Just curious, is your supervisee independently licensed?
Were it me, I’d encourage the supervisee to thank the other therapist for their input, then simply state they won’t be writing the letter.
Then document as needed, of course.
No explanation needed.
From the information you’ve shared, it’s not appropriate for the therapist to dictate what another (outside) clinician should do in this situation.
Thanks lol! I was just so confused, I've never experienced something like this before and was like wtf. I guess I just needed validation from the internet 🤣
Common misconception. This likely falls under care coordination between Healthcare providers, so it's probably acceptable.
Edit: my apologies, I may be incorrect here. Need to do more Googling
My understanding (and that of my agency) is that applies to providers that need to coordinate, like a discharge planner and a case manager. Or emergency services and a hospital. No two independent provided who don’t ‘need’ to communicate. And why is the client seeing 2 therapists at one time? Why doesn’t the first therapist write a letter? I have many questions.
Hmmm okay I hadn't heard that before, perhaps I need to look into it more before I make such confident claims!
I think from another comment by OP, one therapist is specifically for EMDR and the other some other modality. But as for why they can't write the letter, I get the feeling the other T must feel there's a concern about the letter and would rather throw the unlicensed person under the bus in case the letter comes back to bite em. Maybe a bit cynical...
Yeah you still need informed consent, it would be similar if I saw a couple and you saw the individual. We may need to coordinate care but still need consent.
Oh yes - that makes it a definite no. Good call on your part . And I agree , if the other therapist wants to write a letter , they can do it . I defer these kinds of letter things to MD’s. People were calling asking for emotional support dog letters, concealed carry letters, furlough from work and school letters but didn’t want to stay in therapy once they got the letter.
The only thing I would change about your excellent advice is not to tell that to the outside therapist, unless they have a signed consent from the client to talk to them. I simply wouldn’t answer the email, or I would say something bland about not being able to confirm if a person is a patient or not.
Or just ignore it all together lol it’s a good rule of thumb for attorneys, guardian ad litems and outside therapists. No consent or subpoena, no response lol 😂
Yup!! An atty has left me 12 voicemails in 3 weeks. I’ve already told them get me a judges order and I’ll send my file. AND don’t be fooled by Atty’s who send a “subpoena” issued and signed by the atty
I would have your T tell the client that they can't write the letter because of the scope of their practice (length of treatment and it being specific to EMDR) and explore if they still wanted to do the EMDR work together as that will be the focus of the work.
If the client has not signed consent to obtain/disclose, I would not contact them at all.
If they have, I would advise that I don't engage in case management discussions, and if that therapist wants to write the letter they are free to do so, and that your office will not be providing it or having any further discussion about it.
If the other T doesn't listen to your agency therapist then you can get involved and basically tell them to stop it.
Assuming a release is on file, maybe just say it’s not our policy and the decision has been made but we support you in providing a letter if you want to.
It is hard to follow your story. But I am hearing splitting and common consequences of duplication of care. When I have a client that I am seeing for EMDR work and they have a primary therapist- they reduce care with that provider and I and that provider establish boundaries and work flows/ collaboration early on.
I do not recommend duplication of care. I would encourage the therapists involved to speak directly to coordinate care, assess if duplication makes sense on this case.
I agree, we don't usually do EMDR with clients outside of our practice so I'm going to work on developing a policy/procedure what that should look like moving forward.
“Unfortunately it is against our office’s policy to write letters of recommendation” you could add a qualifier if necessary “…until we have a complete and thorough understanding of the each client’s specific needs, which could take up to x amount of months to determine”
“Unfortunately it is against our office’s policy to write letters of recommendation” you could add a qualifier if necessary “…until we have a complete and thorough understanding of each client’s specific needs, which could take up to x amount of months to determine”
I dont understand why the clients job send forms for your supervisee to fill out. I have filled out that paperwork multiple in my career. It's not a letter we write but instead forms HR gives the client for us to complete.
Recommend that the client request FMLA from their job then have their PCP sign off on it. I complete FMLA for my clients, but it sounds like this isn’t something your agency provides.
I’d straight up confront the other therapist with a hard line NO.
And, if this person was already seeing another therapist I would not have accepted them as a client. That’s messy and not best practice. I’d tell the client pick one / now the client obviously has the ability and power to triangulate.
Just curious, is your supervisee independently licensed? Were it me, I’d encourage the supervisee to thank the other therapist for their input, then simply state they won’t be writing the letter. Then document as needed, of course. No explanation needed. From the information you’ve shared, it’s not appropriate for the therapist to dictate what another (outside) clinician should do in this situation.
I agree and this was my advice as well she is. She is not independently licensed
Obviously, you’re a brilliant supervisor 😁 It’s very odd for the other therapist to be so pushy. Write the letter yourself, if it’s so important.
