Case Study gone horribly wrong and data protection questions?

Hi Robyn
I do hope you're beginning to get to the other side of this disturbing experience and are feeling more positive about it. After all, this kind of thing may happen again, for all you know, and at least if it does, you won't be thinking 'I've never known anything like this before'. Hopefully, of course, you won't have to face this kind of hostility again and I'm glad it hasn't put you off. Just goes to show that it takes all kinds....I should say here that I'm not a therapist but, from my own point of view, it seems clear that this woman was possibly not quite the full ticket. You said that she had emotional issues, poor thing, she sounds completely flakey to me. Also I'm picking up on the fact that you were wide open to her psychic disarray and therefore you picked up on her jangled thoughtwaves and this, as much as her behaviour and attitude, helped to discombobulate you. However, I think you acted absolutely correctly. Absolutely. Your responses sound totally professional to me. Now keep telling yourself that there is nothing wrong with you, 99% of your future clients will be lovely people. And because you have got through this unpleasant occurrence, you will be able to cope perfectly with the odd 1%!

Good for you. Keep on trucking!

Lots of love
Sunanda xxx

As a client, they are, under the Data Protection Act allowed to view any personal data held about them, therefore they do have a right to read any notes you have made about them. In theory, notes should be written up regularly after treatment, so that they are available should a client request them. In practice, we will probably have a schedule for doing this, so it will rarely include every treatment carried out to date unless it's writeup day.

I don't understand why the client became defensive, nor why she was expecting a diagnosis. Did you spend time with the client after her first treatment discussing your findings? You were right in stating that you cannot diagnose, merely treat.

Put it behind you, as a learning experience, I have never heard of a case study client becoming so upset, perhaps the healing crisis shocked her, perhaps she has never experienced this before, or perhaps the personalities just didn't mesh.

Whatever it is, move on, the next experience will be better.

The patient has every right to see what you've written about them, be it in your case notes, a letter to her GP, or your write-up for the tutors. Incidentally, I'd also argue that the treatment notes at least should be written up almost immediately.
You're quite right in that you're not a primary health care provider, so you're not responsible for diagnosis; and I'm not sure why the patient would expect a full write-up (for the tutor) to be done at her convenience.
As for sharing the charts as a matter of course, I'd imagine that's an individual choice thing, dependant on each therapist.

Another thing I'd pick up on (para 9), is that you seem to say that you gave her the consent form to sign on the 2nd treatment; I may be reading this wrong, but it sounds as if you did the 1st treatment on impled consent, rather than signed, which could be potentially dodgy.

Confrontations with patients happen, and are always distressing to a greater or lesser degree; the only thing we can do is to learn from it, see how we can avoid the situation should it happen again, and see how to resolve it, should avoidance not be possible. Certainly don't let it put you off what you're doing

hi robyn,

i agree with gussie's thoughts. what had you written that you didnt want to show? and really, there's nothing wrong with telling our findings to clients, as long as you make clear its not a diagnosis. you are a massage therapist anyway... its not so different with reflexology.

just make sure that the notes you write in future are carefully worded, so that you can show them if requested. after one treatment, you wouldnt have written up the study anyway, just your consult type notes.

but i also think you got a difficult client and they are not usually like that, although you were aware that she had emotional problems, just not aware maybe of how severe.

have you asked your tutor about it and what does she say?

i agree with gussie's thoughts. what had you written that you didnt want to show?

Rosie, Robyn will confirm this or not, but I got the impression that she hadn't written ANY notes, except for notations on the foot chart, and was therefore discomfited by not having any to show the client. Is this right, Robyn?

Love
Sunanda x

What quick responses, Thank you for both.

Gussie - Thank you for clearing up the DP issue.

However, I'm now a little concerned regarding what I'm writing up for my case studies. We're required to go into a fair amount of detail regarding what we find and the possible explanations / links etc. My case study write-up's have all been very detailed, my first impressions, family details, emotional states, etc. etc. are all quite intensive, I've made detailed links between what I've captured on my consultation forms and what I've charted on the feet. I've provided an array of possible explanations and interpretations and have done so in much detail. I'm trying learn as much as I can from this course.

