Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

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char12
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Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by char12 »

Hi everyone

I started my Doctorate in Counselling Psychology a month ago and have limited practical experience. I have done my level 2 in counselling skills and have been seeing 1 client for 2 weeks.

I had a session arranged with a client this morning, and somebody else answered the phone and asked if they could take a message. Without even thinking, I told them where I was calling from and that we had a session arranged. As soon as I put down the phone I realised exactly what I had done. To make it worse, i'm volunteering for a domestic abuse charity.

The client has since text apologising that she thought the session was for tomorrow. I apoogised if I had confused the dates and asked if she would still like to do the same session time tomorrow. I have had no reply.

I feel sick and ashamed at my utter incompetence and my confidence is shot. Confidentiality is something that has been drilled into me for years. I am worried about the effect it may have for her, it getting back to the organisation and that maybe i'm not cut out for this. Any advice going forward would be appreciated.
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miriam
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by miriam »

These things happen. I'd try to speak to her and apologise. But nobody is perfect and you'll learn from it, so try not to be too harsh to yourself.

I was part of a worse mistake as a qualified CP in the NHS. I wrote a formulation letter about a lady's difficulties including how she had felt like the black sheep of the family growing up. My secretary sent it to the address she saw in the file. Unfortunately, the lady had done a house exchange with other family members, and this was her old address (the new address was updated on the computer system and in the front of the file, and she had been there over a year - so this was entirely our fault). Unfortunately members of her family at that address couldn't resist opening a "Strictly private and confidential" letter to her, and had read the whole thing - complete with my formulation and her perception of how unhelpful her family had been over time. She told me it had caused a big row. I felt absolutely terrible. But she said it was better out in the open, and wasn't angry and didn't want to make a complaint. BTW, we checked and legally her extended family had committed a criminal offence by intentionally opening mail addressed to someone else, but it isn't something that is usually prosecuted (as it is hard to prove it wasn't just an honest mistake) and the client didn't want to follow that direction of redress.
Miriam

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alexh
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by alexh »

I've had similar incidents too. I think it is very common.

As well as speaking to the client I would also speak to the organisation as soon as you can so they can do whatever they need to.
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Geishawife
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by Geishawife »

I doubt there is a health professional of any description who has not had a similar experience. I know I have! All you can do now is keep the lines of communication open. Yes, talk to the client (who will hopefully see it was an honest mistake and an easy one to make) but also talk to your supervisor and let the organisation know. Please don't be put off by this event. It in no way means you are not cut out for the role. You just made a mistake that any of us could do. Wishing you well going forward with your career.
hawke
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by hawke »

I've also had a confidentiality breach along the journey - I suspect most clinicians have. (In fact, writing this post has made me reflect on a lot of other types of mistakes along the way that have led me to question my suitability for the role... Phoning my service manager at 9pm to admit to losing a burglar alarm fob for the building particularly stands out in my mind!) My confidentiality breach involved mixing up two client's phone numbers on the system as I was updating a record, and I ended up leaving a voicemail for Client 1 on Client 2's phone. I have learnt from it and am now much more careful when changing phone numbers on records, check contact preferences/permissions early on with clients, and leave very vague voicemails in case the wrong person picks it up. I've seen all sorts of mistakes in the NHS where letters go out to the wrong person, or things have been shared with family without permission - it happens.

I would highly recommend talking about it with your manager in terms of practical things that need to be done, as well as your supervisor (service and course) for the emotional fall out. Integrity is a big part of the ethics guidelines for our professions, and that means owning up to and apologising for our mistakes. The service may need to take actions, like reviewing its training processes or policies for phone work etc, but that's part and parcel of a service improving itself. There may be a complaints procedure that the client wants to access, although in my experience, clients care more about receiving a genuine apology and reassurance that it won't happen again.

I think it's one of those situations where feeling guilt can be really helpful, as it drives you to try to correct or make up for the mistake, and then learn from it in future. Shame, on the other hand, drives us to hide our mistakes for fear of rejection of us as a person. I hope it's helpful to hear you're not alone in making a mistake, and that creates some space for self-compassion.
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miriam
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by miriam »

hawke wrote: Wed Nov 25, 2020 5:45 pm Phoning my service manager at 9pm to admit to losing a burglar alarm fob for the building particularly stands out in my mind!
That's nothing. I got locked in, with the alarms set around me (including a police alert silent alarm), after my first day in a new job and had to phone the on-call numbers on the wall to get someone to tell me how to get out the building!

Oh, and on my work experience in a health setting when I was 15, I recognised the surname of a boy I fancied on the big heap of files I was putting back in the filing cabinet and later asked the boy whether the name on the file was his sibling to try and make conversation with him. Thankfully he was quite chill about it "yeah it probably was x's file, s/he has lots of developmental and mental health issues, so s/he probably does go there" and didn't drop me in it. I hadn't looked in the file - which was why in my 15 year old head I hadn't thought about confidentiality - but my Mum set me straight when I told her (she was a CP, but she is now retired) and made me feel terrible by explaining it was a confidentiality breach, as well as coming up with reasons it might not be them anyway (common-ish name, might just have had a blood test or be in a control group for a study).

I'm super pedantic now, and try to really drill it into my team how cautious we need to be with our data protection. I've often really come down on staff who risk breaches (eg writing a list of client names in a diary or notebook that they keep in their handbag; giving information about appointments to callers who say they are from the instructing solicitors without phoning them back on number given in the letter of instruction first; discussing client issues in public spaces even if not using names), particularly if they repeat similar issues again after I've explained!

However, when things do go wrong (and nobody is perfect, so they inevitably will from time to time) I think we in health and social care ought to follow the model of pilots when it comes to learning from our mistakes and near misses, rather than hiding them away out of shame or fear of blame/punitive repercussions.
Miriam

See my blog at http://clinpsyeye.wordpress.com
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mungle
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Re: Trainee Psychologist- beating myself up over rookie mistake (breaching confidentiality)

Post by mungle »

Nothing much to add to the above posts - just another reassurance that you are not the only one. The important thing is how you now handle it - speak up at work about it (hiding it would be an ethical issue) - your supervisor and/or manager can help you work through any actions you need to take. For instance, you might consider with them if you know the client is safe/any abusor has not been alerted or putting the client in danger.
You can work on repairing the relationship with the client and the good news is there is great evidence out there about how mending a rupture in the therapeutic relationship can leave it stronger.
You are human and you made an error - we all do. Welcome to the we're-all-just-human club!
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