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A Therapeutic Dilemma


I see a young (though adult) female client after the mother, also a client arranges the appointment. The index reason for the appointment is recent headaches along with high fever which resulted in the client going to A&E to rule out meningitis. (A lumbar puncture was performed to do this.) The initial appointment with myself was put off because of the admission to A&E though if the pyrexia had been present, I would have been unable to give a massage anyway.

During the consultation, I was ascertained that the pyrexia was gone following three days of antibiotic therapy. Mum stayed in the room which my client wished I assume because culturally, she had some misgivings about a male therapist, though at the end of the appointment she seemed happy with both the consultation and the treatment.

Client lives in London during term time but plans to come at the end of term when she will be living with mother during the summer break.

I intend if she is happy with this to see her on her own and check certain items that came up during the consultation such as alcohol consumption. (Told mother when challenged that she no longer drinks vodca.) Non prescribed medication (Stated at a festival took MDMA but by accident through sharing water bottles.)

When I worked as a mental health practitioner, I would have had the authority to insist on a consultation without mum present for part of the time and would have had a female colleague to call on should this have been needed. As a lone practitioner, I don’t have that luxury. However to maximise the therapeutic benefits of our sessions, it is important to have an honest relationship with my clients and unless I can guarantee confidentiality this is not always possible.

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