In a student environment we're expected to go into alot of detail, in practice this doesn't happen and isn't required. For my massage practice I have detailed consultation sheets and very brief notes that I scribble up before and after a treatment, again these are very brief and are completely non-personal - they relate to physical conditions, illness, anything that the client has brought to my attention that I should be aware of or anything that has come up during the treatment. I guess, what I'm saying is I have no qualms about disclosing practice notes, but I do have some real concerns when it comes to my student interpretations and my involved and details analysis of the client's feet.

Knowing that they're entitled to have this information is going to influence what I write up. For example, with Mrs B, my interpretation and first impressions (which we're required to write up about) would be that she was someone who was apparently quite anxious and very cautious, she had her mobile phone in her hand when she first arrived and was asked who else was in the house and if I lived alone. She phoned a number of times on the drive over saying she was lost and had missed a turning because the car behind her was creeping up on her and she couldn't concentrate. I'd detail all of these facts as well as provide links where I could correlate these impressions with what I found on the feet. I'd also include that she went through an early menopause and is deeply saddened that she has no family, that she feels very lonely and has suffered from depression for all of her adult life. I'd try to correlate as much of this back to her feet, drawing links between for example the hard and yellowed skin along her pelvic floor, the deep fissures on both heels and the paper thin and very dry areas on her uterus reflex and her early menopause and subsequent hystorectomy. The charts and notes I scribbled up were very detailed and had I typed up my interpretations and findings for submission purposes it would have contained even more detail and my own personal interpretation. I'm not sure I'd want to share these notes with someone who is clearly and very obviously in an emotionally vulnerable state, or infact with any of my case studies even if they weren't, just because they are my own personal interpretations. I'm just not comfortable with that at all and would restrict the level of detail and intepretation with what I felt was appropriate for the client as my audience.

I think I'm going to hold back on my case study write ups for the time being and discuss this with my tutors, I'm a little concerned that we haven't touched on data protection and the legal aspects and I'd like this brought to their attention.

Thank you again for the clarity you've provided, I've got alot to think about!

Robyn

chin up

we would all be perfect if we wrote our case study notes up immediatly - unlike ordinary treatment notes you have to write a more detailed explaination to show that you understand what you are finding

regarding notes - not that I have every been asked but if any client wanted to see their notes they would have to put the request in writing - some therapists I know also make a small charge for notes - i think it would depend how long the notes are

You can make a charge for providing photocopies of notes, but not for just showing them to the patient.
Again, you'd need consent to allow the notes off the premises (but not if you're handing them directly to the patient, as it's then their responsibility); but no written record is required for showing the notes to the patient.

The level of detail you can go into with the tutor for a case study is (I think) dealt with elsewhere on this site, and may have data protection ramifications. But for your own notes, all the things you said you think about, and note down, are all fair enough. You can even directly insult your patient in your notes if you so choose - as long as you can back up your claims if challenged (I'd also very strongly recommend not doing so, surprisingly enough). Basically, as long as what you write has basis in what you know/believe/suspect, then you can write what you like.
And yes, the case study write ups still count as part of your case notes, and the patient has the right to immediate access on request. It's very rare that someone will want to though, I've never come across it yet.

In response to a couple of points:

1) When Mrs B arrived for her first treatment I spent alot of time explaining to her that i was a student, that I could not diagnose and the treatment was for her to enjoy and experience the benefits of reflexology which she said she understood all about. I told her I would require six treatments which would be written up and submitted to my school for marking. She asked me questions about the write ups and I explained that I would be making notes during the course of her treatment and would later write up my intepretations.

2) We went through the paperwork and Mrs B signed my consultation form, I asked her to complete and sign my shool's consent form which includes a section to be completed with personal details (name, dob, etc) followed by three lengthy paragraphs explaining what reflexology is, and consenting to the treatment. Mrs B filled out the paperwork and I did not notice she had not signed the consent form until after she had left.

3) I made detailed notes on my foot chart and my consultation sheet is very detailed too. I scribbled up what conditions I would present on, what alternative therapy I would recommend, just the basics. I got as far as setting up her case file, and creating templates, I had NOT started the write up, because I am behind with my case study write ups and I believed she would not return for treatment because I'd not had a response back from her the following week. Arguably, I should have and we are meant to write our treatments up right after we've done them, in reality I am a few days behind with a few of my treatment write ups.

4) When she arrived yesterday I was extremely sensitive and professional with regards to the situtation, I lead her into the treatment room and took full responsibility for my misunderstanding regarding the confusion around holiday. The first thing I asked her to do was sign the consent form saying that I'd noticed she'd not signed it last time.

