Ask the Therapist
Constantly Changing Timeslot
I wonder if you'd comment on whether or not consistent appointment times are significant in the treatment of PTSD and dissociation due to childhood abuse. I become angry and hurt when my therapist gives "my" time (i.e., always 3:00) which we'd agreed upon to someone else and bumps me to another time because my day is less scheduled than theirs. For awhile, he said he understood that my appointment times needed to be kept the same, but now he's begun switching me around again to make it more convenient for someone else. I feel like it's disrupted the trust I have in him and struck at the foundation upon which I was rebuilding my life. Of course, my emotions are complicated by the fact that it's triggering the feeling of being pushed aside as a child to make room for four younger siblings, when I wasn't even permitted to sit next to my parents any more because I was told the younger ones "needed" it. I feel traumatized by my therapist's actions and don't know what to do. We're in the process of talking about it, but I'd appreciate an outside opinion in the matter, since he doesn't seem to understand me on this.
A strict interpretation of the APA Ethical Standards, Code of Conduct and Best Practice would indicate that it is inappropriate for a therapist to impose his personal/professional needs, and/or the needs of another, upon a patient. In short, it is unprofessional and quite probably unethical to switch one patient's standard timeslot in order to accomodate oneself or another patient except in the case of gravest emergency.
As for structure and consistency in the treatment of PTSD, you're spot on.
