CA Ethics - Punishable Actions?

[foreverbull]

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Just came across this today from my state Board of Psychology's disciplinary action notices:

"Dr. X stipulated to placing his license on probation for three years, and is subject to its revocation if he fails to comply with the terms and conditions of probation, after an accusation was filed alleging he failed to document a patient’s comments regarding her romantic and sexual feelings for him and his response to her comments; failed to seek consultation to determine the best course of action; failed to extend therapy sessions to address the patient’s feelings; and failed to provide referrals for longer term therapy for the patient’s anxiety and depression."

Does anyone else find some of the allegations concerning in terms of their being considered unethical (aside from the failure to provide referrals)? I don't think there is a specific code that stipulates that most of these were "failures." Thoughts from other practitioners?

 

[erg923]

Just came across this today from my state Board of Psychology's disciplinary action notices:

"Dr. X stipulated to placing his license on probation for three years, and is subject to its revocation if he fails to comply with the terms and conditions of probation, after an accusation was filed alleging he failed to document a patient’s comments regarding her romantic and sexual feelings for him and his response to her comments; failed to seek consultation to determine the best course of action; failed to extend therapy sessions to address the patient’s feelings; and failed to provide referrals for longer term therapy for the patient’s anxiety and depression."

Does anyone else find some of the allegations concerning in terms of their being considered unethical (aside from the failure to provide referrals)? I don't think there is a specific code that stipulates that most of these were "failures." Thoughts from other practitioners?

Yes.

You "document" what you need to for the record, and mostly for billing purposes, frankly. There's all kinds of "process" stuff that I've chosen not to document on an EMR over the years.

I would assume that if you are licensed you are/should be assumed to be competent with the various issues of this profession, including standard transference issues, unless you were proved not to be prior to such.

Moreover, I would wonder why such an issue needs "additional consultation"...it's likely the most common issue to come up in long-term psychotherapy. Why would it be assumed that we can't handle this? It's natural, and the vast majority of the time benign and fleeting.

 

[Rivi]

Yes, this seems sketchy to me... I wonder how this came to the boards attention, and why they responded this way? It makes me think there may have been something else going on.

 

[erg923]

Yes, this seems sketchy to me... I wonder how this came to the boards attention, and why they responded this way? It makes me think there may have been something else going on.

Could be, but these kinds of things are all supposed to be public record. With some amount of redacting for privacy of course.

 

[WisNeuro]

I would imagine there is more to the story. Public board discipline notes tend to be very brief, and not really explain the nuance of the situation.

 

[AbnormalPsych]

So, those were the accusations filed? Any information about the board's investigation process and findings? It looks like the clinician agreed to probation, but I think a lot of detail is missing here.

 

[G Costanza]

Since when are we mandated to extend sessions to address patient's feelings?

I'd be really curious to see if someone can dig up more context.

 

[AppsAintNoThang]

Just came across this today from my state Board of Psychology's disciplinary action notices:

"Dr. X stipulated to placing his license on probation for three years, and is subject to its revocation if he fails to comply with the terms and conditions of probation, after an accusation was filed alleging he failed to document a patient’s comments regarding her romantic and sexual feelings for him and his response to her comments; failed to seek consultation to determine the best course of action; failed to extend therapy sessions to address the patient’s feelings; and failed to provide referrals for longer term therapy for the patient’s anxiety and depression."

Does anyone else find some of the allegations concerning in terms of their being considered unethical (aside from the failure to provide referrals)? I don't think there is a specific code that stipulates that most of these were "failures." Thoughts from other practitioners?

I don't see this anywhere in California's BOP press releases on misconduct. Where do you see it?

 

[foreverbull]

It was in the summer newsletter (page 10):

http://www.psychology.ca.gov/forms_pubs/summer_2017.pdf

That was all that was provided; no further detail, and I can't find anything else about it. There may be more to the story we aren't privy to, but the fact that most of these actions/inactions were specifically listed as "failures" in the board's post seems overreaching, in my opinion. I would hope that this isn't a case of the board colluding with a client bitter about termination...because it seems at first glance that the client brought up attraction during termination, possibly as a last ditch effort to keep sessions going? We may never know...

 

[smalltownpsych]

I am thinking he terminated the patient for expressing her sexual feelings to him and didn't document how and why he did it and provide an appropriate referral. If I felt I could not work with a patient because of some type of boundary violation on their part, I would make sure to document and consult and document the consult.

 

[foreverbull]

I am thinking he terminated the patient for expressing her sexual feelings to him and didn't document how and why he did it and provide an appropriate referral. If I felt I could not work with a patient because of some type of boundary violation on their part, I would make sure to document and consult and document the consult.

I would think that would be a case of client abandonment as the ethical violation rather than what the board listed.

 

[deleted343839]

he failed to document a patient’s comments regarding her romantic and sexual feelings for him and his response to her comments

I agree that the big-picture issue is inappropriate termination/abandonment, although the wording is vague enough that the psychologist's "response" might have been inappropriate in some other way too. I'm impressed by how uninformative that whole summary is.

 

[AppsAintNoThang]

I agree that the big-picture issue is inappropriate termination/abandonment, although the wording is vague enough that the psychologist's "response" might have been inappropriate in some other way too. I'm impressed by how uninformative that whole summary is.

You can see the full accusation if you look up the name in the license search. Sounds like the issue was that the psychologist engaged in "inappropriate sexual discussions" in the sessions following the pt disclosure but documented none of them, then terminated with no referrals. There's no details on what the inappropriate sexual discussions were or how they verified it, I imagine he just didn't contest it.

 

[smalltownpsych]

I have sexual discussions with my patients pretty much every day and I tend to not document them because of patient privacy concerns. When a patient discloses something reportable or there is a potential ethical or legal issue, then I would document it. I have only had one patient disclose sexual feelings toward me and I as I recall I documented it. I don't think talking about sexual feelings is really that helpful for psychotherapy anyway unless there is a specific context for it such as victims of sexual trauma and then it would completely inappropriate to personalize the sexual feelings and violate that boundary. In other words, I would not want to enact the same pattern of boundary violations that the patient already experienced.