Ethics of commenting on public cases?

[futureapppsy2]

The recent Charlie Sheen media coverage (and that of Britney Spears before him) has made me wonder about the ethics of giving professional opinions on public cases. It seems like something that could get on *very* thin ice very quickly and yet is also fairly commonly done, for better and worse, and perhaps even a good opportunity for psychoeducation / raising awareness among the general public if done carefully. Thoughts?

For an example, see this local newscast video of a psychologist giving his opinion on Charlie Sheen's recent, strange interview: http://www.youtube.com/watch?v=GRNGgkHnFN0&feature=player_embedded

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[cara susanna]

Great question, I've often wondered this myself.

 

[mvan1]

I feel the same about shows like hoarders.

 

[O Gurl]

There is also a "Dr. Drew" special where he gives his 2 cents. There is something severely off-putting about a "professional" publicly giving unsolicited mental health advise and diagnosing someone they do not personally know.

At least with Dr. Phil and Hoarders, people come on willingly and sign a release to appear on TV. Not that it makes a good idea... just a less sketchy one.

 

[Hopen]

A recent instance that I was quite shocked by someone publicly commenting on their clients behaviors and mental state was in the documentary "Inside Job", about the recession and inappropriate moves on the part of many a Wallstreet investor. The documentary was excellent, except for an extremely questionable segment in which a therapist who claimed to treat many of these Wallstreet bankers commented on their reckless behaviour (ie cocaine use), and mental instability. To me, this seemed like a breach of client-therapist confidentiallity, especially when held up to the codes of ethics for Psychologists in the US and Canada. I looked up the therapist to see what his qualifications are, and found that he is an Licensed Mental Health Counselor, who seems to chase the spotlight.

From his website: "In addition to my practice I've authored advice columns for the Los Angeles Times and Metro Newspaper; New York, Boston, and Philadelphia editions. Additionally, I'm frequently consulted by the media to address issues with celebrities, mental health concerns, and lifestyle issues. For more information check out my website: www.jonathanalpert.com”

Can he get away with this because he is an LCMH Conselor? Is he not constrained by similar ethics code to those of (PhD, PsyD level) Psychologists?

 

[stigmata]

I am not sure of the ethics, but it is almost always poor judgment. I would think that agreeing to comment on public cases/situations could be okay, but all too often people include thoughts on diagnosis, predictions for the future, and make their statements all too personal as opposed to "in general".

 

[AcronymAllergy]

A recent instance that I was quite shocked by someone publicly commenting on their clients behaviors and mental state was in the documentary "Inside Job", about the recession and inappropriate moves on the part of many a Wallstreet investor. The documentary was excellent, except for an extremely questionable segment in which a therapist who claimed to treat many of these Wallstreet bankers commented on their reckless behaviour (ie cocaine use), and mental instability. To me, this seemed like a breach of client-therapist confidentiallity, especially when held up to the codes of ethics for Psychologists in the US and Canada. I looked up the therapist to see what his qualifications are, and found that he is an Licensed Mental Health Counselor, who seems to chase the spotlight.

From his website: "In addition to my practice I've authored advice columns for the Los Angeles Times and Metro Newspaper; New York, Boston, and Philadelphia editions. Additionally, I'm frequently consulted by the media to address issues with celebrities, mental health concerns, and lifestyle issues. For more information check out my website: www.jonathanalpert.com”

Can he get away with this because he is an LCMH Conselor? Is he not constrained by similar ethics code to those of (PhD, PsyD level) Psychologists?

While he isn't bound by the APA ethics code, I would imagine there is something similar for licensed mental health counselors. However, it's perhaps possible that he obtained consent from his clients to disclose treatment-related information. I'd hope he would have at least discussed such disclosure issues with these patients prior to beginning treatment.

 

[aventurine]

I am not sure of the ethics, but it is almost always poor judgment. I would think that agreeing to comment on public cases/situations could be okay, but all too often people include thoughts on diagnosis, predictions for the future, and make their statements all too personal as opposed to "in general".

Agreed.

 

[O Gurl]

Let's also bear in mind that some of these "professionals" are actually practicing outside their area of training. This "Dr. Drew (Pinsky)" character is an MD, not trained in psychiatry, but an internist... who is diagnosing Sheen as hypomanic on national television.

 

[cara susanna]

To be fair, Dr. Drew does have experience in chemical dependency. But, yeah, he is definitely going outside of his scope here.

 

[O Gurl]

To be fair, Dr. Drew does have experience in chemical dependency. But, yeah, he is definitely going outside of his scope here.

True. This is his justification for "Celebrity Rehab" although I would argue that lack of training in mental health would severely limit his abilities in addiction medicine...unless he is just there to provide medical withdrawal. However, he takes on therapy roles, which he is simply not qualified to do. Even so, the patients of "Celebrity Rehab" agree to participate. Charlie Sheen did not. It is really unsettling.

 

[LM02]

Dr. Drew is also on the clinical faculty in the Dept of Psychiatry in the USC medical school. I actually like him quite a bit, as he really educates people about the biopsychosocial model when treating those 'Celebrity Rehab' patients.

