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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 55. This is the beginning of the thread.
Posted by gardenergirl on July 21, 2004, at 23:56:47
Hello,
I just wanted to ask for some input on contact between therapist and client after termination. I received an email today from a former client. It was lovely to hear from her, and she seems to be doing well. This client was someone I worked with all year during my placement, and I enjoyed working with her. Termination was difficult for me with her, as I was aware that I would want to know how she does in the future.She also had become somewhat dependent for the majority of our working together, but had worked through some of that before termination. Termination happened because she was ready, but also because of the end of my placement at the agency. When we terminated, I used a model set forth by one of my professors, saying, "I would always enjoy hearing from you and how you are doing, but I may not be able to respond to contacts, once our therapy relationship ends." I'm not sure I am totally invested in this approach, but I did try it on for size.
Anyway, I would like to reply, but I am a tiny bit concerned that it could trigger some of the dependency. On the other hand, it could reinforce her internalization of her therapist which helps her with moving forward indpenendently.
What do y'all think? If you've contacted your former T's in the past, have they responded? If they did or did not, how did that feel? What were you looking for in the contact?
Thanks in advance,
gg
Posted by Susan47 on July 22, 2004, at 0:15:51
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
I've never contacted a T after termination; however, being someone who likes to be trusted, I would like to say please give her a chance. She may have handled things well and if you reject her now it would damage her self-confidence. Maybe she's only looking for reassurance. I take it you are a T.. have you ever been a client?
Posted by gardenergirl on July 22, 2004, at 0:36:31
In reply to Re: email contact after termination, posted by Susan47 on July 22, 2004, at 0:15:51
Thanks for your thoughts. Actually, I am still in training...need to finish dissertation proposal and then internship. And I am currently a client, so I haven't had the experience of terminating from a valued relationship and then pursuing contact later.
And I do trust this client. I think that must be why I gave her a business card, which was a personal card, not related to the center where I was working. I think it was all I had on me to write on at the time. But I knew she would not abuse having my email addy or I would not have given it to her. So my intial reaction is to respond. Maybe training has beaten too much boundary fear into me??? :) Actually, I just need to develop a strategy that feels right for me.
Thanks,
gg
Posted by rs on July 22, 2004, at 6:15:11
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Hi. As you know I have contacted a T that I saw for many years. When he moved he made it clear that there was not to be any contact. If I wanted to write to mail it to his adress at the time and they would foreward it to him. Did that once. Ok. After about three years started therapy again. Talked about my old T and how the termination was wrong. How could someoene after all the years just not have contact. So a dear person here found his adress for me and I wrote him a letter and told him how I felt. T now knew this. Anyway he wrote back and was happy to hear from me etc. His number was on the letter head. One day I called and left him a message. He called back. I told him abouot my new T etc. No therapy involved at all. Just a general discussion on what was going on in therapy and how I felt he terminated in a wrong way. He agred. He told me that if he could be helpful in my treatment I could call him. Last week really needed his professional opinion concerning my therapy. He called me back. I told him what was going on. He gave me his opinion but did say to tell my T what we talked about etc. I did that. Anyway it helped me because he knew me. But he would never give my therapy if you know what I mean. I now know that if I just want to call him and say hi and general stuff it is ok. I hope this makes sense. It does help to know that if I come across in therapy I mean a major one he will be there to support me in the decision. He knows me and how I react to therapy. I told my T all bout the converstation and he is happy that I did that and have him for things like this. Do I still miss this person. Yes I do but not like I did. My new T is much better in many ways. But again he would never do therapy with me only if it has to do with me staying in therapy. He did say he likes my new T after hearing me talk aboout him. I know this must be a hard one for you especaill about the dependent issue. Hope all is well.
Posted by fallsfall on July 22, 2004, at 8:21:51
In reply to Re: email contact after termination, posted by rs on July 22, 2004, at 6:15:11
As a "dependent" therapy patient, this is my first reaction: Do send something back, but make it a bit removed - like "I was glad to hear from you and glad to hear you are doing well. I'd love to hear an update in the future."
The rest of this post is "rules" that I would like to give to a former therapist if I were in the situation you describe. I don't have the capacity today to write this in a less demanding way - sorry. I trust that you can pull the meaning from what I say without feeling like I am making demands or stating absolutes. I did find it interesting to try to envision what kind of contact I would find helpful, and what would not help. I hope that my viewpoint can help you decide what response will be most helpful for both you and this specific client.
