Malpractice in psychotherapy: an overview

Article Abstract:

Although psychotherapists are sued less often than many other medical professionals, the number of claims against them, as well as the size of the awards granted to the plaintiffs, have risen dramatically in the last 10 years. Malpractice is often difficult to determine in many psychotherapeutic situations, primarily because standards of practice have not been established. A review is presented of a number of areas where psychotherapists may become vulnerable to malpractice suits, and pertinent cases are described. The most notable areas of malpractice involving psychotherapists concern breach of confidentiality and mismanagement of the therapeutic relationship, especially in cases of sexual exploitation. In cases of malpractice, the plaintiff must first demonstrate that the practitioner failed to conform to standards of care, and must then show that this has caused harm. It is pointed out that a number of obligations on the part of the therapist come into play once the relationship with the patient has been established: the therapist must remain neutral and aware of his own emotional reactions; the therapist should consult with a colleague if countertransference feelings become unmanageable; the therapist should not abandon the patient in the middle of therapy; and the therapist is obliged to end treatment when it is ineffective, harmful, or completed. Currently, therapists have also been involved in cases where it has been claimed that they did not act to prevent a patient from doing harm, either to himself or to others. The difficulties of determining the predictability of violence are discussed, as are the conflicts between maintaining confidentiality and warning potential victims. To help prevent a growing incidence of malpractice claims, it is suggested that psychoanalytic training include courses that address both ethics and statutory and case law. In addition, sensitivity training on ethics should be emphasized, and guidelines should be established to assist therapists in making decisions that may involve peer consultation for clinical or ethical problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Prevention, Ethical aspects, Malpractice, Psychotherapists, Therapist-patient relations, Psychotherapist and patient

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Interrelations between ego functions and personality traits: their relation to psychotherapy outcome

Article Abstract:

The measurement of ego functions, such as judgment, have been useful in attempts to define the ego. Ego functions generally mediate between input from the environment and inner states, and their measurement can provide information regarding an individual's mental health. One tool for psychiatric evaluation is the Ego Function Assessment that has been used, in part, to assess the treatment process. Three subscales of this questionnaire, measurements of judgement, synthetic-integrative functioning (ability to deal with contradictory information), and mastery-competence (actual performance in relation to ability to interact with the environment), were modified and administered to 43 men and 47 women who were admitted to a clinic-based outpatient psychotherapy program. Subjects also completed a Personality Profile Index and the clinicians completed a rating scale for each patient. It was found that ego functions had significant relationships to personality measures. For instance, those who were judged to be competent with respect to mastery of their environment also reported feeling accepting, assertive, and sociable. Submission, depression, passivity, and aggressiveness were not reported by these people. Though not strongly correlated, there was also evidence that outcome is positively affected by high levels of competence and mastery. It is suggested that these ego functions are representative of underlying determinants of functioning and outcome and it is recommended that they be used to develop a more extensive measurement tool. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, Measurement, Testing, Psychotherapy patients, Ego (Psychology), Personality, Personality (Psychology), Ego Function Assessment

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The procession of times and paradigms

Article Abstract:

Changing paradigms in psychotherapy are discussed in relation to the new millennium. The need for flexibility is stressed.

Editorial, Practice, Psychotherapy

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