I find this overall topic interesting, as I agree that the APA ethics code is pretty explicit about only diagnosing in a defined professional relationship. At the same time, we can also provide a lot of general psychoeducatipn to the public when misinformation is propagated or certain people/groups are exploited. In this case, it really does seem that all of this attention may be reinforcing manic symptoms that are pretty clearly observable to anybody who knows anything about mania. Whether you call it bipolar, or substance-induced mood disorder, or what have you, I think it's important for the public to understand that this is a serious manner and not comedy.

At the same time, we have to be responsible about how we provide psychoeducation. Some professionals do this much better than others.

 

[roubs]

Is it unethical to describe your client population in general? I mean really I did not need this guy to tell me that Wall Street types use cocaine. Don't they tell you this at recruitment pitches?

 

[O Gurl]

Dr. Drew is also on the clinical faculty in the Dept of Psychiatry in the USC medical school. I actually like him quite a bit, as he really educates people about the biopsychosocial model when treating those 'Celebrity Rehab' patients.

Ok, but does this give him the expertise to provide therapy and diagnose psychiatric conditions by proxy?

 

[Jegg]

The recent Charlie Sheen media coverage (and that of Britney Spears before him) has made me wonder about the ethics of giving professional opinions on public cases. It seems like something that could get on *very* thin ice very quickly and yet is also fairly commonly done, for better and worse, and perhaps even a good opportunity for psychoeducation / raising awareness among the general public if done carefully. Thoughts?

For an example, see this local newscast video of a psychologist giving his opinion on Charlie Sheen's recent, strange interview: http://www.youtube.com/watch?v=GRNGgkHnFN0&feature=player_embedded

Legally, in my state at least, there is nothing about commenting on a public figure that would threaten licensure as long as the person isn't a client/patient. It isn't grounds for a slander lawsuit either.

I suppose Principle 5 of the APA codes might be argued as applicable to these scenarios, but it would likely come down to an argument of whether or not Mr. Sheen had given up his right to have professionals respect his dignity because he broadcast these issues as a public personality. It may even be argued that he has made such a fool of himself (in the public's eye...) that anything professionals are saying to frame his behavior as pathological may be benefiting him rather than hurting him at this point. I guess the APA could kick someone out of their membership ranks if their ethics committee felt it broke any of their codes, assuming the offending individual didn't argue their case well and/or refused to make some type of amends for the conduct.

 

[KayJay85]

Here is a thought I am having now about my own reactions to this issue.

It is interesting to me that there is a fine line between professional and unscrupulous behavior that is being hinted at by this thread topic. If a forensic psychologist makes an analysis of a person for the courts under public record for money then it is professional behavior (assuming he or she is honest...). If a psychologist makes an analysis of a celebrity for the court of public opinion for money or self-promotion then it is unscrupulous behavior.

I think the difference between the two, for me at least, may be that the forensic specialist is given explicit permission by the client/patient, while the celebrity only gives tacit permission by broadcasting his or her issues to the court of public opinion.

Perhaps it is not illegal or against APA codes, but I suppose I find the ambiguity of the tacit permission to be too tenuous for my comfort.

Very well put, Jegg.

"Doctors have a manual that gives us the definitions of psychiatric disorders"- Dr. Drew Pinsky prior to making the case that Sheen is hypomanic.

That's great, Dr. Drew. You can read a manual. However, I would agree that he is reaching in terms of his scope as others have pointed out. But what bothers me most is the unscrupulous nature of analyzing a public figure for ratings. If he cares so much, he should contact Sheen's family directly.

 

[Jegg]

Very well put, Jegg.

"Doctors have a manual that gives us the definitions of psychiatric disorders"- Dr. Drew Pinsky prior to making the case that Sheen is hypomanic.

That's great, Dr. Drew. You can read a manual. However, I would agree that he is reaching in terms of his scope as others have pointed out. But what bothers me most is the unscrupulous nature of analyzing a public figure for ratings. If he cares so much, he should contact Sheen's family directly.

I erased my post (also added a line). I'll repost it below... Sorry...

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Here is a thought I am having now about my own reactions to this issue.

It is interesting to me that there is a fine line between professional and unscrupulous behavior that is being hinted at by this thread topic. If a forensic psychologist makes an analysis of a person for the courts under public record for money then it is professional behavior (assuming he or she is honest...). If a psychologist makes an analysis of a celebrity for the court of public opinion for money or self-promotion then it is unscrupulous behavior.

I think the difference between the two, for me at least, may be that the forensic specialist is given explicit permission by the client/patient, while the celebrity only gives tacit permission by broadcasting his or her issues to the court of public opinion.

Perhaps it is not illegal or against APA codes, but I suppose I find the ambiguity of the tacit permission to be too tenuous for my comfort. I suppose I also feel that this type of self-promotion on the part of a psychologist borders on narcissistic as well, but I suppose if there is a chance that a great deal of people will be helped and/or educated about a stigmatized issue, then it is an acceptable foible.

