Between 1990 and 2004, there were 916 medical malpractice reports involving clinical psychologists made to the National Practitioner Databank in the United States. Many attorneys who defend psychotherapists before licensing boards and in civil suits are often asked a question – what are the common areas where therapists are most vulnerable? It is important to identify these common pitfalls so that they can be avoided.
Inappropriate or Excessive Self Disclosure
Although self-disclosure is a common treatment technique, and surveys of psychologists and MFCCs indicate that more than 70 percent use self-disclosure at least occasionally, many civil suits and licensing board cases allege inappropriate or excessive self-disclosure. There are two keys that determine if a particular disclosure is ethical – (1) is the disclosure for the purposes of the patient or the therapist? and (2) is it the appropriate type of disclosure for a patient with that type of mental condition?
For example, where there is a history of child sexual abuse with the patient, it may be ethical and appropriate for the therapist to disclose that they have a similar background as a way to establish a degree of empathy. On the other hand, if there is no such history and the information is disclosed because of problems that the therapist has, it would be inappropriate. "How does the patient’s therapy benefit from the disclosure?" is always the question that should be asked.
Use of Techniques without Proper Training
An issue that has recurred over the last 10 to 15 years has been the use of treatment techniques which therapists are not well trained in. An example of this is in a case from New Hampshire, Hungerford v. Jones 722 A. 2d 478 (1998), where one of the allegations was that a social worker, who did not have adequate experience in treating patients with repressed memories, led a patient to believe that her father had sexually abused her, when he had not.
A key point in the New Hampshire Supreme Court’s decision in allowing the father to sue his daughter’s therapist was that the therapist’s only training in repressed memories was a single lecture on memory retrieval techniques attended at a weekend symposium.
No technique should be used by a therapist if they do not have proper training and experience in them. As a practical matter, when the use of the technique is initiated without complete training, it can result in licensing board actions and/or potential liability.
Contact Outside of the Office
It is a general rule that patients should only be seen in the therapist’s office, that is, unless there is a specific therapeutic purpose for it. There are instances when it can be appropriate to see a patient outside the office for a therapeutic reason. However, such instances should arise very rarely and they should always be properly documented in the file.
If there is going to be contact out of the office, it should be documented in advance by the therapist, including what the purpose is and what the therapist hopes to achieve. Once the meeting contact has taken place, the therapist needs to document the events and how the perceived objectives were met or not met. Obtaining a peer consultation prior to a session that takes place out of the office (other than phone contact) is a good practice to follow.
If you or a loved one has suffered harm due to the unethical practices of a New York psychotherapist, you need to get the expertise of a fantastic law firm like Rosenberg, Minc, Falkoff, & Wolff of RMFW Law at 212 697 9280. The first meeting with a malpractice attorney is free of charge. Give us a call. What do you have to say?
We know a winning case when we see one. We are not paid until you are paid. We have the medical experts to back up your claims.