Really, the concern for me is do I have to share what my personal interpretations of my case studies are with my case studies should they ask?

The issue for Mrs B was not that she has the legal right to my notes (which we've established she does) but that she was under the impression (not from myself) that these treatments would be some kind of diagnostic tool for her to identify any health / emotional issues. She is quite entitled to have copies of my consultation form and my foot chart and the preliminary work I've begun, but that is all I have to share with her if she requests this.

Hope this clarifies.
Thanks for all the input.
Robyn

Hi RobynM
Gosh what a time you had with the client.
I was very impressed by what you said about her life and her feet.You are very intuative and seem to be very good,not just a student.
Can I ask why when she asked you didn't tell her what you said here (the intuative bit)? Maybe she caught you off guard?
I had a similar experiance with a person I gave an Aura Soma reading to.I was worried about saying what was on the tip of my toungue as I didn't want to hurt the person,but deniying what I knew to be true made the whole situation escalate as yours did.
From your post my gut feeling say's she needed to hear what you didn't say.I think that is why she got upset,she was desperate to understand herself and needed you to give her the full truth. Maybe no one has done this ever.
If you do feel you need to,you could possibly write a letter telling her what you felt (not diagnosed)
Maybe next time you could have a leaflet ready that say's what a client could feel or go through after a treatment or you could remember to remind the client of this?
This is only my thoughts and I wasn't there,but we do get situations to strengthen us and you will probably never let this happen again.
I must say ... you seem very intuative and I think you got her problems spot on!!!
Good luck with the rest
Blessings
H x
:hippy:

I wouldn't feel too bad. This client said to you 'I came her to find out what's wrong with me'. This alone would have had my alarm bells ringing.

You acted correctly, so don't feel too bad. I would have perhaps been more honest and explained that due to the mis-interpretation you didn't think she would be coming back so was not intending to write any notes up.

The lady was rude and considering you were working on her for free, even ruder. Also, had she really wanted to 'discover more about herself' she wouldn't have been so rude and would have worked with you and not against you.

There are all sorts of clients you will encounter, and with some you will build a pretty good picture as to why they are ill. Their behaviour tends to give it away.

Hi Robyn

I was a psychiatric nurse for 20 years and, reading between the lines of what you have said about this lady, imo I think her problems go far deeper than any complementary therapies can handle.

You said her problems were emotional and psychological.....that could mean anything....do you know if she has/had any actual proper psychiatric diagnosis.

Even with depression or anxiety states it is not unknown for people to become very paranoid (which it sounds this lady was). Some psychotic conditions, even when in a remission state, may just be bubbling away under a surface.

I had a lady who once came for reiki that had my alarm bells rattling big time so much that I actively discouraged her from having any more treatment (she told me she suffered ffrom depression but it became quite apparent to me that she was really quite psychotic). Some would say reiki may have helped her but her thought processes were extremely bizarre and imo she needed specialist help.

As for case studies/notes, I would never write anything I wouldn't be prepared to show anyone anyway. Same with mediacl profession they have to be prepared nowadays to be scrutinised.

Patchouli

Hi Robyn,

It sounds to me like this lady hasn't been totally honest with you when presenting her past medical history. Maybe there was something she didn't want you to know, and as you have been so good with your findings, she may have thought you know more than you are telling her? It's just a theory but it would explain why she was so desparate to look at your notes, to check what you know! It's sad when this sort of behaviour happens, especially when you are still in training. However, I think you handled the situation very well. I don't know if I would have been so understanding.

When I write my notes, I keep them very professional and do not enter anything that I have not discussed with the client at the time, therefore if anyone wanted to read their notes, they would'nt find anything they didn't know already.

That's not to say that I don't make personal notes at home about things that I wouldn't want them to see like my own opinions on their state of mind or personal things that they have told me which I know they wouldn't want written down, but what I need to remember for their future treatments.

However, Im sure this will make you stronger in the future. These sort of clients are few and far between.

Good Luck with your studies.

2) We went through the paperwork and Mrs B signed my consultation form, I asked her to complete and sign my shool's consent form which includes a section to be completed with personal details (name, dob, etc) followed by three lengthy paragraphs explaining what reflexology is, and consenting to the treatment. Mrs B filled out the paperwork and I did not notice she had not signed the consent form until after she had left.

