Dear Therapist: I recently figured out that my close friend has the same therapist. I don't necessarily see anything wrong with this, but I would love a professional opinion. Is this uncomfortable for the therapist? Am I supposed to feel uncomfortable? Is this considered a "no no" for therapy?
Frame Therapist Avigail Schotz weighs in...
The first thing I wonder is how you figured it out - if it was based on something your therapist said or something your friend said? More on that later, but the very short answer is that there are no ethical or legal restrictions on therapists working with people who know each other. Therapists can’t have dual relationships - aka, they can’t be your therapist and your manicurist or your hiking buddy - but they can technically see you and your bestie. Of course, the longer answer to whether or not it’s a good idea depends on a few factors.
The first and most important factor is whether or not your friend is likely to come up as a subject in your therapy, and vice versa. As a rule of thumb, this is the criteria I consider when a client refers a friend my way. If they have a very close, complicated or in any way conflicted relationship, I politely decline and offer referrals. This is mostly a desire to protect the therapeutic relationship with my client - wanting them to feel like their needs are centered in our work. It’s also a matter of confidentiality. I wouldn’t want to somehow mix up who told me what - which wouldn’t be likely, but, being a human being, could happen. Imagine if, for example, you got in an argument with this friend and needed to discuss it. You might wonder what the other friend said in therapy, or what the therapist knows or doesn’t know. Messy!
There can be other factors affecting the therapist’s comfort, including what a therapist might casually find out about a person - for example, if the therapist hears that they both went to a party where there was substance use, and one of them is struggling with substance addiction. While therapists are trained to protect confidentiality (except in cases of child abuse, elder abuse, self-harm or imminent harm to a specific other person), an issue like that could potentially cause some discomfort. Of course, sitting with discomfort is part of the job, and we use peer consultation and supervision to help us navigate these sorts of things. For some therapists, this sort of discomfort may be something they’re not willing to risk. That is on them to sort out, not you.
I have known at least one client who “shared” his therapist with a friend and then felt harmed by a breach in confidentiality, when the therapist casually expressed that she knew something about him from the other client. This is where we get to my first question - how you figured it out. If the therapist slipped up, it may be worth a conversation, or an evaluation on your part about whether this therapeutic alliance feels protected. If you figured it out another way, perhaps that actually attests to your therapist’s ability to hold confidentiality.
Finally, you may want to consider whether or not this may affect your relationship with your friend - if one of you, for example, has a very positive or impactful relationship with the therapist, while the other does not. Even if the therapist is highly skilled, not everyone’s a great fit and this could in some cases feel emotionally bruising. You or a friend might also feel proprietary about their therapist - that their relationship with that therapist is sacred and not to be shared.
While all of the above is possible, I have worked on a number of occasions with different clients who were colleagues and friends, and it hasn’t posed any issues. It sounds like your experience was an unplanned coincidence, and that you feel okay with it. So much of therapy can involve us detangling ourselves from ideas about what we’re “supposed” to feel. In this case perhaps the best piece of information is what your gut has to say.
About the therapist: Avigail Schotz (she/her) is a Los Angeles-based therapist and former TV writer, who believes in the power of story to shape experience. She works with adults, teens, and couples and much of her work focuses on issues arising for those in the creative arts and in the LGBTQIA+ community.
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