1. Send something back so that she knows it was OK for her to send the email in the first place.
2. Don't comment on specific things in her email (don't give her the impression that she can count on you for feedback). For me, if a former therapist gave a comment (even a positive one) or advice I would yearn for her continued help.
3. Do echo the general tone of the email - Glad things are going well, or sorry things are rough. This would tell me that she still "cared" - that how I was doing mattered. Otherwise I might feel abandoned???
4. If it is true, tell her she can repeat communication in the future - if you are concerned that she might contact too often you could say "I'd love to hear how you are doing again next year (or "in a couple of months" or "in the winter")" - that would indicate that she shouldn't send you a weekly email.
5. Don't ask any questions that would suggest that you want a return email. If she sends you an email and you send one back that she needs to respond to you may get into a frequent-email-exchange relationship which you probably don't want (and probably isn't good for her).
6. Send your reply 4 -7 days after you got her email. You don't want to set up a precidence of quick replies, but you don't want her agonizing for more than a week about whether she did the right thing.
She is lucky to have had you for a therapist.
Posted by Miss Honeychurch on July 22, 2004, at 8:36:05
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
gg,
I think fallsfall has given you some great advice! Keep the response general and warm, but not too specific. But definitely DO respond. You obviously played an important role in her life and she is probably just trying to let you know that the things you taught her or helped her work out are indeed working.
I plan on doing the same sort of thing with my T once I'm done. Maybe once a year. And I would never really expect a response. IT's also motivated though by the fact that I never want my T to forget me, so maybe I would be staying in touch for the wrong reasons.
On the other hand, I also want to show him how much his help HELPED me. I mentioned to him not too long ago that there were no words I could say which could adequately express my thanks to him. He said the best way to thank him was to continue working hard. I feel by updating him that I would be showing that I was still working hard at the skills he taught me and this would therefore be translated into thanks.
Posted by pegasus on July 22, 2004, at 12:46:54
In reply to Re: email contact after termination, posted by Miss Honeychurch on July 22, 2004, at 8:36:05
I agree with falls rules also. As you've probably heard, I've been in this situation on the other end for a while now. Although, it's a bit different because my therapy was nowhere near ended, but my T had to move away. So, that was a very hard termination. Before he left, he told me that I could call or email him.
So, the way it has worked out is that I emailed him after about a month, and he wrote right back saying that he was glad to hear from me, and had felt the lack of communication, and giving me some info about his move and what a hard transition it was. I've emailed him about once every two weeks or so since then. I'm trying to taper that off now, and haven't written in about a month and a half. But I'm going to send him one today. ;)
He has responded to about half of my emails. He doesn't generally ask me questions, but he does usually send a fairly substantive email. He tells me that he's a poor correspondent, especially with email, and doesn't check for email every day. And sometimes forgets to reply, which doesn't mean that he doesn't care, just that he's busy. So, while I hate it when he doesn't reply, I do understand. And I'm glad he does that, rather than sending curt emails every time. He's also making a point to encourage my continued therapy, and development of a relationship with my new T. (He was very unhappy when I told him I'd quit with one T. I think he was worried that I'd try to stick to him like glue forever.) He's very clear that we're only in contact personally, and that we're not doing therapy, and that he doesn't want our contact to get in the way of me developing a relationship with my new T.
It's hard, and I do still feel somewhat dependent on him, and I'm sure the emails exacerbate that some. But, I'd have been devastated to have lost all contact with him when he moved. I don't know that I would have been willing to talk to other Ts if I had thought that the great relationship we built dissolved completely the instant he moved. I would have lost a lot of faith in therapeutic relationships in general. I was not ready to end therapy, and it broke my heart that I lost him right in the middle of everything. It would have been too much to completely lose the relationship along with the therapy. So, I think he did the right thing in my situation.
Just something to think about. Hope it's helpful.
pegasus
Posted by daisym on July 22, 2004, at 12:55:36
In reply to Re: email contact after termination, posted by Miss Honeychurch on July 22, 2004, at 8:36:05
I agree with everyone else. I haven't had the experience of terminating myself but when my son did I updated his therapist via email every once in awhile. He always responded with a "great he is doing so well" kind of response. It was important to me to hear from him. It also made it easier for me to call and say, "he needs to come back."
In my own work, we graduate kids at 36 months from our program. Parents are usually VERY attached to their home visitor (imagine the dynamics there -- sick/disabled child, this angel comes into your home to work with the child and help you through all of it). We have a reunion picnic every summer so families can check in and the home teachers get to see how the child is doing. It works out really well.
