goodbye therapist?

Discussion in 'General Parenting' started by idohope, Nov 13, 2009.

  1. idohope

    idohope Member


    We are on our third therapist and felt that we finally found someone who was helping our family. difficult child initially refused to go but after my initial posting to this board, I starting working on it again with difficult child and have gotten her to go to see therapist 4 times. This is the first therapist that difficult child has willingly gone into the office and stay without a parent present. therapist has been moving slowly and building rapport. The relationship has been developing.

    Then therapist tells us. She is moving to another practice and she signed a non-competition agreement when she joined the practice she is leaving and that after 1 more month she will not be able to have difficult child as a patient anymore.

    I cried in the office when she told me. What a blow. So much work on my part and difficult children in getting to the point of being able to see a therapist. I can not stand the thought of trying to find someone new and starting over. I feel like we have such a short critical window before puberty hits to try to improve things and this is such a set back. Who knows if I can get difficult child to see someone else.

    I am very upset and feel that financial decisions are having a negative impact on my daughters health care. This is not a hairdresser or an insurance agent, this is a mental health care provider who has spent months building a relationship with a child who needs help.

    therapist says that nothing can be done. She has been exploring options and initially said that writing letters (to owners of practice she is leaving) might help but now has asked that I do not write letters as it will just make things personally difficult for her and that it has been made clear to her that this is a legal issue that can not be changed. in my opinion it should be illegal to interupt a patient's care like this.

    How dare these people who are making this happen call themselves health care providers.

    Has anyone faced this? Any advice?
  2. DDD

    DDD Well-Known Member

    I'm so very sorry. Many of us have experienced that trauma and I still remember the personal pain it caused me to discover that all my loving efforts and sense of "team building" were gone.

    Feel free to mourn the loss and start as soon as possible to find a new
    replacement. Is it possible that another therapist at the same practice would be suitable so difficult child would be in familiar territory and perhaps could have a few joint sessions before the severence?

    Sending hugs. DDD
  3. Marguerite

    Marguerite Active Member

    I'm wondering if this is the therapist's way of saying, "Yes, I do happen to be leaving, but actually I will be glad to not take your child as a client so please don't fuss, I'd rather walk away."

    I don't know, it's just a guess. I also agree, in a situation like yours you should be able to go to the practice owners and say, "We've had a very hard time finally building up a connection at last with a therapist we're finally happy with and now they're leaving and tell us that they've had to sign a clasue saying that won't transfer any patients - the chances of you replacing this person with someone who our child can connect with is, on the face of it, unlikely. Can you release the therapist from this clause particularly with respect to my child? Please be aware we are making this request without the knowledge and approval of this therapist, who didn't want to cause any difficulties for you. But unless you can assure us that there would be someone of equal capability and connectedness to our child (and nobody can guarantee that before the fact since the fit between client and therapist is so individual) that chances are, we'd be needing to leave your practice anyway as we go searching yet again for a therapist our child can work with."

    Again, I don't know how this would be received.

    Your main aim is to have a good ongoing relationship with a therapist for your child. You do what you have to do in order to have this. Writing a letter after she's asked you not to could damage the relationship with this therapist. But not writing the letter means saying sayonara anyway. Writing the letter could also burn your bridges with this practice who just MAY have a brilliant replacement in the wings.

    It's not an easy choice and we can't make it for you, since there are so many other factors. But at least we can help you brainstorm!

  4. idohope

    idohope Member

    Thanks for the feedback and support.

    I could be wrong but I think that therapist does want to keep my difficult child and other patients. My sense is that she is being threatened with legal action. She provided me and I would imagine other parents/patients with names to write letters to and this is coming back at her rather than helping her get out of an agreement that she wishes she never signed. I think it is very hard for her to do this to her patients and she would not do it without good reason. So I think there is something in the management of this practice that is unacceptable to her and making her feel that she needs to leave.

    I will not continue with this practice. If this is how they treat their staff and patients I want nothing to do with them. They have lost me anyway.
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I didnt have this exact same thing happen but my therapist was told suddenly that there was a problem in billing my insurance and that she couldnt see me anymore as a client. This was after a year of her seeing me with my insurance! Someone was slow on the uptake. I kinda wondered about it because there was never a charge for her on my EOB's but I didnt make any stink.

