Can sharing hobby-related activities with a therapist cause a lady problems?

[ztonk]

A former provider with kids contacted me with a question that I have no clue how to answer. She provided and still lives in the great state of Texas.

She's been out of the hobby for several years and has recently discovered "therapy". She wants to talk about her time in the hobby with the therapist but is concerned that if she mentions illegal activities (such as being an escort) that she could be reported to the authorities and that she could end up losing her kids. Does being an escort open her up to child endangerment accusations or anything like that? She never provided anywhere near where her kids lived.

Does she have reason to be concerned?

z

[Guest070715-1]

She needs to be careful. Best to say she was in porn or had sugar daddy arrangements. Therapists are able to disclose or report illegal behavior that could be of danger to anyone. Especially not wise if shs has children. She cant confide in a friend or fellow hobby gf? Why therapy was she traumatized? Just a couple of things to consider. I am a great listner and was raised by one parent who is a counselor so im a natural lol

[Jannisary]

Hopefully ShysterJon will weigh in on privacy and patient confidentiality laws in Texas.

In regards to the therapy itself, I would suggest that your friend tries to find a therapist who is if not "pro sex work" at least "understanding" of it. Many therapists are not at all.

[sketchball82]

This should not be a concern.

HIPAA (the Health Insurance Portability and Accountability Act) is a Federal law that creates minimum standards for confidentiality in the medical field. While my bar memberships do not include Texas, in my neck of the woods, states maintain ever higher ethical ideals than HIPAA. However, I will discuss only HIPAA's ethical standards with the understanding Texas may have an even higher bar for a therapist to disclose a session.

In general, a therapist will be strictly forbidden from reporting these activities unless you report ongoing domestic violence (e.g., a pimp that may still be beating someone into submission?) or abuse of children, the elderly, or someone with disabilities (e.g., illicit activities regarding another sex worker wherein someone is taking advantage of the sex worker). In general, if those activities are not "ongoing" the therapist cannot report it. However, there is a gray area where the therapist may assume it may be ongoing when you didn't intend to imply it or do not believe it is. Or if you make the therapist believe that you are a harm to yourself or others, it may be reported (i.e., threats to commit suicide because you can't live with your past sex work). Nevertheless, aside that, a therapist is strictly forbidden from reporting your session to the police.

There is one exception, and that is when the courts issue a subpoena. Do note the difference between a psychologist and a psychiatrist—both of which may be referred to as therapists. The former is educated and trained as a social scientist and the latter went through medical school and holds an M.D., D.O., or the like and is certified as a psychiatrist, which as your probably know is a type of a physician. As a physician, the bar is significantly higher for a prosecutor to subpoena information because physician-patient privilege attaches to any physician-patient relationship whereas scientists (i.e., psychologists) do not get that benefit. In practice, this rarely comes up so it is quite minor, but in theory if a friend gets caught providing and outs someone else and the police dig up that provider's psychologist, then a writ may be issued to question or depose that psychologist, whereas the courts would refuse to issue that same writ to a psychiatrist due to physician-patient privilege.

The short answer is no, she has no reasonable reason to be concerned. She should tell her therapist everything--that's what therapy is all about.

[SaytownFinest]

The short answer is: If she's just talking about her p4p past, she should be absolutely fine.

The longer answer is more complicated. Is she sharing anything that causes the mental health professional to believe that there is a "probability of imminent physical injury by the patient to the patient or others" or a "probability of immediate mental or emotional injury to the patient"? If so, then the therapist at his or her discretion may disclose information only to medical or law enforcement personnel; however, there is no mandatory reporting--it's entirely up to the subjective belief of the mental health professional.

If your friend talks about p4p and then starts to talk about other facts which cause the mental health professional to believe that a child is being abused or a child is imminently at risk of abuse in the future? Now we are talking mandatory reporting to law enforcement/CPS.

[ShysterJon]

Originally Posted by ztonk

A former provider with kids contacted me with a question that I have no clue how to answer. She provided and still lives in the great state of Texas.