Sounds to me like she perhaps has insecurities and deliberately avoided signing the consent form with, perhaps, the intent that she would consent to you submitting all the write-up to the tutors at the end of the treatements after she had read what you had written, and probably after she was "happy" with it. Can you imagine if you'd given 6 free treatments, written them all up, she's checked them over and then said she wasn't happy with what you'd written and thus wasn't giving the consent? Be thankful that this came out after just the one treatment as it's saved you wasting your own time. 😉

Really, the concern for me is do I have to share what my personal interpretations of my case studies are with my case studies should they ask?

The issue for Mrs B was not that she has the legal right to my notes (which we've established she does) but that she was under the impression (not from myself) that these treatments would be some kind of diagnostic tool for her to identify any health / emotional issues. She is quite entitled to have copies of my consultation form and my foot chart and the preliminary work I've begun, but that is all I have to share with her if she requests this.

Yes, she was definitely under the wrong impression about using it for a diagnosis. When you write up your notes and thoughts there's a clear distinction (although sometimes it can be a fine line ;)) between writing something like (and forgive me cos I'm not that 'up' on reflex.) "I could feel crystals in her left big toe, which would indicate possible issues around the head area. The client had reported having regular headaches, which she believes may be linked to stress at work" to writing something like "I could feel crystals in her left big toe, this links to the head and headaches that the client had mentioned and I feel could be caused by the excess of caffeine the client has been drinking due to stresses of work that she has also reported".

The latter attempts to diagnose the causes which, as you know, you shouldn't be doing, whereas the former keeps to the facts and would be something that you should have no issue with showing the client.

You could also consider having a write up of your findings and the treatment in a brief annotated form, such that if clients request to see what notes you have on them you can show them this form to placate their inquisitiveness, and then for your case study you can have a more wordy write up with your own opinions which, in effect, are your opinions and provide no more "personal details" about the client than the annotated notes. This latter one would be just for yourself and your tutors. In your annotated version you show to your clients you can also use the proper terminology which will probably mean little to them anyway.

Love and Reiki Hugs

When you write up your notes and thoughts there's a clear distinction (although sometimes it can be a fine line ;)) between writing something like (and forgive me cos I'm not that 'up' on reflex.) "I could feel crystals in her left big toe, which would indicate possible issues around the head area. The client had reported having regular headaches, which she believes may be linked to stress at work" to writing something like "I could feel crystals in her left big toe, this links to the head and headaches that the client had mentioned and I feel could be caused by the excess of caffeine the client has been drinking due to stresses of work that she has also reported".

The latter attempts to diagnose the causes which, as you know, you shouldn't be doing, whereas the former keeps to the facts and would be something that you should have no issue with showing the client.

actually, giles, the latter would be perfectly fine... its still not a diagnosis and is looking holistically at cause, which is what we are supposed to do. 🙂 no surprises in too much coffee and stress causing headaches :eek:.

now, if you said "I could feel crystals in her left big toe, this links to the head and headaches that the client had mentioned and I feel it could be caused by the tumour i could "feel" in that area, due to the sensitivity showing up in the toe area" thats a diagnosis!!

as a student, in most cases (i think this case is exceptional and rotten luck) most clients are very intrigued as to our findings and i will always discuss areas of imbalance (crystals/ sensitive etc etc) with clients, there and then. often, they are quite aware of problems in those areas and sometimes have forgotten to mention their sluggish digestion or whatever, so, findings are often no surprise, even when you link the physical aspects with the emotions (crunchy shoulders = weight of the world etc etc).

if findings and interpretations (dont forget to say the magic "it could be") are discussed, then notes will reflect the chat, so no secrets.

Excellent advice from everyone above... the only thing I would add is that while it is potentially a bit more exciting to have an "interesting" case study, ultimately you are better off without this particular woman. AND you've learnt some lessons - so a result all round!

Purple Peach

your point about personal notes at home - dont they have to be available to a client as well?
I would be really uncomfortable if I thought/knew a therapist was writing stuff about me that I did not have access to.

just a thought

BIA in reply to your point, if I made a charge it would be for the photo copying of the notes for the client - not just showing the notes

Yeah, you wouldn't win any favours trying to charge someone for just looking at them unless they had specifically made an appointment to come and see their notes and they were taking up your time just for that purpose.