    She refused to leave me hanging because she knew that if she just stopped seeing me I would never see another therapist. She was it. So we started having lunch dates. Eventually they got it worked out and supposedly I am now back on the patient roles. I think. I still dont go to the office. They have my insurance info so I suppose they are billing. I dont check the EOB' I know they wont bill me. Im a pet patient. If I have to be a ghost, so be it. They want me to work for them! They just cant find me a
  6. Jeppy

    Jeppy New Member

    If your difficult child can't go to the therapist at the new practice, what about you? If you were not therapist's patient at the current practice could you and difficult child go together as family counseling and it be billed under your name at the new practice rather than billed under difficult child's name? Maybe you could get around this on a technicality that way.
  7. idohope

    idohope Member

    therapist had originally suggested that as a possible way to continue. Now says this is not possible (because of the legal issue). My sense is that they will be monitoring her patient list closely at her new practice because of the resistence to the non-competition agreement.

    I still can not believe that this is legal and that someones financial decision is able to take away appropriate care from my daughter.

    The kicker is that the new practice is in our hometown when we have been driving 1/2 hour to get to therapist...
  8. Marguerite

    Marguerite Active Member

    Therevwould have to be a time limit to the clause, surely. I mean, in 20 years' time, your child's child may need a therapist and who does she see?

    See if you can quietly find out the terms. I would also try to quietly (and cheaply) get independent legal advice on this. One cosideration you could throw at the practice - they are losing your child's therapsit, can they replace thta therapist with someone of equal calibre that your child will accept? Because if they cannot do this, then surely that negates this agreement, at least as far as your daughter is concerned?

    For whatever reason, this good therapist is leaving. The practice requires that she not take any patients with her. This (to my mind) means that the practice is endeavouring to hold on to the patients, which tells me that in order to do so, they MUST meet the same needs of those patients that are being met now with the current therapist.

    I know therapist said to not talk to them, but I would be talking to the practice manager and making it clear, you are raising this out of your own concerns, and after being asked not to by the therapist; your concerns are to be assured that once therapist is gone, your daughter will have someone available that she will see, that she can connect with. It hasn't been an easy road and to have to make changes too often is damaging. You need an assurance from them that whoever they get to take on therapist's caseload, will be of equal competence andalso someone they can guarantee your daughter will accept readily and willingly. Can they assure you of this NOW? If they cannot, can they provide a referral for your daughter to someone perhaps closer to where you live, who is able to meet those needs?

    That contract can bite both ways.

  9. Sharon74

    Sharon74 Guest

    I can't give you any advice, but I can sympathize. I don't know what we would do if my son could not see his therapist anymore. I don't think we would be able to replace her. It took a VERY long time for my son to build a relationship with her and it would be devistating to suddenly end that relationship.
  10. babybear

    babybear New Member

    I can't believe they would be able to monitor her client list at a new job. That would be a violation of privacy laws. I would think that she can only be prevented from actively recruiting her current clients from coming with her, or even telling you where she will be practicing.

    I would suggest that you find a way to find her after she leaves. Maybe she has a website or facebook page? The company she works for now does not have the right to tell you when an where you can get care.

    I have been stuck in a non-compete contract. I hated it, it was probably not legal, but I honored it because I agreed to it. I certainly did not refuse to see clients that knew me from my previous job when they did find me. That just wouldn't make any sense.
  11. idohope

    idohope Member

    An update: difficult child's primary care doctor said that he would contact the management of the practice to request that therapist be allowed to continue to see difficult child as he does not think it is in his patients interest to have care interrupted.

    therapist said that she is getting pressure because she is talking to patients and parents and telling them that she is moving and about the agreement and the practice does not want her doing that. BUT the practice has not notified us yet about therapist leaving. therapist said that they will be sending a letter but at this point therapist will be gone in a few weeks and the practice has told us nothing.

    So I plan to call the practice on Monday and try to book out future appointments and see what the practice tells me. This way I can react to information that they provide me, rather than to the information that therapist provides to me, so that she does not get in any deeper for what she is telling patients.
  12. Marguerite

    Marguerite Active Member

    That practice does not sound like it is putting the patients first. Either that, or they're very inefficient and just haven't got their act together yet. I suspect they may even let you book those future appointments, then try to slide you in with the "new therapist" they will be hiring/have hired. Or call you the week before the appointment falls due to let you know it will be with someone else.

    in my opinion the therapist is the one doing the right thing here, by letting people know. If they realise tat you've been told also and begin to give therapist grief about it, ask the practice managers why they have left it to the therapist to tell you. You would gladly have heard it from the practice managers, but they simply haven't done what they should have.

  13. idohope

    idohope Member

    Update: We will continue with the same therapist at the new practice. I will be become the identified patient, which is not ideal but I think is valid. I meet with therapist more often than difficult child. It truly is family therapy, we are all stressed by the behaviors.

    How did I accomplish this?

