Have you heard??

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Has anyone heard of this before: I had e-mailed my son's counselor for a list of names for therapy. He's 15 and still contending with bullies. His counselor said that once I find a counselor, I should sign a permission slip so she and the counselor can communicate and help my son deal with his peers more effectively. This scares me! Am I being cut out?? Has anyone been through this before?? I don't think I'm going to go for this. Please help. These boys that are bothering my son actually should be arrested for dealing within the school and other things. I can't believe this!

It does not mean that you are being cut out. Neither counselor can share information without your permission. My guess is that they specialize in different areas - "couselor" is not quite as broad a term as "doctor", for example, but just as there are many types of doctors, there are many types of counselors. This is a very normal request for a school counselor to make (actually, she's going above and beyond what I've come to expect out of the overwhelming majority of school counselors; I'm impressed). It would not be out of the ordinary for your son's therapist, once you find one, to make the same request.

The beauty of private care is you do not need to let the school know anything. I think they are just following procedure, and it's unlikely they'll even remember and ask you about it if you don't sign to allow communication. I don't think there is anything underhanded from what you have said so far, and even if there is, the best response is probably to say "thank you so much for your help, I appreciate the list of names and will talk to the counselor about signing a release once we are able to set that up." But don't feel obligated to do so, you're not!

If you like a private counselor, having them advocate for your child can be very effective. I had a private counselor who was not even a help to me or my child directly, but his presence at a CSE meeting made an impression and it helped us get things better.

So I guess I would say this is your decision, you have the power to choose a counselor and to decide when and whether a private counselor talks with the school, try not to feel helpless about this. And the private counselor is I assume to help your child cope with feeling upset by the situation, has nothing to do with what should happen at school to control the bullying.

Any time I provide therapy to a person who is also seeing another therapist or psychiatrist, it is standard to get a release form signed from the client (this is a legal requirement of HIPAA before I can contact others and disclose information about the client). It is good practice to touch base with the other clinicians providing care and to make sure that we are not working across purposes. For example, if I were treating a phobia with a client, I may use exposure therapy, which requires them to experience anxiety in the presence of a feared object until the anxiety goes away. If they had also been prescribed Xanax by a psychiatrist and they insisted on taking it during our exposure sessions then this would effectively nullify my treatment (since the drug would completely inhibit that anxious response, and no learning would occur). Knowing that ahead of time and working it out with the psychiatrist, we can agree upon rules for how the client is going to go through my treatment, while still having access to the Xanax when absolutely necessary. If there are sudden changes in medications, I would also need to know about these, as they may explain behaviors that I am scratching my head about. I in turn could share my understanding of the behavioral changes with the psychiatrist, which could help them narrow in on the right set of meds.

It gets even messier with two therapists / counselors / psychologists. There are at least three major schools of thought about psychotherapy, and many different approaches practiced by different people. It is important to know that another therapist is not actively working towards goals that conflict with my own. Those are the reasons that (on rare occasions) not collaborating with others may hamper treatment.

Collaborating can also help treatment. If I were to work with a school counselor, we may share techniques that have worked, and collaborate on ideas that may help the child. I (as a weekly outpatient session therapist) may have more direct access to the child, and more of an opportunity to get to know them, whereas a school counselor may have access to that child during or immediately after a crisis. My insights may help him/her deal with that crisis better. The counselor's insights may give me a more rounded picture of what is happening (in case the client isn't completely accurate in his/her reporting of events).

If you are concerned about potential conflicts with the school (such as battles over IEPs), you may specify what types of information you are willing to have the therapists share, and what you would like to remain private.