I'm sure you will find what works best for you. Remember, in therapy, one size does NOT fit all.
Posted by pinkeye on July 22, 2004, at 13:36:43
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Hi GG,
I have been in contact with my T for about two years now through emails. He allows me to write to him as much as I wish. But he replies maybe about once in a month or two. I wrote to him on different frequencies, initially once every two weeks, sometimes once a month, back to once every two weeks, sometimes more than one mails in a week etc.My T's continued support to me through emails is a God Send Gift. I wouldn't have evolved so much if he had strictly adhered to the rules and cut off contact with me. I needed to know that he really cared about me as a person, just not a patient. 2 years later, I have evolved so much, all thanks to his support. Even just writing to him helped me process all my thoughts, and made me take better decisions. That said, he never replies at once. He always replies atleast a week later. In retrospect I think it is a good strategy to do, so you give your patient time to think about what she/he wrote to you and help themselves.
My case was a little different though, I was in my home country and had to meet him during a crisis, and I had to leave back for US without having full therapy done. So he allowed me to write to him without hesitations. And his replies initially were full detailed. But now, that I am much better, his replies are more generic and short. And generally along the lines "sorry you are going through, glad you are doing well" etc. And in our country where he practices, the rules are not as strict as in US, and he knows he won't get sued. So if you have to obey stricter rules to protect yourself here, go for it.
Therapy cannot be done like a business transaction, once your business gets done, move away. It has to be done more as a personal relationship. So do by all means atleast reply to your patient. Even if a short one. You don't have to reply to all her/his emails continuously. Once in a while replying with a short emails would be excellent. If you feel you can continue doing therapy via emails and your boundary won't get violated, by all means do that as well. Or if that is too much for you, just reply generally asking them to seek professional help somewhere else.
Posted by gardenergirl on July 23, 2004, at 8:03:20
In reply to Re: email contact after termination, posted by rs on July 22, 2004, at 6:15:11
I'm so glad that you have been able to maintain contact with someone so important to you. And it sounds like it works well for you and for your new T. That's great!
Take care,
gg
Posted by gardenergirl on July 23, 2004, at 8:18:54
In reply to Re: email contact after termination, posted by fallsfall on July 22, 2004, at 8:21:51
Falls,
Your "rules" are very helpful. I feel like I can use them to come up with a response that will be validating and yet maintain boundaries.And thanks for the kind words. You are so sweet and helpful!
Thanks again,
gg
Posted by gardenergirl on July 23, 2004, at 8:22:20
In reply to Re: email contact after termination, posted by Miss Honeychurch on July 22, 2004, at 8:36:05
Miss Honey, I doubt that Bean would ever forget you, but it sounds like you have a good plan!
Take care,
gg
Posted by gardenergirl on July 23, 2004, at 8:25:18
In reply to Re: email contact after termination, posted by pegasus on July 22, 2004, at 12:46:54
Peg,
It sounds like your situation was very painful. I'm glad your T maintains contact with you. And it sounds like it's a good thing (yikes, I sound like Martha Stewart!) I'm impressed by everyone's ability to maintain contact with a former T and yet build a strong relationship with a new one. I don't know why I think that is counter-intuitive to me, but I'm glad to see it works well for you.Take care,
gg
Posted by gardenergirl on July 23, 2004, at 8:28:41
In reply to Re: email contact after termination, posted by daisym on July 22, 2004, at 12:55:36
That reunion picnic sounds like so much fun! And it makes sense to me how keeping contact with your son's T helped him return. I think I may ask my T if I can stay in touch with him when we are done. Whenever that is! :)
Take care,
gg
Posted by gardenergirl on July 23, 2004, at 8:36:54
In reply to Re: email contact after termination » gardenergirl, posted by pinkeye on July 22, 2004, at 13:36:43
Hi pinkeye,
I like your comments about therapy not being a business relationship. I agree. Even though there is a business aspect to it, it's the personal relationship that is important. I appreciate your thoughts on this. I actually can't continue to do therapy via emails, as I am not yet licensed. But I do think I will reply to her.Thanks again,
gg
Posted by jane d on July 23, 2004, at 13:50:56
In reply to Re: email contact after termination » Susan47, posted by gardenergirl on July 22, 2004, at 0:36:31
> And I do trust this client. I think that must be why I gave her a business card, which was a personal card, not related to the center where I was working. I think it was all I had on me to write on at the time. But I knew she would not abuse having my email addy or I would not have given it to her. So my intial reaction is to
GG,
I see you have already made your decision but I was so interested in the question and in all your answers that I wanted to jump in too.I'm like Susan in that I like to be trusted. And it bothers me that trust seems to be lacking in my dealings with mental health professionals. I know that they may have different rationales for it but the secrecy about their private life always makes me feel like they expect me to suddenly turn into a stalker. Prohibitions on future contact would too. With my dentist or a doctor that I have seen frequently so something unrelated I would have no hesitation with staying in touch. A relationship was established over the years just thru the frequent contact. And I know a great deal about their lives in passing too. That feels normal. That therapists in general would react differently feels stigmatizing to me.