    I called and tried to book out future appointments and after getting bounced a bit spoke to the clinical director who said that therapist would be leaving practice but would not discuss any contractual information with me saying it was not relevant to decisions about difficult children care. Would not answer me when I asked if difficult child would be able to continue with therapist. I said repeatedly that it was clear that what was in difficult children best interest was to continue with therapist and to not interupt that relationship. Clinical director said she was not familiar with difficult children specific case and could not comment but would get back to me.

    I relayed all this to difficult children regular doctor who said he would write a letter stating that staying with therapist would be in best interest of his patient difficult child.

    Two weeks after initial conversation with clinical director I heard from therapist that we could continue to see her at new practice.

    I am very relieved and so glad that I did not accept what they tried to do here. Thank you all for the support. I come to this board and it gives me the strength to get back out there and do what needs to be done.
  14. JJJ

    JJJ Active Member

    We had the exact same thing happen. Tigger finally had a good therapist. Due to Medicaid, we are stuck with whomever the County Mental Health assigns to us. We have been through some horrible tdocs with them and some that are simply incompetent. This one was great. They HAVE NOT PAID HER for seeing patients for over 4 months. She finally couldn't live on the part-time pay they were giving her for giving assessments. So she got a job 20 miles away and got permission from her new boss to see any of her boys (she sees 30) as pro bono because the new office doesn't do medicaid. After all of this, the COUNTY mental health invoked some line in her contract that says she can't see any of these 30 boys at her new office.

    Course, the county mental health has a 4-6 months WAITING LIST for kids that need services; 1 hour appointments are rare and some therapist appointment are as short as 20 minutes.

    It makes no sense but there it is.

    Sorry to add my vent to your vent ;) but I wanted you to know you are not alone in your frustration over the craziness of the system.
  15. Marguerite

    Marguerite Active Member

    It shows - it pays to keep pushing. When bureacuracy interferes with what is in te patient's best interests, then it is not a HEALTH service.

  16. JJJ

    JJJ Active Member

    Congrats on making it work. You've given me hope to try and push a solution here too.
  17. TerryJ2

    TerryJ2 Well-Known Member

    Yaaayyy! You did the right thing!
    I am so sorry about the mess. Speaking from the point of view of having our own clinic, and having noncompete clauses, it is commonplace. However, my husband sees pts for the other dr when he is on vacation or sick, and vice versa, so there is some back-and-forth. I don't see any of that where you are/were, and understand completely why it isn't advisable.
    I'm so glad it worked out!
  18. idohope

    idohope Member

    The Saga continues. We had appointment last week and therapist told difficult child she was moving to a new place. difficult child skipped out the office saying now we wont have to travel so far to see her.

    I spoke with therapist 3 days ago and she said that her insurance was not worked out at the new place and that we would need to pay out of pocket and deal with the insurance company ourselves at the new place until the paperwork was complete. I spoke to husband and we decided that we could do that (so that there was not a big gap in visits until paperwork done).

    Then today I got an email that therapist sent last night saying she can not see us anymore and that it is beyond her control. Yesterday was her last day at the old practice. Maybe they sprung something on her.

    Dont know what to feel. Mad, sad, tired. I have not responded to therapist. Need to think a bit and calm down. I am upset that all the explaining to difficult child has to come from me now, instead of therapist.

    Thank you for support and listening. I see that others have struggled too with similar issues. Dont let this deter you, JJJ, from pushing to resolve your issue.
  19. recovering doormat

    recovering doormat Lapsed CDer

    I'm coming in late to this discussion but I read through the previous posts, and let me say I am disgusted and upset for you and your family. How can they be so %^%$*$ petty?

    My difficult child 1 is now 19, and when she was 13 she started seeing a therapist at a local clinic. She is slow to develop trust but she came to really like this woman and opened up. Then therapist left to take a new position at a high school. My daughter was devastated, and it was like starting at square one again. so I can imagine your worry and frustration. She did meet another therapist at her middle school (p.t. employee of school-based heath clininc) and developed a nice rapport with her. She ended up seeing her outside the clinic when school ended for another three years (at a clinic and then in her own practice). The clinic she had joined after her middle school practice was a large community based one with a huge turnover, particularly of the younger MSW's who were fresh out of school, so I don't think they had a noncompete clause (don't know how they would have enforced it). In any event, most of the clinicians saw private patients on the side because they couldn't have lived on what they made at the clinic.

    I am so sorry for your trouble. I wish I could think of something that would work, but it sounds like this clinic is micromanaging their staff to a ridiculous level. I think you're better off finding another clinic, that's for sure.
  20. Marguerite

    Marguerite Active Member

    Hmm. I'm leaning more towards my original impression, that this therapist is trying to use the move as an excuse to not take any clients with her.

