Scales

  
Select A Topic . . .
Access to Records - "Noncustodial Parent"

Advertising

Advertising - "Expertise"

Advertising - Sliding Fee Scale

Attending the Patient's Wedding (or Other Significant Event)

Authorization Forms

Avoid These Common Errors

Bequest from Patient

Business License

Child Abuse

Child Abuse - Emancipation of Minor

Child Abuse Report Required or Permitted?

Child Abuse Reporting

Child Abuse Reporting - Duty to Investigate?

Child Abuse Reporting - Neglect

Confidentiality - "No Secrets" Policy (Couple Being Treated)

Confidentiality - AIDS/HIV

Confidentiality - Child Abuse Investigations

Confidentiality - Conflicting Requests

Confidentiality - Couple Being Treated

Confidentiality - Dangerous Patient?

Confidentiality - Death of the Patient

Confidentiality - Exception

Confidentiality - Fact of the Relationship

Confidentiality - Group Therapy

Confidentiality - Pregnancy of a Minor

Confidentiality - The Search Warrant

Confidentiality - The Unexpected Caller

Confidentiality and Authorization Forms

Confidentiality and HIPAA

Confidentiality and the Dangerous Patient

Conflicts

Consent to Treat Minor (Sole and Joint Legal Custody)

Consent vs. Authorization

Custody and Visitation Disputes - The Big Mistake

Dangerous Patient - Immunity From Liability

Dangerous Patients and the “Tarasoff Duty"

Dangerous Patients and the Therapist's Duty

Disciplinary Actions

Dual or Multiple Relationships - An Overview

Elder Abuse

Elder Abuse/Dependent Adult Abuse Reporting

Ethical Standards - Conflict with the Law

Ethics

Family Law - "Joint Custody"

Fees

Fees - Barter

Fees - Raising Fees

Fees - Sue the Patient?

Fees - The Sliding Fee Scale

Gifts - To and From Patients

HIPAA

HIPAA - Enforcement

HIPAA - Patient Access to "Psychotherapy Notes"

HIPAA - Psychotherapy Notes/Records

HIPAA - Right to Amend Records

HIPAA - Subpoena for Records and Notes

Hypnosis/Hypnotherapy

Immunity From Liability

Informed Consent

Informed Consent - Videotaping/Risks

Informed Consent: Hugs and Other Touching

Laws, Regulations, and the Attorney Generals' Opinions

Liability for the Acts of Others

Licensing and Certification

Mandatory Continuing Education - Does it work?

Negligence vs. Gross Negligence

Online Therapy

Online Therapy - Disclosure

Online Therapy - HIPAA

Online Therapy - Insurance Coverage

Parental Access to Records of Minor

Partnerships - Be Careful

Privilege - A Common Waiver

Privilege - Group Therapy

Privilege - Waiver

Privilege and Confidentiality

Privileged Communications

Professional Corporations

Records - Destruction at the Request of the Patient?

Records - Removal of Information From File

Records - Stolen, Lost or Destroyed

Referrals

Scope of Competence

Scope of License

Self Disclosure

Something Lighter - Cancel the Appointment

Something Lighter - Law and Sausage!

Something Lighter - Reimbursement

Something Lighter - Self Defense

Something Lighter: A Definition of "Psychotherapy"

Telemedicine - Hours of Experience Toward Licensure?

Telemedicine: Telephone Counseling/Therapy?

Termination - Who is the Patient

Termination of Employment: Who "Owns" the Patient?

Termination of Treatment

Testifying in Court

Think About This - Child Abuse?

Treating Children

Treating Multiple Members of a Family - Conflicts

Treatment Records

Treatment Records - Ownership

Using Patient Information in Public Presentations

Verbal Abuse - Free Speech

 

Bulletin Archives

 

Bulletin Archive

 
by Richard S. Leslie, J.D. Click here for profile.
Attorney at Law - "At the Intersection of Law and Psychotherapy"


Scope of Competence

(February 2007
, Volume 1)

… Licensing laws, regulations, and/or ethics codes will typically contain provisions that prohibit practitioners from engaging in practices or activities that are beyond the scope of their competence, as established by their education, training and experience. These rules typically leave it to the judgment of the individual practitioner to determine whether or not he or she possesses sufficient skills and abilities to engage in the activity. Even if competent, however, one may be prohibited from doing something because of the applicable scope of license. Physicians have the broadest scope of license of all health practitioners, but the rules about practicing within the scope of their competencies limit their activities. Although physicians can typically practice psychotherapy within the scope of their license, most do not do so because it is not within the scope of their competence. Likewise, not all physicians perform surgery even though it may be within the scope of their license.

 

It can always be alleged by a disgruntled patient or client that the practitioner was not competent to do what he or she did. For instance, while it might be within the scope of the license for certain mental health licensees to administer and interpret psychological tests, it may not be within the scope of their competence. In such a lawsuit, the patient’s attorney will surely question the licensee about what coursework, what experience, and what education qualified him/her to perform the tests involved. Or, suppose that a practitioner used hypnosis or practiced hypnotherapy (assuming such work was within the scope of the license) while treating a patient. Again, a patient’s attorney may try to show that the practitioner did not have the requisite experience, education and training to perform such functions.

 

When therapists and counselors are first licensed, they typically have self-imposed limits regarding what they feel comfortable doing in their professional practices. As time goes on, they may want to expand their practices into new areas and new patient populations. This is part of the process of becoming a seasoned practitioner. How do they do this without violating the rule about not practicing outside the scope of their competencies? They read books, take coursework in degree programs, attend workshops and seminars, get supervision, and consult with those who have expertise in the area. It is important to be a good record keeper with respect to these kinds of activities so that if ever questioned, practitioners can demonstrate that they expanded the kinds of cases they handled in a responsible manner.