I definately can see a benefit to me to knowing that the option for contact was there. I already find myself thinking about her opinions on my actions and end up being influenced for the better. A bit like she's looking over my shoulder. And I would expect that feeling to continue in much the same way that you want to show the professor or mentor who's gone the extra bit for you that you've done well. I don't know that I'd ever actually have to get in touch to get that benefit - just know that it was possible. (Of course this is a bit exploitative - getting use out of your therapist without paying. :) ).
That's me as a client. However if you were my sister my thoughts would be a little different. If your job exposes you to risks you have to protect yourself in your private life. If you think that your clients might become stalkers then you need to do everything you can to prevent that - whether your trustworthy clients like it or not. You can tell them it's professional policy and why it exists while making clear you know it doesn't apply to them if you must explain that. Protecting yourself includes people who aren't threatening physically but want to intrude on your personal life. Or who want you providing therapy and supporting them when you are off duty. You'll need that off duty time.
And of course, you need to protect yourself legally and with your licensing board. And finally, though I argued at the start that you should trust people I'd also suggest hedging my bets. Use a different email address for your clients and former clients. And save the emails you send and receive. I don't know whether it's appropriate to put them in the clients file. I seem to recall someone being very upset about that - but it might be professional standards. But if you don't do that set up another file just for these contacts. Just in case you need to defend yourself down the line.So much for trust.
Jane
Posted by gardenergirl on July 23, 2004, at 17:48:40
In reply to Re: email contact after termination » gardenergirl, posted by jane d on July 23, 2004, at 13:50:56
Jane,
You bring up some good points that I think were resonating in my gut, but I hadn't articulated. I actually know of a fellow student who had a former client track her down at home and start writing and calling her. It was a difficult situation. I don't have that vibe from this person, and I am comfortable with the idea of responding, but I think we all do worry about people like the Bob character from "What about Bob." :)And my silly school publishes our home information in the directory unless you request privacy in writing on the third Tuesday when the moon is full, on paper you can only get in Botswana every third decade. sigh
Thanks,
gg
Posted by pegasus on July 23, 2004, at 19:20:27
In reply to Re: email contact after termination » pegasus, posted by gardenergirl on July 23, 2004, at 8:25:18
Hi GG,
I can see why you might think it was counterintuitive. It was confusing for me at first too. But, in my situation, if my former T had not allowed any contact after he moved, I wouldn't have dared risking going into another therapeutic relationship. So, even though it may slow down forming a relationship with the new T, in my case, the alternative was no therapy at all, and feeling betrayed, abandoned, and deeply hurt by my one long-term therapy experience. Therapy would have seemed far too dangerous to risk again. It's only because he allowed me to see that his caring was real and not just by contract, and that my trust in him was not misplaced, that I could even imagine talking to another T again.
I think those who advocate hard and fast rules about never contacting clients after termination are potentially doing a grave misservice to those clients. There are situations where I think contact is the only ethical choice. On my end, I don't even know that I would have survived under those cirucumstances.
pegasus
Posted by Raindancer on July 24, 2004, at 11:44:51
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Hello gardenergirl,
I 'm training to be a T and will have my first clients early next year. I hope some of them will want to remain in contact with me after therapy is over. It's a tremendous compliment. My own T says that if I write to him after therapy, he will always reply and this is a terrific comfort and makes me feel less dependent rather than more so.
Being who you are, I believe that you will go with your gut feeling and reply to your client while not holding out the hope of very frequent correspondence. You obviously have to take care of yourself in this and not write to all your ex clients, otherwise you won't have time to do any therapy!!
I think anyone is really lucky to be in therapy with you. All the very best.
