 states, subject to both State and Federal Law including HIPAA.  I can't speak for LDS Family Services directly, but I can speak to the realities of therapy in general.  

In order for any service to be paid by a third-party payer, there has to be a signed Authorization for Release of Confidential information.  If you want your health insurance to pay for your therapy, they have the right to know otherwise confidential information including dates of service, type of service performed, diagnosis, prognosis, treatment goals, progress toward treatment goals, and other factors impacting that progress.  The fact that LDS Family Services requires the ROI for a Bishop who is paying for treatment is hardly unique.  

That said, I have no doubt that a not-insignificant percentage of therapists do not follow Best Practices and communicate more information than needed and/or do not adequately inform their clients about the extent of those disclosures.  This happens outside of LDS Family Services as well and is a professional violation.  I've seen a number of professionals working for LDS Family Services who seem to blur the line between professional treatment and ecclesiastical stewardship.  Again, certainly not all, or even most, professionals working for LDSFS.  And those boundaries can also be blurred in private practice (both for and against religious belief).  Overall, I don't believe that a few individuals make the entire system unethical or broken.  

As a side-note that is on the topic, I have seen that LDS Family Services is generally cutting back on the amount of direct treatment they are providing to members.  In our area, it is far more common for a Bishop to refer individuals to a provider in the community rather than to LDS Family Services.  I think this is a good thing.  

 

Posted
Just now, Veggie juicer said:

Lots of typos ^^ my apologies

 

2 minutes ago, Veggie juicer said:

Signed up here just to address this issue.  I've been a private practice therapist for 10 years, temple recommend holding.  LDS services cannot accomodate demand in our state, so I get some overflow.  Bishops like working with me because I'm cheaper than LDS services and I'm good at what I do.  LDS services has a reputation in my field as hiring anyone with a degret and a recommend, so quality is not always a characteristic of an LDS services employee. That said, I'm sure there are good ones out there.

When a bishop calls me, I explain that if he is paying for therapy, I always suggest he require the client to kick in any percent amount so that there is some financial skin in the game.  Often,  a bishop will employ that plan.

Then I tell the new client, that I will need a release signed.  It is a release I have created.  Legally I have to have a release so that I can infor the bishop that I have met with this client and need to be paid for these dates.  I will also infirm the new client that the check requires 2 signatures, that means anyone in the bishopric and ANY of the secretaries will potentially know that "you are in therapy."  Also, I cannot guarantee privacy regarding what and to whom bishop will share info.  

I make it clear that bishop and client that will not share any info, other than dates and general progress. 

I have had two very bad experiences early on and am very careful with this process.  Bishops serve a spiritual purpose but are grossly under trained to handle much of what hits them. 

Thanks for weighing-in!  I second what you have said. (I'm only 5 years in. . . )

Posted (edited)
12 minutes ago, Veggie juicer said:

Signed up here just to address this issue.  I've been a private practice therapist for 10 years, temple recommend holding.  LDS services cannot accomodate demand in our state, so I get some overflow.  Bishops like working with me because I'm cheaper than LDS services and I'm good at what I do.  LDS services has a reputation in my field as hiring anyone with a degret and a recommend, so quality is not always a characteristic of an LDS services employee. That said, I'm sure there are good ones out there.

When a bishop calls me, I explain that if he is paying for therapy, I always suggest he require the client to kick in any percent amount so that there is some financial skin in the game.  Often,  a bishop will employ that plan.

Then I tell the new client, that I will need a release signed.  It is a release I have created.  Legally I have to have a release so that I can infor the bishop that I have met with this client and need to be paid for these dates.  I will also infirm the new client that the check requires 2 signatures, that means anyone in the bishopric and ANY of the secretaries will potentially know that "you are in therapy."  Also, I cannot guarantee privacy regarding what and to whom bishop will share info.  

I make it clear that bishop and client that will not share any info, other than dates and general progress. 

I have had two very bad experiences early on and am very careful with this process.  Bishops serve a spiritual purpose but are grossly under trained to handle much of what hits them. 

Thanks for posting this!  Your perspective is an important one and you give some valuable information.

I'd wondered if it was the church who required this form to be signed (to give the permission to release confidential information to the Bishop) or if it was the therapist who required it if the patient is not paying for the therapy.  Do you have anymore input on that?  Is this form only required for those members who opt to have the ward funds pay for their therapy?  

