Breaking Up Is Hard to Do: Terminating Therapy Before Things Get Out of Hand
June 30th 2012Cases that come to our attention as malpractice claims, ethics claims, or Board of Registration complaints raise the question: why did the treating clinician not terminate the treatment before things got so out of hand?
Grand Rounds-Boundary Issues in Clinical Practice
May 8th 2012Psychotherapists have fiduciary power and-from a risk management perspective-the clinician must act in a manner in which misconduct cannot be inferred. In terms of boundary violations, some preventative measures (like psychodynamic education) can be taken.
Ethical Aspects of Self-Disclosure in Psychotherapy
May 18th 2010The issue of self-disclosure in psychotherapy is one of complexity and some evolution.1-16 Most discussions about the practice refer to boundary questions because self-disclosure by the therapist to the patient is a boundary issue. Self-disclosure has, of course, a number of dimensions, including clinical, therapeutic, technical and-in some cases-legal or regulatory. Despite the rich and interesting clinical issues relating to self-disclosure (outlined in Gutheil and Brodsky1), the focus of this article is on the ethical aspects of self-disclosure.1,15,16 Of necessity, the discussion centers on the more exploratory forms of psychotherapy, such as dynamic therapy, rather than on behavioral therapies, co-counseling, substance abuse treatment, or pharmacological treatment.
Detainee Interrogations: American Psychological Association Counters, but Questions Remain
September 2nd 2008I am writing to correct several inaccurate assertions in the essay, “The American Psychological Association and Detainee Interrogations: Unanswered Questions” (Psychiatric Times, July 2008, page 16), by Kenneth S. Pope, PhD, and Thomas G. Gutheil, MD.
The American Psychological Association and Detainee Interrogations: Unanswered Questions
July 1st 2008News accounts and court records of detainee interrogations in such settings as the Guantnamo Bay detainment camp and the Abu Ghraib prison have sparked controversy over involvement of mental health professionals and behavioral scientists. Authors of articles in medical, psychological, legal, and scientific journals have struggled with complex ethical questions about psychiatrists and psychologists who participate in planning or implementing detainee interrogations.
Boundary Concerns in Clinical Practice
April 2nd 2008In the historical context of American psychiatry, the concept of boundaries is a relatively recent development.1 Freud reportedly analyzed some patients while walking along the river Danube, gave patients gifts, and was known to share a meal with a patient.
Forensic Psychiatry as a Specialty
June 1st 2004What are the qualities of forensic psychiatry? In reviewing the basis on which forensic psychiatry is defined as a specialty or, more accurately, a subspecialty of psychiatry, the author discusses the altered relation between physician and "subject," the consultative role in relation to the legal system, and the areas of specialized knowledge and skills that attend the field.
Clinical Concerns in Boundary Issues
August 1st 1999It is relatively recent that boundary issues in clinical practice have attained professional awareness, although some early concepts portended the issue. Several decades ago, for example, the term boundary violations referred almost exclusively to what we now term sexual misconduct.