What you do if you are having trouble with a patient is you say TO THE PATIENT that you would like to try referring them to someone else and is that okay with them. If you're really at your wit's end, quit. You do not go behind their back and ask total strangers and their aunts and gods know who else about how to deal with them. What the fuck. Do you think. You're doing.

He mostly just looks confused. 

"What, is that a rule where you're from or something? Can't see that it'd work here – I don't know who'd I refer him to, like I said most of the others are on circuit at any given moment, not to mention the matter of it being within the Heraldic Circle, things come up that're sensitive for Kingdom security. It's my responsibility to make things work out and I try to do that however I can. I certainly can't quit and leave it to chance; this is really important for, um, reasons that have to do with Kingdom security that I actually can't tell you."

He looks mildly offended. "I wouldn't tell a random stranger about it! You're basically a Mindhealer too, obviously you're going to be responsible about it."

I got here yesterday! You don't know me! More importantly Vanyel doesn't know me! Even if you got his okay to complain about him to me, you didn't do the work of making it clearly that and not just you deciding privacy is imaginary because you don't like your job! Subtle arts talent is not correlated with being judicious with information and if I had claimed they were you'd have no way to be sure I wasn't lying. I haven't even mentioned yet the confidentiality oath I took so you weren't going off that. Even if you knew for a fact I would never act inappropriately with something you told me, or tell anyone else, your patients still have a perfect right that I, as, myself, a person, not be told. When somebody can't think straight without help they may find it necessary to sacrifice some of their privacy to get help with that. This is a real and difficult sacrifice and it is a disgrace to make it any worse than it has to be by letting any information escape that privileged relationship. I am ashamed of you.

Now Lancir looks startled. And defensive. He opens his mouth to speak, stops, closes it, scowls down at his desk. 

"...All right, fine, I don't know you all that well – I sort of slid into assuming you were as responsible as one of our Healers. Who, incidentally, do have the chance to ask each other about patients and I've been wishing I had that for the last thirty years. My bad." He doesn't look very sorry, though. 

He puts his hands on the desk. "However, you're not from here and I am – I'm asking you for advice because you do come from a world that has any kind of institutional expertise whatsoever, I want that advice, but you really don't have to be rude about it and I do want you to try to understand the constraints we were operating under until just now when you showed up." 

I don't know exactly what personnel circumstances have gone into making it so you're the only Mindhealer in town. Perhaps they are very dire. If you need to complain you anonymize. You flip a coin for gender, change every detail you can while retaining the substance of what you're venting about, and you tell people who don't know and won't meet the patient in terms such that if they heard you they wouldn't recognize themselves. I'm going to inform Vanyel that this happened, incidentally, he deserves to know that he can't expect you to keep things confidential until and unless he decides some new commitment on your part is credible.

Anyway, that's part of my institutional expertise. Until something with tentacles literally eats your brain for your secrets you don't let any privileged information escape with narrow exceptions for patient-prompted confirmations and denials or defending yourself against slander. Also important is that you minimize social and power relationships with your patients, and especially you don't have sex with them. You try to avoid treating people who are going to talk to you about each other or who are socially close to your own friends or family, though that one's hit hardest by a personnel shortage. You avoid conflicts of interest where you are incentivized - not just actually going to as far as you know, incentivized - to derive out-of-scope benefit from treating a patient. You get consent, uncoerced unpressured per-occasion, every single time you do anything more invasive than talk. If you do any such things you warn about all the risks of side effects. I'm suspecting based on your Kingdom security remark among others that some of this is going to be difficult for you.

Lancir looks nonplussed more than anything else. He sits back and rubs his forehead. 

"A minute, just – trying to get my head around your thinking here..." He fidgets with the accounting-report. "I don't know, that all sounds like a way of thinking that's not about the Heralds at all. For one, in a way we kind of are each other's family, and the whole way my role as Monarch's Own works is that I'm second-in-command of the Kingdom and also I'm responsible for all the Heralds' wellbeing–" he spins to glare in a random directly, "Taver could you pick literally any other time to give me an earful about how she's got a point? If you're so clever you could've said something thirty years ago, damn it." 

