"Before the mid-1980s, there were no court cases involving nonphysical talking cures. In fact, the law rarely examined the practices of psychotherapists or the standard of care they must meet in their diagnoses and treatments. Upon occasion, a legal dispute arose between a patient and a therapist for breach of confidentiality, billing errors, or some such disagreement. These cases were sporadic and did not have much of an impact on how therapy was practiced.Today, mental health professionals are in the legal spotlight. The absorption of healing by managed care, the explosion of lawsuits against therapists, and the expansion of rules of ethics have altered forever the therapist's world. It is professional suicide for a therapist to be unaware of the rules of ethics and law that have re-written the contours of the profession. Therapy may no longer be practiced solely within the confines of the therapist's office. The distance from the couch to the courtroom was never shorter.
Dr. Reid has assessed this increasingly hostile climate in which psychotherapists have become forced to practice, and he has provided an excellent first-stop book alerting therapists to the dangers, often quite hidden, raised by ethical and legal regulations. A Clinician's Guide is written in a highly readable conversational style, and it does not bog down with extraneous details that would sidetrack the main points. The reader is treated to an easy to understand look at how the legal system impacts on therapists, problems of confidentiality and privilege, issues of informed consent, and dozens of other "hot ticket" areas where a slip can lead to a subpoena.
The good news is that careful risk management can avoid the ever-present ethical and legal problems. The additional good news is that the information therapists need to prevent malpractice is fascinating to read. Therapists will find A Clinician's Guide absorbing and entertaining. Ironically, however, at professional conferences, mental health professionals more frequently attend sessions on some new, untested treatment modality (which is precisely the kind of procedure likely to get them sued), and far less frequently attend sessions of ethics and forensics which could save their lives and licenses.
Graduate schools, conference providers, and healers in general must now recognize that proper training in ethical issues and legal regulations is an essential part of the knowledge necessary to be a professional. Any therapist who fails to protect himself or herself, also fails to protect his or her patients. Read A Clinician's Guide and get started on the road to safe practice."
Alan W. Scheflin is a Professor of Law at Santa Clara University School of Law. His writings in the fields of hypnosis, memory, mind control, ethics, and risk management have earned him seven major awards, including two prestigious Guttmacher Awards from the American Psychiatric Association.
From the introduction - A Clinician's Guide to Legal Issues in Psychotherapy is about lowering your legal risk in clinical practice, including understanding common forensic issues and standards as they apply to mental health professionals, recognizing potential problems, and clarifying the risk-benefit issues involved in what you are doing. It is not about how to avoid trouble if you are doing something you already know is bad, nor is it about watering down your clinical approach simply to mollify unreasonable critics, lawyers, or insurers.
Good, ethical practice, putting patients first, goes a long way toward protecting you from lawsuits. On the other hand, anyone can sue you, for almost any reason. Anyone can file a complaint with your licensing board or certifying body. Anyone can make your life miserable, whether or not you are eventually "exonerated." It is thus important to try to stop problems before they start, and to know something about the law's way of handling those that do arise. You practice good care, so document it. You usually know "the right thing to do" when faced with ethical quandaries, so do it. You know how to check your colleagues' credentials and reputations, so don't associate with people or organizations that are likely to get you -- and patients -- into trouble.
This book was written specifically for nonphysician mental health practitioners, including psychologists, psychotherapists, and counselors. Although it does not focus on material directly related to biological treatments, biological diagnosis, and the like, it does address many issues encountered by psychiatrists and professionals who work in medical settings or with physician colleagues. The material comes largely from my own experience at the interface of mental health and the law. Much of the topic emphasis is from you: your responses to the Zeig, Tucker 1997-98 national survey on forensic issues in the mental health professions.
You will find that I prefer the word "patient" to "client" or (God forbid) "consumer" or "recipient." I am aware of the need to treat the people whom we are trying to help with respect, and of the damage that unfair stigma can do to recovery and self-esteem. Nevertheless, I quietly campaign for "patient" for a number of reasons. First, "patients" have a specific place in the public mind, a place that is different from that of a "client" or "consumer," and which associates the person with deserving a certain standard of care and treatment. Second, people take patient status much more seriously than client or consumer status, and we need to be more serious about mental health and mental illness. Third, legislatures and payers take the concept of patient more seriously, for purposes of funding treatment and research. Fourth, the term "patient" is harder to trivialize than the other terms. It is grossly unfair to drive a semantic wedge between the mentally ill and other "patients," and thus to imply that people with depression, schizophrenia, or panic disorder merely need good information or advocacy from their clinicians.
I have been a clinician, teacher, writer, and researcher for many years, and now devote much of my time to working at that interface, reviewing and evaluating cases, assessing litigants, advising courts and attorneys, and sometimes testifying in court or at deposition. ... I am sometimes retained by the plaintiff, sometimes by the defense, and sometimes by the Court itself. What you will find in these pages is designed to keep you from having unwanted contact with people like me, and to provide information that may help if you do.
William H. Reid, M.D., M.P.H.
Horseshoe Bay, Texas
See also
For more information, visit Dr. Reid's Psychiatry & Law Updates website at www.reidpsychiatry.com.
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