She's been out of the hobby for several years and has recently discovered "therapy". She wants to talk about her time in the hobby with the therapist but is concerned that if she mentions illegal activities (such as being an escort) that she could be reported to the authorities and that she could end up losing her kids. Does being an escort open her up to child endangerment accusations or anything like that? She never provided anywhere near where her kids lived.

Does she have reason to be concerned?

z

For the result feared by the ex-provider (EP) to occur (that is, possession of the EP's kids transferred to the state or perhaps a relative of EP), at least the following events would have to take place:

1. The EP tells her therapist of events that presented a real danger or actual harm to the EP's children.
2. The therapist tells LE of the harm or danger.
3. LE pursues a case against the EP for child endangerment.
4. The EP is convicted of child endangerment.

Discussion

We'll assume the EP told ztonk the truth and that the EP never endangered or harmed her children by engaging in prostitution. If that's true, that's the end of the analysis. But let's assume the EP lied to ztonk and the EP did endanger or harm her kids and told her therapist about it.

Under Texas law, would the EP's therapist be permitted or even required to file a report with the police regarding the danger or harm? I don't think so, under this set of facts. The EP is no longer providing, and the danger or harm under this set of facts is limited to danger or harm connected to prostitution. But what if the authorities heard of the danger or abuse not from the therapist, but from someone else, charged the provider with child endangerment, and subpoenaed the therapist to testify at the trial? In such a case, the law provides "A [mental health care] professional may disclose confidential information in . . . . any criminal proceeding, as otherwise provided by law." (Texas Health and Safety Code, section 611.006(a)(7).) 'May' isn't the same as 'must,' so whether to disclose the patient information to LE is up to the therapist. (Also note that the law allows such disclosure in "a judicial proceeding affecting the parent-child relationship" -- that is, a family law case regarding child possession.)

There is no patient-therapist privilege under the evidence rules in Texas courts. However, there is a patient-PHYSICIAN privilege in civil cases (with exceptions not relevant here). There is no patient-physician privilege in criminal cases. (Texas Rule of Evidence 509.)

Bottom line: A therapist CAN, but is NOT REQUIRED TO, disclose to LE information regarding a patient's admissions about child endangerment or harm. But if called to testify at trial, a therapist MUST disclose the information.

Note: The issue of child possession and prostitution comes up here frequently. Hardly a few weeks ever go by without a provider contacting me because some jackass baby-daddy is threatening to mess with the girl regarding child possession because the girl is a provider. Maybe 10 years ago I wrote a long article about this on ASPD, after having read every reported Texas court opinion on the issue (not many exist). Since then, I'll periodically update my research. I can confidently say that no court will deny a provider child possession SOLELY BECAUSE the girl provides. There would need to be other factors present for possession to be restricted or denied -- that is, evidence of danger or harm.

In case anyone is wondering whether the authorities would pursue prostitution charges under this scenario, my answer is not 'no,' it's 'fuck no!'

btw, sketchball82: HIPPA doesn't apply to information regarding suspected child abuse.

[sketchball82]

Originally Posted by ShysterJon

btw, sketchball82: HIPPA doesn't apply to information regarding suspected child abuse.

I know.

Originally Posted by sketchball82

In general, a therapist will be strictly forbidden from reporting these activities unless you report ... [inter alia] abuse of children, the elderly, or someone with disabilities...

I wouldn't have answered had I known you would since I gather you practice this type of law. I'm in patents, but I wanted to help make sure the question went answered even if it wasn't by an attorney "experienced" in this area.

[ztonk]

Thanks for all the good information.

ShysterJon: Owe you at least one adult beverage sometime!

ztonk

[ElisabethWhispers]

https://ncsfreedom.org/

http://aasect.org/

I've been checking for some therapists that are sex worker/kink friendly and the above are two sources.

Your friend will have to do some research, but there are some therapists who will actually visit with you over the phone, if you cannot get together.

Seems smart to try to find a therapist that has SOME understanding of what we do, or is more accepting of it.

I would imagine, from the limited scope of counselors that I've run across in my lifetime (there have been enough), that plenty of them have HUGE prejudices with regard to sex work.