Raindancer
Posted by gardenergirl on July 24, 2004, at 12:11:52
In reply to Re: email contact after termination » gardenergirl, posted by Raindancer on July 24, 2004, at 11:44:51
Awwww, thanks Raindancer. That's very sweet. I'm glad you have already talked about this with your T. I plan to have a similar conversation once we get closer to termination, whenever that might be.
Good luck with your training. Seeing clients is so rewarding, and you learn so much from it. I'm sure you will be a natural.
Feel free to email me if you ever want to chat about training or wearing two hats on this board, or anything... gardenergirl 88 at yahoo dot com
Take care,
gg
Posted by Raindancer on July 25, 2004, at 6:24:44
In reply to Re: email contact after termination » Raindancer, posted by gardenergirl on July 24, 2004, at 12:11:52
Thanks gardenergirl, I shall be glad to. Warmest wishes.
Raindancer.
Posted by pinkeye on July 26, 2004, at 14:30:09
In reply to Re: email contact after termination » rs, posted by gardenergirl on July 23, 2004, at 8:03:20
GG,
I have a question for you. As a T, do you like hearing from your old patients? What do they mean to you? Do you feel you are bugged when you receive lots of emails? I am asking this to see what my T would have felt.
Pinkeye.
Posted by gardenergirl on July 26, 2004, at 15:51:00
In reply to Re: email contact after termination, posted by pinkeye on July 26, 2004, at 14:30:09
Well, I've only heard from two clients after termination, but my clients from last year are in nursing homes, so it would be unlikely to hear from them. My clients this past year may be more likely, so we'll see as time goes by.
I didn't mind hearing recently from an old client. In fact, I was delighted. And last fall I ran into my old supervisor who filled me in on how my clients from the nursing homes were doing. I was happy to hear that too.
So right now, I'm not feeling bugged at all. I suppose if I were to get very frequent emails from a few clients, I might feel overwhelmed and would also be worried that the clients had not successfully terminated.
But I'm just guessing...not enough experience to say...
I can say I genuinely care about my clients, so knowing how they are doing is nice. But perhaps if I heard that they weren't doing well, I might be more concerned and feel some sense of responsiblity to try to help. Although I would not be able to resume therapy with them, so it would be a difficult feeling to cope with.
I'm just rambling...hope this helps.
gg
Posted by pinkeye on July 26, 2004, at 16:22:17
In reply to Re: email contact after termination » pinkeye, posted by gardenergirl on July 26, 2004, at 15:51:00
Thanks GG, that helped to know that you liked hearing from your old client.
Maybe I can write to him once in a while and not often.
Thanks
Pinkeye> Well, I've only heard from two clients after termination, but my clients from last year are in nursing homes, so it would be unlikely to hear from them. My clients this past year may be more likely, so we'll see as time goes by.
>
> I didn't mind hearing recently from an old client. In fact, I was delighted. And last fall I ran into my old supervisor who filled me in on how my clients from the nursing homes were doing. I was happy to hear that too.
>
> So right now, I'm not feeling bugged at all. I suppose if I were to get very frequent emails from a few clients, I might feel overwhelmed and would also be worried that the clients had not successfully terminated.
>
> But I'm just guessing...not enough experience to say...
>
> I can say I genuinely care about my clients, so knowing how they are doing is nice. But perhaps if I heard that they weren't doing well, I might be more concerned and feel some sense of responsiblity to try to help. Although I would not be able to resume therapy with them, so it would be a difficult feeling to cope with.
>
> I'm just rambling...hope this helps.
>
> gg
Posted by li hing on September 22, 2004, at 2:29:57
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Wow I read all of the posts under this thread and I must say that some of you had such nice therapists.
My counselor was a
major butthead. She told me that I could contact her after termination.
I e-mailed her and she got angry because I was writing too much. I had
thought that we had a close counseling relationship. We saw each other
for 2 years. She never responded to any of my e-mails and ended up
sending me a nasty letter in the mail telling me not to write and that she
won't read anything that I send her.This caught me by surprise and a lot of hurt. I cried for months and
days.Recently I got to see my file that she kept for me. I found out she never
read the letters that I sent to her in the snail mail after termination.
Letters she promised she would read and that she would "love to hear from
me" I guess after all the e-mails, she decided that she hated me and
shoved my unopened letters into my file. I am so angry.In any case for therapists who respond to their clients after termination, I wish you were my therapist. I mean a simple, hello would have been all I needed as a client.
okay, enough for now!
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