(Thanks in advance....and welcome to the forum too :) )

Edited by ALarson
Posted

If a therapist is going to have any communication with anyoneach other than the client regarding the client, the therapist is required by law to have a Release of Information.  The release of information form can be and is encouraged to be as limiting as possible for the purposes of the info receiver. 

I would imagine that since LDS social services is a branch of the church, that the church came up with their own forms as they were developing the therapy programs.  If the client waves their rights, the church and the service provider are both compliant with the law. 

I am not crazy about that system.  I'm happy to see bushop's refer out to qualified specialists.   I think one of the greatest strengths a therapy relationship has is absolute and total confidentiality.

Everyone has secrets. It's extremely relieving to lay them down, with no fear.  Often, laying them down offers new perspective that lightens the load.  IMO I have the best job in the world, I see miracles every single day.  I couldnt, if people didn't trust me. I am very careful when working with a bishop,  and together with the spiritual guide and my own understanding, people can find their way to peace.  

Posted
42 minutes ago, Veggie juicer said:

Signed up here just to address this issue.  I've been a private practice therapist for 10 years, temple recommend holding.  LDS services cannot accomodate demand in our state, so I get some overflow.  Bishops like working with me because I'm cheaper than LDS services and I'm good at what I do.  LDS services has a reputation in my field as hiring anyone with a degret and a recommend, so quality is not always a characteristic of an LDS services employee. That said, I'm sure there are good ones out there.

When a bishop calls me, I explain that if he is paying for therapy, I always suggest he require the client to kick in any percent amount so that there is some financial skin in the game.  Often,  a bishop will employ that plan.

Then I tell the new client, that I will need a release signed.  It is a release I have created.  Legally I have to have a release so that I can infor the bishop that I have met with this client and need to be paid for these dates.  I will also infirm the new client that the check requires 2 signatures, that means anyone in the bishopric and ANY of the secretaries will potentially know that "you are in therapy."  Also, I cannot guarantee privacy regarding what and to whom bishop will share info.  

I make it clear that bishop and client that will not share any info, other than dates and general progress. 

I have had two very bad experiences early on and am very careful with this process.  Bishops serve a spiritual purpose but are grossly under trained to handle much of what hits them. 

I very much respect the way you do things. 

Posted (edited)
13 minutes ago, Veggie juicer said:

If a therapist is going to have any communication with anyoneach other than the client regarding the client, the therapist is required by law to have a Release of Information.  The release of information form can be and is encouraged to be as limiting as possible for the purposes of the info receiver. 

I would imagine that since LDS social services is a branch of the church, that the church came up with their own forms as they were developing the therapy programs.  If the client waves their rights, the church and the service provider are both compliant with the law. 

I am not crazy about that system.  I'm happy to see bushop's refer out to qualified specialists.   I think one of the greatest strengths a therapy relationship has is absolute and total confidentiality.

Everyone has secrets. It's extremely relieving to lay them down, with no fear.  Often, laying them down offers new perspective that lightens the load.  IMO I have the best job in the world, I see miracles every single day.  I couldnt, if people didn't trust me. I am very careful when working with a bishop,  and together with the spiritual guide and my own understanding, people can find their way to peace.  

Thanks for your response!  I greatly admire how you view things and how you respect your client's right to confidentiality.

I hope that most therapists who work for the church have a similar set of ethics in place.  I can only go by my experience, but where I've seen issues is when a Bishop oversteps and starts asking or probing and the therapist feels obliged to answer.  I do believe most therapists would not just volunteer confidential information.

 

Edited by ALarson
Posted

Lds therapists could easily feel that they are subject to the authority of the bishop.  I can swe how it would be easy to feel obligated to provide answers to questions asked. 

I don't feel that obligation.   I have deep respect for the calling and scope of practice of a holy calling.  That does not give bishop a right to call the shots on my work or to get confidential info from me.  

 

Posted
11 minutes ago, Veggie juicer said:

Lds therapists could easily feel that they are subject to the authority of the bishop.  I can swe how it would be easy to feel obligated to provide answers to questions asked. 

I don't feel that obligation.   I have deep respect for the calling and scope of practice of a holy calling.  That does not give bishop a right to call the shots on my work or to get confidential info from me.  

 

Very much agreed.  