    It's not you, it's her. Because you've bent overbackwards to make this possible, but still obstacles keep getting thrown up. Stupid obstacles, silly bureaucracies, petty issues. You knock then down, more turn up.

    I would choose now to begin looking elsewhere. Because I suspect if these problems get solved, more will materialise.

    I've sen this sort of thing before. Most recently, it was during the making of a certain film which happened to have a lot of autistic kids in it (the segment in which our kids were involved). The bulk of the kids in this segment were either on the point of graduating from high school or just graduated. All were good kids. The production people had hired a Special Education teacher to work with these kids (difficult child 3 especially) who was a lovely lady, very kind (however, I still had to be very hands-on with difficult child 3, this lady was doing the wrong things sometimes and trying to soothe him down when really, what he needed was an explanation).
    As we wrapped up filming, everybody was swapping phone numbers. But this lady said, "I can't allow any further contact, it's because I am generally working for the education department and I can't have social contact with any student who is likely to need my services professionally."
    She was very regretful, extremely apologetic, saying things like, "if only..." and we all took this at face value. But she forgot, she was talking to a lot of parents who have had GREAT experience with the way aide support works in our schools. Also, with kids who were never ever going to be in a setting where she was ever gonig to have professional contact with them - most of them had graduated out of any such likelihood. And we knew she was making excuses. It was a sham - she simply wanted to ensure that all contact was cut off. She'll work with these kids when paid to do so but otherwise, that is it. I have since quietly asked official education department rulings on this and I was right, it was all a smokescreen, there is no such rule.

    It's like doctors I've known (and other health professionals, but doctors especially) who do their utmost to avoid ALL social contact with anyone who has ever been in the "patient" category. I've attended medical conferences (slipping into the health professional category due to my qualifications) when the advertised attraction to doctors attending was, "professionals only". Why do they need this? Because socially, doctors can be paranoid. They like to know they will have a safety zone around them, that they can talk more freely to others present, that nobody is going to go up to them and start trying for an armchair consultation. The thing is, most people know better. Many doctors put up with it or have their own methods of handlnig that when it does arise. But too many professioanls especially in the health industry and even more especially, in the mental health business, go to extreme lengths to pick and choose who they will see and who they will not. Not just professionally, but socially. They biud huge buffer zones around themselves and if they decide to cut someone off (socially or professionally) they have perfected a number of ways. It was funny seeing how some doctors reacgted to my presence at the last such conference I attended - one doctor came up to me to discuss an article he had written which he wanted me to publish; he was the one who buttonholed me, but within minutes another doctor came up to the two of us and began talking to the doctor who had approached me. Doctor No 2 then briefly turned to me and said, "Do you mind? This is private." (hard to be private when you're all standing at the buffet getting lunch! But I recognised that I had been dismissed!)
    It had all the hallmarks of a doctor rescuing a colleague from an interloper. Really bizarre. Doctor No 1 didn't get a chance to get back to me until the conference was almost over. Meanwhile I had no trouble approaching and interviewing any number of other doctors present.

    In the example I gave of the woman paid to work with the kids (difficult child 3 especially) - she was lovely, she was kind, she and the kids had fun together, we all enjoyed chatting together. We helped her, she helped us. No conflict at all. But she grabbed the chance to cut off all contact when really, there were no rules or guidelines she would have been breaking. Because if such a rule existed, then way back when difficult child 3 was starting school, we would have had to invoke that rule. All difficult child 3's aides have been people we know socially, and his last aide has become a good friend who we often make social contact with. I know where all of them live.
    I also know where the aide in question lives, who doesn't want any contact. She doesn't know it, but I have her address and phone number because someone inadvertently emailed me a cast/crew list (so I have some other interesting addresses too). But I am happy to respect the request for no contact, even if it was given in what I consider a dishonest way.

    In my experience, the profession you can trust least to handle this sort of thing honestly, are the tdocs. Medical doctors come in a very close second. I've known a few tdocs and the younger ones especially do seem to be the most sane and least paranoid, but there are still a lot of very strange, unstable and paranoid people practising in that profession.

    So don't take it personally from her. But I think it's time to stop trying, you're expending energy that she is sabotaging.

    You could ask her point blank, "Is all this for real, or is this your way of trying to extricate yourself from old clients? It's OK if you are actually trying for a fresh start, but I do need to know. Please let me know so I can make some decisions based on sound information. I need to expend my energies effectively and not have my efforts wasted - if I am trying to do something in ensuring continuity of your services when you actually would rather I didn't, then tell me now."

    Last edited: Dec 19, 2009