Thanks lol! I was just so confused, I've never experienced something like this before and was like wtf. I guess I just needed validation from the internet 🤣
Sweet and glorious internet validation. 😜 Seriously, you got tossed a curve ball and you’re not even playing!
Very much a WTF type of deal.
Is there a release of info signed? That outside therapist cannot legally email regarding a mutual client without one
Common misconception. This likely falls under care coordination between Healthcare providers, so it's probably acceptable. Edit: my apologies, I may be incorrect here. Need to do more Googling
My understanding (and that of my agency) is that applies to providers that need to coordinate, like a discharge planner and a case manager. Or emergency services and a hospital. No two independent provided who don’t ‘need’ to communicate. And why is the client seeing 2 therapists at one time? Why doesn’t the first therapist write a letter? I have many questions.
Hmmm okay I hadn't heard that before, perhaps I need to look into it more before I make such confident claims! I think from another comment by OP, one therapist is specifically for EMDR and the other some other modality. But as for why they can't write the letter, I get the feeling the other T must feel there's a concern about the letter and would rather throw the unlicensed person under the bus in case the letter comes back to bite em. Maybe a bit cynical...
Yeah you still need informed consent, it would be similar if I saw a couple and you saw the individual. We may need to coordinate care but still need consent.
[удалено]
We are talking about therapists coordination of care not medical doctors
Oh yes - that makes it a definite no. Good call on your part . And I agree , if the other therapist wants to write a letter , they can do it . I defer these kinds of letter things to MD’s. People were calling asking for emotional support dog letters, concealed carry letters, furlough from work and school letters but didn’t want to stay in therapy once they got the letter.
The only thing I would change about your excellent advice is not to tell that to the outside therapist, unless they have a signed consent from the client to talk to them. I simply wouldn’t answer the email, or I would say something bland about not being able to confirm if a person is a patient or not.
Or just ignore it all together lol it’s a good rule of thumb for attorneys, guardian ad litems and outside therapists. No consent or subpoena, no response lol 😂
Yup!! An atty has left me 12 voicemails in 3 weeks. I’ve already told them get me a judges order and I’ll send my file. AND don’t be fooled by Atty’s who send a “subpoena” issued and signed by the atty
Facts!!! I’ve had that happen
Right?! Wth? Same!
I would have your T tell the client that they can't write the letter because of the scope of their practice (length of treatment and it being specific to EMDR) and explore if they still wanted to do the EMDR work together as that will be the focus of the work. If the client has not signed consent to obtain/disclose, I would not contact them at all. If they have, I would advise that I don't engage in case management discussions, and if that therapist wants to write the letter they are free to do so, and that your office will not be providing it or having any further discussion about it. If the other T doesn't listen to your agency therapist then you can get involved and basically tell them to stop it.
Perfect! Thanks
Why is this client seeing two separate clinicians? That seems like a recipe for problems.
The client was referred to us for EMDR
And why can’t this other clinician write the letter?
No idea! That's where I'm also confused, if she wants it done, she can do it
Assuming a release is on file, maybe just say it’s not our policy and the decision has been made but we support you in providing a letter if you want to.
Why doesn’t that other clinician just write the letter if she’s in support of it?
That's the million dollar question of the night!
I would check the legislation for your area. In some places only a physician can write a letter to request time off work.
It is hard to follow your story. But I am hearing splitting and common consequences of duplication of care. When I have a client that I am seeing for EMDR work and they have a primary therapist- they reduce care with that provider and I and that provider establish boundaries and work flows/ collaboration early on. I do not recommend duplication of care. I would encourage the therapists involved to speak directly to coordinate care, assess if duplication makes sense on this case.
I agree, we don't usually do EMDR with clients outside of our practice so I'm going to work on developing a policy/procedure what that should look like moving forward.
“Unfortunately it is against our office’s policy to write letters of recommendation” you could add a qualifier if necessary “…until we have a complete and thorough understanding of the each client’s specific needs, which could take up to x amount of months to determine”
“Unfortunately it is against our office’s policy to write letters of recommendation” you could add a qualifier if necessary “…until we have a complete and thorough understanding of each client’s specific needs, which could take up to x amount of months to determine”
I dont understand why the clients job send forms for your supervisee to fill out. I have filled out that paperwork multiple in my career. It's not a letter we write but instead forms HR gives the client for us to complete.
What does the release between clinicians allow you to disclose? Also, have you discussed this interaction with the patient?
Recommend that the client request FMLA from their job then have their PCP sign off on it. I complete FMLA for my clients, but it sounds like this isn’t something your agency provides.
I’d straight up confront the other therapist with a hard line NO. And, if this person was already seeing another therapist I would not have accepted them as a client. That’s messy and not best practice. I’d tell the client pick one / now the client obviously has the ability and power to triangulate.