[KelseyBelle]

They can not share anything unless they say there gonna hurt someone or something. And if they were to do something and the law was to go to them they would have to get a warrent, and thats if it was bad enough.... The girl has every right to go and talk to a doctor and shouldnt fear anything and if the doc did squeal shed have a hell of a law suite on her hands.

Doctor patient confidentiuality (or how ever you spell it)

[ShysterJon]

Originally Posted by lilred69

They can not share anything unless they say there gonna hurt someone or something. And if they were to do something and the law was to go to them they would have to get a warrent, and thats if it was bad enough.... The girl has every right to go and talk to a doctor and shouldnt fear anything and if the doc did squeal shed have a hell of a law suite on her hands.

Doctor patient confidentiuality (or how ever you spell it)

I'll assume you're opining on Iowa law, since that's where you're based. No offense, but I think a recent decision by the Iowa Supreme Court flat-out disputes your analysis:

http://www.brickgentrylaw.com/news/9...unication.aspx

[Whispers]

Originally Posted by ztonk

A former provider with kids contacted me with a question that I have no clue how to answer. She provided and still lives in the great state of Texas.

She's been out of the hobby for several years and has recently discovered "therapy". She wants to talk about her time in the hobby with the therapist but is concerned that if she mentions illegal activities (such as being an escort) that she could be reported to the authorities and that she could end up losing her kids. Does being an escort open her up to child endangerment accusations or anything like that? She never provided anywhere near where her kids lived.

Does she have reason to be concerned?

z

I've been in the position of being licensed and falling under statutes that dictate "mandatory reporting"....

In Texas it is not a matter of whether or not the therapist WANTS to report..... She is required by law to report certain things..... including instance of child abuse or endangerment.

Whether or not a person loses custody of their kids in the state of texas is SUPPOSED to be about a danger being present NOW... at the time of removal......

IF the therapist were to make the report they would be asked in the process of taking the report if they believed a condition currently existed that endangered the child.....

The urgency with which an investigator would go out to look at the matter would depend on what was reported as occurring NOW.....

Once on the scene the investigator is going to make a determination if there actually DOES currently exist a condition that endangers a child.

In a clean properly stocked and safe environment with no signs of any issues it is unlikely an investigator would remove the children.

If the matter is something from her past and there exists no current dangers and her ability to care for them financial comes from legitimate and identifiable sources she might see a followup visit but not much more.

I would like to say that is how it always works.....

Some of the Investigators and Case Workers in the system here in the State of Texas often act with personal prejudices and opinions formed outside of the facts. I've seen kids removed from homes for very flimsy reasons and family put through the ringer for months... eventually the system gets it right but at every point when a decision is made benefit of the doubt is given to the accusations and the kids are "protected".

There is no accountability in the members of the system either....

If what she feels she needs to share for therapeutic reasons involves prior child abuse, neglect or abandonment in any form or could be construed as such...... I would suggest to her to find a therapist with a church.....Although licensed... Many men and women of faith set aside a written responsibility to the state of Texas and will consider what is done as done and not report.....

The system is not all bad...... There are those in the system open minded to set aside what she may have done.... and look simply at the current situation provided there was no prior abuse,,,,,

[algrace]

Out of personal curiosity, do circumstances of a custody battle play into the psychiatrist v psychologist argument?

Seems like a big if, but in the event that EP had been awarded custody, the noncustodial parent may have reason to dig into her past and that privileged information would be helpful to ascertain the potential for future harm/danger of the children should EP ever go back to providing.

[ShysterJon]

Originally Posted by algrace

Out of personal curiosity, do circumstances of a custody battle play into the psychiatrist v psychologist argument?

Seems like a big if, but in the event that EP had been awarded custody, the noncustodial parent may have reason to dig into her past and that privileged information would be helpful to ascertain the potential for future harm/danger of the children should EP ever go back to providing.

If evidence is material (that is, it makes a proposition more or less likely) and relevant doesn't extinguish a privilege -- in fact, it could be argued that the more material the evidence, the greater the need for application of the privilege. Also, evidence of "the potential for future harm/danger of the children" doesn't sound relevant to me. The court considers evidence regarding current and imminent dangers, not speculative future dangers.

[algrace]

Thanks for addressing my curiosity