Letters to the Editor
J.C. Miller
Published Letters: 366 Editor's Choice: 36
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Burdened,
[Read the article: I know my co-worker's evil secrets -- because I was his therapist!]
[Read more letters about this article: Here]I hope you have or will read the letters from damnthatxanadu and cate_r. In my experience with confidentiality issues, their points seem essentially accurate.
However, I don’t agree that you are necessarily in a dual relationship with your former client or obligated to leave your position due to a dual relationship. You didn’t say that you are working with, but instead are “sharing an office with” the new colleague. Depending on the level of interaction, it may not constitute a significant relationship. Also, a dual relationship with a former (as opposed to current) client may not become an ethical issue unless there is the potential for exploitation or harm by you.
Some additional points to consider:
1. You said, “Simply declining to provide an explanation could cue people to the possibility that he was a past client of mine.”, which is a good reason to avoid claiming any type of conflict of interest. That would potentially identify him as having been in treatment and thereby violate trust and client rights to confidentiality. Secondarily, it would set you up for legal and/or professional sanctions.
2. While you clearly can’t and shouldn’t identify him as a former client or disclose his protected health information, he can. You might have a private talk with him in which you ask if he has any concerns which he might want to discuss with a supervisor, followed by a letter to him documenting your concerns.
What I most admire about your query is your concerns about potential harm to clients, who are always vulnerable and always in a power differential. You might check your agency’s policy manual and your professional code of ethics – there is a good chance that you will find provisions which mandate or strongly encourage your reporting of any apparent violations of client rights or harm to clients. These provisions, along with state rules regarding the provision of mental health services, likely would look favorably on your reporting, in good faith, of concerns about his actions which may be harmful to clients.
As Cary noted, if your concerns and reports of any unethical or harmful behavior to clients by him are supported, documented, and completely independent of any information gained through your prior relationship, you should be on solid ground.
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artistic license
[Read the article: The body electric]
[Read more letters about this article: Here]The course and consequences of the disability suffered by Ms. Bauer’s son are tragic, as is the overuse and misuse of psychotropic medications, for whatever reason. What is also potentially damaging is disingenuousness, hyperbole, or just plain lack of care in the service of an engaging narrative, the latter artfully accomplished by Ms. Bauer.
Ms. Bauer's son developed classic symptoms of schizophrenia, including course and associated stressors, and was diagnosed as such. Catatonia alone does not account for psychotic symptoms. The fact that results were unfavorable with two atypical neuroleptics does not rule out the diagnosis of schizophrenia. The fact that ECT and an unnamed psychotropic med have provided mixed results and prognosis doesn’t clarify the diagnostic picture.
Does it matter? It does if readers come away with beliefs that “antipsychotics don’t work” or “it’s all because he was misdiagnosed” or that their best bet for help with serious mental health issues is the Internet. As a number of writers have noted, the treatment of mental health issues is largely an art, and patients, their families, and providers alike often suffer frustration in struggling to create relief and wellness.
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full-witted model
[Read the article: I dream of Darcy]
[Read more letters about this article: Here]Thanks for a nicely written, constrained, literate, and insightful piece by Ms. Traister, who seems even more measured and generous in her appraisal of the commoditization and needed distortions of Jane Austen’s work than in her treatment of certain other cultural phenomena.
The final 10 paragraphs set things right. Perhaps we learn less from Austen through layers of interpretation of her symbols than by what she chose to live and model - a free and creative woman, supporting herself and taking pleasure in intimate associations on her own terms, without need for social norms or binding contracts.
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big mommas
[Read the article: Big momma's house]
[Read more letters about this article: Here]There is a degree of heritable propensity or risk for essentially every trait, behavioral or otherwise, and “genetics” (or germ theory) alone no more explains obesity than schizophrenia or alcoholism. It does usefully distract from environmental forces that drive these and other disorders.
Beyond basic physical safety and physiological needs, what the young child needs most, and invariably suffers from lack of, is the secure, nurturing attachment provided by a primary caretaker who can consistently respond with touch, holding, eye contact, and engagement. Obesity that restricts movement or causes lethargy can be an effective barrier to a young child’s needs being met, as in the case of a child (who had developed a childhood anxiety disorder) recently observed clinically to approach her obese mother to be picked up and held – “I can’t, I’m too big.”
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Jeebus H. Christ !
[Read the article: Rabbit Bites: What's wrong with Gen Y?]
[Read more letters about this article: Here]Drink some fracking coffee, wake up, and watch it again. It’s about loser parents, not kids. You don’t find it at all amusing because it hits too close to home – to the coercive, controlling, punitive parenting you used on your kids. Remember? The ones who don’t want to have anything to do with you, or are 30 and still acting like a six-year-old afraid to displease mommy or daddy, the ones who shame and over-control their own kids now?
Thanks H.