Treating Children

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Avoiding Liability Bulletin – January 2006

… One of the issues that therapists and counselors face when the patient is a child involves the right of the parents to access the treatment records of the minor. The right of access by the parents, and the nature and extent of any such access, is typically determined by state law, even for those who are “covered providers” under HIPAA. State laws vary widely with respect to parental access issues. Suppose that the patient is an eleven year old girl and that the father has telephoned the therapist and demanded a copy of the girl’s records within five days. Suppose further that the therapist believes that providing the records to the father would be harmful to the patient. May the therapist deny the request?

In order to respond appropriately, therapists and counselors must have a thorough knowledge of the provisions of state law or regulation. For example, in one state the therapist is not only allowed to deny a parental request for the records of a minor when the therapist believes it would be harmful to the minor (either physically or psychologically), but is essentially required to deny the request. In that state, the therapist must also deny the parental request if he or she believes that access to the records would have a detrimental effect on the therapist’s professional relationship with the minor (a broad standard). Additionally, that state’s law requires that requests for records be made in writing, so the therapist is not under a duty to comply, assuming that there is no other reason for denial, until a written request is received. Most state laws allow a longer period of time than five days in which the therapist must provide a copy of the records.

What is the law in your state and for your licensure? Find out now, before you are faced with a request that you need to respond to in a relatively short time frame.

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Richard Leslie

"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.

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