Avoiding Liability Bulletin – August 2007
… How much self-disclosure by therapists and counselors is appropriate? Some practitioners who get in trouble, often in cases involving allegations of an improper dual relationship, are vulnerable because they have disclosed too much personal information to the patient. Usually, such disclosures appear to have been made for the benefit of the licensee rather than for the benefit of the patient or client. While there are no hard and fast rules and reasonable minds can differ about this subject matter, one thing is clear – the disclosure should be made for the benefit of the patient and to aid in the patient’s treatment.
A study was recently concluded with respect to physicians and the issue of self-disclosure, and the results disturbingly showed that much of the conversation between physician and patient was for the benefit of the doctor and was not reasonably related to the treatment of the patient. The study pointed out that one of the primary purposes of physician self-disclosure is to help to more quickly and closely connect with the patient, thus establishing a better doctor-patient relationship that is more likely to produce a better treatment outcome. This would seem to be especially true with respect to the relationship between a psychotherapist and a patient.
One must be careful in making self-disclosures that they are not made, either wittingly or unwittingly, for the purpose of satisfying the ego of the practitioner or for “taking care of” the practitioner. In many dual relationship cases, the nature of the disclosures made by the therapist will actually help the licensing board to establish the unethical dual relationship. For example, in cases involving alleged unethical sexual or romantic relationships between therapists/counselors and patients, they often involve evidence that the therapist or counselor had first made disclosures about his or her own sex life or fantasies. Such disclosures are hard to justify under any circumstances.
To read one of our newer blogs titled Self Disclosure – Personal Blogs, click here!
ABOUT THE AUTHOR
"At the Intersection of Law and Psychotherapy"
Richard S. Leslie is an attorney who has practiced at the intersection of law and psychotherapy for the past twenty-five years. Most recently, he was a consultant to the American Association for Marriage and Family Therapy (AAMFT), where he worked with their various state divisions to develop and implement their legislative agendas. He also provided telephone consultation services to AAMFT members regarding legal and ethical issues confronting practitioners of diverse licensure nationwide. Additionally, he wrote articles regarding legal and ethical issues for their Family Therapy Magazine and presented at workshops on a variety of legal issues.
Prior to his work with AAMFT, Richard was Legal Counsel to the California Association of Marriage and Family Therapists (CAMFT) for approximately twenty-two years. He was director of Government Relations for CAMFT, and as such was the architect of CAMFT’s widely regarded and successful legislative agenda. He represented CAMFT before the regulatory board (the Board of Behavioral Sciences) and was a tireless advocate for due process and fairness for licensees and applicants. He was a regular presenter at workshops and was consistently evaluated as CAMFT’s most highly rated presenter. He also sat with the CAMFT Ethics Committee and acted as their advisor on matters pertaining to the enforcement of ethical standards.
Richard is an acknowledged expert on matters pertaining to the interrelationship between law and the practice of marriage and family therapy and psychotherapy. For many years, he taught Law and Ethics courses for a number of colleges and universities in their marriage and family therapy degree programs. While at CAMFT, he provided telephone consultation services with thousands of therapists in California and elsewhere for over twenty years. He is highly regarded for his judgment, his expertise, his direct style, and his clarity.
Richard has been the driving force for many of the changes and additions to the laws of the State of California that affect MFTs. In 1980, he was primarily responsible for achieving passage of the "Freedom of Choice Law" that required insurance companies to pay for psychotherapy services performed by MFTs. Passage of that law allowed MFTs to earn a living, allowed them to better compete in the marketplace, and strengthened the profession in California by leading to a great increase in the number of licensees and CAMFT membership. Currently, about half of the licensed marriage and family therapists in the country are licensed in California.
While at CAMFT, Richard was primarily responsible for, among other things, the successful effort to criminalize sex between a patient and a therapist. He was successful in extending the laws of psychotherapist-patient privilege to MFTs, thereby giving patients the same level of privacy protection as when seeing a psychiatrist or psychologist. He fought tirelessly and successfully for the right of MFTs to refer to themselves as "psychotherapists," to perform psychological testing services, to be appropriately reimbursed by California’s Victims of Crime Program, and to be employed in county mental health agencies throughout California.
Richard was admitted to the Bar in New York (1969) and in California (1973). While practicing in New York, he served as a public defender, and later, as an Assistant District Attorney. Shortly after moving to California, he worked for the San Diego County Human Relations Commission as their Law and Justice Officer. While there, he worked successfully to achieve greater racial diversity in the criminal jury selection system and to expose and stop police abuse. For such work with that agency, he was the recipient of the Civil Libertarian of the Year Award by the San Diego Chapter of the American Civil Liberties Union.