Posted (edited)
3 hours ago, ALarson said:

I really wish they'd do away with that form.  I'm not sure why they feel it's ok to share information from the sessions with the Bishop, but I honestly believe that mos therapists are still very careful and most Bishops very much respect the member's privacy.  We've had at least one disastrous result from the therapist giving information to a Bishop and he betrayed that confidence.  It was an abuse situation and luckily an isolated case.

The info seems justified to share on the basis of ensuring treatment is for what is believed needed by the church leader and not misused.  It should be made clear that is the only reason to share and no other unless the therapist asks the client if they would like it shared

In the case of abuse, perhaps a special protocol should be created to ensure neither bishop nor therapist endangers the victim  

For an example of misuse where a Bishop needs to know, they go in for couples counseling and after that is resolved, one of the couple stays in counseling to help with anxiety issues. Important, but leadership should have the right to determine if the Church pays for it

Using codes like insurance companies could fulfill that need without confidentiality being violated 

Edited by Calm
Posted
1 hour ago, Veggie juicer said:

How do I edit after posting? I know I should before I post but patience is not in my repertoire.  :)

25 posts and you can edit

Posted
1 hour ago, Veggie juicer said:

Signed up here just to address this issue.  I've been a private practice therapist for 10 years, temple recommend holding.  LDS services cannot accomodate demand in our state, so I get some overflow.  Bishops like working with me because I'm cheaper than LDS services and I'm good at what I do.  LDS services has a reputation in my field as hiring anyone with a degret and a recommend, so quality is not always a characteristic of an LDS services employee. That said, I'm sure there are good ones out there.

When a bishop calls me, I explain that if he is paying for therapy, I always suggest he require the client to kick in any percent amount so that there is some financial skin in the game.  Often,  a bishop will employ that plan.

Then I tell the new client, that I will need a release signed.  It is a release I have created.  Legally I have to have a release so that I can infor the bishop that I have met with this client and need to be paid for these dates.  I will also infirm the new client that the check requires 2 signatures, that means anyone in the bishopric and ANY of the secretaries will potentially know that "you are in therapy."  Also, I cannot guarantee privacy regarding what and to whom bishop will share info.  

I make it clear that bishop and client that will not share any info, other than dates and general progress. 

I have had two very bad experiences early on and am very careful with this process.  Bishops serve a spiritual purpose but are grossly under trained to handle much of what hits them. 

Useful info and sounds wise

Posted (edited)

What types of counseling do bishops refer usually?  We have a few therapists here on the board now and it would be interesting to me to hear

I assume most often it is couples counseling. 

Edited by Calm
Posted
11 minutes ago, Calm said:

The info seems justified to share on the basis of ensuring treatment is for what is believed needed by the church leader and not misused.  It should be made clear that is the only reason to share and no other unless the therapist asks the client if they would like it shared

In the case of abuse, perhaps a special protocol should be created to ensure neither bishop nor therapist endangers the victim  

For an example of misuse where a Bishop needs to know, they go in for couples counseling and after that is resolved, one of the couple stays in counseling to help with anxiety issues. Important, but leadership should have the right to determine if the Church pays for it

Using codes like insurance companies could fulfill that need without confidentiality being violated 

Oh, I get that (and agree).....I'm referring to personal and confidential information that a member feels comfortable discussing with a therapist, but is not aware that information may be shared with the Bishop (who then may share it with others as well).  In the cases I've known about where there were issues, it is my opinion that confidences were not kept as they should have been.

Posted
17 minutes ago, ALarson said:

Oh, I get that (and agree).....I'm referring to personal and confidential information that a member feels comfortable discussing with a therapist, but is not aware that information may be shared with the Bishop (who then may share it with others as well).  In the cases I've known about where there were issues, it is my opinion that confidences were not kept as they should have been.

Not questioning your comments, just adding my own thought on how abuse of the system, including lack of confidentiality might be avoided. 

Requiring communication be in writing might lead therapists to be more cautious. 

Posted
36 minutes ago, Calm said:

What types of counseling do bishops refer usually?  We have a few therapists here on the board now and it would be interesting to me to hear

I assume most often it is couples counseling. 

I do couples and family counseling.  Lots of affair work.  

Bishops often refer out for complicated cases of porn (addiction?) And for childhood abuse that is getting in the way of present relationships. 

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