Mostly you would charge for any copies of the notes the client wishes to take away with them, and you are entitled to do this.

Missing consent forms happen; officially they shouldn't, but they do, and we all sometimes forget to check for them; they're also only part of your defence, the larger part is that the patient voluntarily stayed there and accepted treatment, consent can be implied from that.

I'd be extremely concerned about the option of keeping 2 sets of notes, one for patients to see, and one for your own use. So would any potential solicitors if you were ever in that situation.

I know you're not responsible for diagnosis, but I'd advice that you still think of all your notes as being part of the patient's medical record. This means that you should be able to defend everything you've written in there, and that they should record everything you've done to the patient.
Your case study write up forms a part of your notes too, and should be included there. If the patient tells you something they don't want written down (bearing in mind access to the notes is strictly confidential), then they shouldn't have told you. If it's your own conclusions, then they are your conclusions, and should be kept in the notes, as long as you justify your thought process - I won't try to think of a scenario as I know too little about reflexology to make an appropriate one.

You may not be responsible for diagnosis, but that doesn't mean that you can't draw conclusions, and write them down. It means you shouldn't present that information to a patient as FACT (or supposed fact), and that you should in no way give the impression to the patient that it is a medical diagnosis. In fact, I suggest that you have a moral obligation to draw conclusions, so that you can help the patient stay healthy in the first case - suggesting that a patient's headaches may be linked with their stress levels and caffeine intake is not diagnosis; bit it is conclusion, and one that is fair to draw, and explain to a patient.
In an extreme, you'd be able to conclude a suspicion of cancer; as long as you could point to a source of information that links the findings you have with cancer; but you cannot diagnose cancer. Incidentally, if you do, you would have a moral obligation to report this to the patient's GP (not to the patient, you're not trained in that); though you'd have a hard time of it trying to get him/her to listen to you, and there would be issues of data protection if you haven't got the patient's consent to share information with him/her.

your point about personal notes at home - dont they have to be available to a client as well?
I would be really uncomfortable if I thought/knew a therapist was writing stuff about me that I did not have access to.

My thoughts on that comment, are 'tough' I can keep private messages to myself if I want to and, no, they would not be available to the client. The client would not know they existed. You said that you would be uncomfortable at the thought. I worked in a GP's surgery years ago and the nurses used to keep personal notes on the patients, so we knew who were timewasters and who were not. It happens everywhere.

I'd be extremely concerned about the option of keeping 2 sets of notes, one for patients to see, and one for your own use. So would any potential solicitors if you were ever in that situation.

As for the above comment. Please don't make it sound as if I am keeping two sets of records on clients, just in case i'm sued or a case goes to court. That's a little over reacting to what I actually said. I said that I keep my notes in a professional manner and I write nothing in them that I would like to client to see. What I meant was if you want to write anything personal that you think may distress a client, either 'dont' or keep it to yourself. NOT TWO SETS OF FULL NOTES don't be ridiculous. I could'nt be bothered to be honest to do that.

My thoughts on that comment, are 'tough' I can keep private messages to myself if I want to and, no, they would not be available to the client. The client would not know they existed. You said that you would be uncomfortable at the thought. I worked in a GP's surgery years ago and the nurses used to keep personal notes on the patients, so we knew who were timewasters and who were not. It happens everywhere.

It does not happen everywhere. IMO you are wrong to do what you do, in fact if I ever found out that a therapist or nurse kept private notes about me that I could not see I would certainly see a solicitor about it.
I have to say that the word ‘tough’ In your quote fills me with concern.

Have you had no support from your school over this one? As they are teaching you, they should know - not only to protect you but also to protect othter students that this woman might go to. She seems to want something for nothing, and also she doesn't trust that anyone is telling her the truth.

They should also answer the DP questions - esp as to how much personal info they want and how much detail.

My thoughts on that comment, are 'tough' I can keep private messages to myself if I want to and, no, they would not be available to the client. The client would not know they existed. You said that you would be uncomfortable at the thought. I worked in a GP's surgery years ago and the nurses used to keep personal notes on the patients, so we knew who were timewasters and who were not. It happens everywhere.

Hi PP

As a qualified nurse of 20 odd years I can categorically say that I have never, evr came across any nurse (or doc) who kept "private" notes....just should not happen.