 

[cara susanna]

Though I dislike Dr. Drew, I actually do agree that Charlie Sheen's behavior seems similar to what you'd see in a hypomanic episode (in case my couching language is not enough, disclaimer: not a diagnosis)

 

[bmedclinic]

Though I dislike Dr. Drew, I actually do agree that Charlie Sheen's behavior seems similar to what you'd see in a hypomanic episode (in case my couching language is not enough, disclaimer: not a diagnosis)

though I'm apathetic about celebrities and celebrity therapists alike, I seem to recall one of "them" (Dr Drew, Dr Phil) justifying what they were doing in one of these instances by saying they didnt know Sheen personally, but had observed his behavior.

Still seems sketch/unprofessional to me, and not even in a grey area either-- just relaying their justification as I recall it.

 

[LM02]

Ok, but does this give him the expertise to provide therapy and diagnose psychiatric conditions by proxy?

Of course not. I agree that we should not diagnose or treat by proxy. But he actually does have some credentials to be commenting on mental health and addiction.

I also do not think it's inappropriate to comment on observable signs of a condition without formulating an official diagnosis. In this case (which, to be fair, is pretty extreme and textbook), you've got someone giving repeated and lengthy interviews where he is endorsing euphoric mood and exhibiting irritability, textbook grandiosity, pressured speech, flight of ideas, poor decision-making, and paranoia. Can I say he has bipolar disorder? Not necessarily. It could be substance-induced mood d/o or something else entirely. But he is certainly demonstrating signs of mania (duration and severity would rule out hypomania). And this is an opportunity for professionals to provide some education to the public around what that is.

Just my $.02. I don't necessarily see this as such an all-or-nothing circumstance.

 

[O Gurl]

Of course not. I agree that we should not diagnose or treat by proxy. But he actually does have some credentials to be commenting on mental health and addiction.

I hear you and certainly am not suggesting he is some unqualified quack. I still think we may have to agree to disagree in terms of his credentials to make the sort of statements he did in the medium that he chose to do so. By that I mean that if he were talking with someone over dinner and made his observations as someone who as worked closely with mental health professionals in addiction treatment, that is one thing. To do an hour-long special on someone's mental status while presenting oneself as an expert in the area(mental health, I mean) is another. For instance I have done a fair amount of rehab psych with SCI patients--certainly no where near the number of years Dr. Drew has. However, I have worked with lots of rehab medicine docs and PT/KT/OT experts. I would certainly never make public comments regarding someone's functional goals after an SCI--even if it was a pretty clear injury with pretty textbook expectations (or as close to that as possible) because I am simply not qualified to do so.


I also wish I could be as optimistic about the idea that Dr. Drew and others are simply looking to raise awareness, but my grumpy cynical side says this is all about capitalizing on a very public issue.

 

[LM02]

I hear you and certainly am not suggesting he is some unqualified quack. I still think we may have to agree to disagree in terms of his credentials to make the sort of statements he did in the medium that he chose to do so. By that I mean that if he were talking with someone over dinner and made his observations as someone who as worked closely with mental health professionals in addiction treatment, that is one thing. To do an hour-long special on someone's mental status while presenting oneself as an expert in the area(mental health, I mean) is another. For instance I have done a fair amount of rehab psych with SCI patients--certainly no where near the number of years Dr. Drew has. However, I have worked with lots of rehab medicine docs and PT/KT/OT experts. I would certainly never make public comments regarding someone's functional goals after an SCI--even if it was a pretty clear injury with pretty textbook expectations (or as close to that as possible) because I am simply not qualified to do so.


I also wish I could be as optimistic about the idea that Dr. Drew and others are simply looking to raise awareness, but my grumpy cynical side says this is all about capitalizing on a very public issue.

And I'll be honest and say that I had no interest in watching Dr. Drew's special, so I have no idea how far he went with this. I think a 30-second sound bite on the news is appropriate, but I absolutely agree that a 1-hour special focused on one public figure's mental status is going way too far!

I was mostly commenting on the larger question, which is not always so clear-cut.

 

[Jegg]

I'm sure Dr. Drew is wooing Mr. Sheen to be on Celebrity Rehab as well. It would certainly boost the ratings up significantly higher than they have ever been before, and my understanding is that the ratings are already particularly high (no pun intended!).

 

[Shatani]

The recent Charlie Sheen media coverage (and that of Britney Spears before him) has made me wonder about the ethics of giving professional opinions on public cases. It seems like something that could get on *very* thin ice very quickly and yet is also fairly commonly done, for better and worse, and perhaps even a good opportunity for psychoeducation / raising awareness among the general public if done carefully. Thoughts?

For an example, see this local newscast video of a psychologist giving his opinion on Charlie Sheen's recent, strange interview: http://www.youtube.com/watch?v=GRNGgkHnFN0&feature=player_embedded

great question and responses!

ive always felt uneasy about it and make it a point to NOT do that...a couple of my friends were asking me about it last week and i basically told them that i dont like to diagnose people ive never met. it just seems irresponsible to me. maybe im a bit of a debbie downer though...