He grimaces, turning back to her. "Sorry. My Companion – I'm not a very strong Mindspeaker so I can't answer silently. Anyway, um, I guess I don't always like my job, and sometimes I wish it could be someone else's, but this is the deal I got handed." He taps his fingertips to the desk as though counting her points. "...Oh. Why per-occasion consent? It's not like it's any surprise that I'm going to use it sometimes, and if I stop to ask then I lose the right moment for it. Everything would take ten times as long and maybe you've got that kind of time but I generally don't." 

...you're second in command of the kingdom, you all use each other as surrogate family, and you go around unsurprisingly sticking yourself into people's heads based on information they probably filter for you because you will tell strangers and their relatives. And your horse. This doesn't seem kind of bad to you? What if someone just doesn't like you? What if you intimidate them? What if they want to go slower and you're in too much of a tearing hurry? What if they care a lot about losing your good regard?

He's quiet for a pretty long time. 

"...You know," he murmurs finally, "this probably isn't how I'd set things up if I were doing it from first principles. I just inherited things being this way. I do have concerns sometimes that people are intimidated or care a lot about my good regard or are just embarrassed. Never knew what to do about it." He shrugs. "Although I don't think it's an issue that I tell Taver. It's expected that we tell our Companions just about everything. They might talk to each other about it but that doesn't mean it's got any chance of leaking to another Herald, they're very good about that." 

Again, Companions themselves are people that it would be absolutely reasonable not to want told, especially if it winds up being all of them and not just yours.

"Hmff." Lancir doesn't look like he particularly believes her, but he lets it slide. "I'll...consider your points," he says stiffly. "Some of them might be workable here and worth trying. Er, are there any rules you haven't covered in the extensive list so far?" 

I have the rules memorized for use in practice, not so much in list form. I suppose I could pretend you're my new patient and demonstrate an intake interview.

Lancir looks like he wants to roll his eyes but doesn't, quite. "Sure, you could do that." 

Here's the spiel I was giving the Elves edited a little for context.

What are your therapeutic goals you're most interested in working on?

Lancir is taking notes. He’s having some trouble keeping up, even in shorthand.

“Damn,” he says mildly, dragging a hand over his face. “I should’ve asked you to do it under a first level Truth spell - uh, for reference, that does nothing to you, only shows externally if you’re lying, I think your subtle arts could verify that. Anyway, you’re right and I was being unjustifiedly trusting before, but if this is your oath, then...gods, I’d be willing to have any of the Heralds who wanted see you, issues of Kingdom security or not. You have no idea how many headaches that would fix for me.”

I can repeat it under a lie detection if you want. If that works on telepathy.

“It should work fine. In our world it’s pretty damned hard to lie at all in Mindspeech, but yours could well be different.” His eyes go unfocused for about fifteen seconds. “There, it’s on. Can you sense anything?”

I can't use subtle arts to detect magic. I could probably find it if I were looking at you to see that you're performing whatever action was involved but not to find it directly.

I have taken an oath of confidentiality. I will never reveal information that I gain in my professional capacity as a therapist to third parties without patient request except as necessary to counteract slander of myself.

"..Well, I didn't think you were lying but now I'm extra sure. Truth Spell works normally on you as per everything I can tell." He frowns. "Hmm – maybe tell a lie now so I can check that it's not just failing to pick up intent at all?" 

My name is Emily.

"...No, it went out there, so I'm pretty sure it does work normally." Lancir is still looking a bit irritated, and defensive, but he folds his hands over the desk. "Good. I, hmm... For what it's worth, I am fairly convinced that your way is better than ours, if not that I could or should have been doing things differently before this. So. Still stands that I'm really glad to have you here, and I hope you are willing to help us out even if we're a bit, er, barbaric by the standards of where you come from." 

For whatever it's worth I'm sure you have Materia beat in lots of ways, it just had solid social tech around the one thing.

"I guess we'll have to see what you notice when you've been here longer." He sighs, heavily. "Well. Taver seems to think that I owe Vanyel an apology, which I suppose I brought on myself. Should we go do that?" He stops, thinks, rubs his chin again. "I mean, unless you'd been thinking you would inform him without me there so, I don't know, so he can react without worrying about my judging him or something." 

I don't have a particular guideline for that. We can do that now if he's likely to be free.

Lancir’s expression goes flat for a moment. “Taver thinks he should be, yes.”

You all stop making facial expressions when you talk to your Companions.