If the NMC or GMC (in the case of docs) ever got wind of thgat it would result in the person being immediately struck off, no two ways about it.

ANY notes are available for a client/patients perusal.....that is law.

Patchouli

your point about personal notes at home - dont they have to be available to a client as well?
I would be really uncomfortable if I thought/knew a therapist was writing stuff about me that I did not have access to.

My thoughts on that comment, are 'tough' I can keep private messages to myself if I want to and, no, they would not be available to the client. The client would not know they existed. You said that you would be uncomfortable at the thought. I worked in a GP's surgery years ago and the nurses used to keep personal notes on the patients, so we knew who were timewasters and who were not. It happens everywhere.

you are perfectly entitle to keep information on which patients are likely to not turn up, who might need reminder phone calls etc, but that's all part of the patient record, and is entitled to be there, it does not need to be kept private from the patient; in fact, if you are doing this, or know someone else who is doing this; then I suggest you seriously reconsider your position, or mention to them that they are breaking the law (ignorance of the law is no excuse)

I'd be extremely concerned about the option of keeping 2 sets of notes, one for patients to see, and one for your own use. So would any potential solicitors if you were ever in that situation

As for the above comment. Please don't make it sound as if I am keeping two sets of records on clients, just in case i'm sued or a case goes to court. That's a little over reacting to what I actually said. I said that I keep my notes in a professional manner and I write nothing in them that I would like to client to see. What I meant was if you want to write anything personal that you think may distress a client, either 'dont' or keep it to yourself. NOT TWO SETS OF FULL NOTES don't be ridiculous. I could'nt be bothered to be honest to do that.

If I made it sound that way, I sincerely apologise; however, you made it sound like you're keeping information about patients away from anything the patient can see - that's strictlu illegal.
If you want to write something personal that may distress the patient, then write it in the patient's notes; writting it elsewhere is illegal. The chances are the patient will never see their notes, and the notes are meant to reflect fact, and thoguhts exptrapolated from fact; the patient may not want to be told that they're overweight or depressed, or that their lifestyle is hurting them, but that doesn't make it untrue, and it needs to be noted.
If you belong to a regulatory body of any description, I suggest you look at the rules. If you hold data about patient, then you are required to register with the information commissioner ([url]website link[/url]); and you are required to obey the law.
I never meant to imply that you were keeping a full set of notes at home; but if you include so much as a patient's name without their permission, then you are breaking the law.
The fraction of sentence I've highlighted from you is almost certainly a typo, but is accurate for what you claim to do.

I don't think anymore can be said. Things are amazingly taken the wrong way and blown up out of all proportion some times. In my case there is no more comment!

I don't think anymore can be said. Things are amazingly taken the wrong way and blown up out of all proportion some times. In my case there is no more comment!

Wow you lot are so judgemental. Purple Peach was just making a suggestion to someones problem, yeah maybe it wasn't the best way of putting it, but all this talk about legal stuff, solicitors, breaking the law. You get so wrapped up in your perfect selves. (I don't think so) GET A LIFE YOU LOT.

Excuse me, posh totty (what a wonderful name BTW, is it ironic?) but as a totally disinterested non-therapist observer on this thread, I really don't think there's any need for the wooden spoon to come out. There are people on here who make - or hope to make - a living by practising their therapies and in today's litigious society it makes perfect sense to be sure of one's legal liabilities and obligations. No one wants to be on the receiving end of an accusation of malpractice. Inflammatory expressions such as 'GET A LIFE YOU LOT' (in caps no less) are really not the way to go. Sorry, but that's the way I see it - and no, I'm not a mod, just a long term HP member.

With love
Sunanda x

Thank you Sunanda I'm glad you think my name is wonderful. I didn't have to think long and hard about it.. It is just 'ME' I'm POSH, I'm LOADED and I am TOTTY XXXXXXX

Wow you lot are so judgemental. Purple Peach was just making a suggestion to someones problem, yeah maybe it wasn't the best way of putting it, but all this talk about legal stuff, solicitors, breaking the law. You get so wrapped up in your perfect selves. (I don't think so) GET A LIFE YOU LOT.

Judgmental, NO, just relaying the facts as we see them.

No one has said they are perfect or have given the impression that they need a life.

Many people on HP give their opinions and advice freely and without reservation. If their opinions and advice can help some one in their chosen therapy then IMO that is a good result and a credit to HP members.