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Determining if someone is fit to work as a therapist?

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biomom

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How do you know when someone in mental health should step aside for awhile due to mental health reasons? How do you assess this? What questions could I ask?
 
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PsyDr

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How do you know when someone in mental health should step aside for awhile due to mental health reasons? How do you assess this? What questions could I ask?

If you're doing a medicolegal evaluation, you should be WELL familiar with this literature and guidelines. If you are not familiar, then you are ethically obligated to refer out.

If you're just advising someone, then you should be familiar with intricacies of their specific work, the specific risk factors of relevance, the specific proposed risks, etc. Simply being ineffective in clinical work is not sufficient cause for such a determination. It has to be risk.
 
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biomom

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I am not evaluating this individual. This is a peer. I’m concerned that her personal problems may be affecting her ability to work.
 
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dcpsychdoc

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I am not evaluating this individual. This is a peer. I’m concerned that her personal problems may be affecting her ability to work.

Are you concerned that this person is an impaired professional? If so, what guidance does your code of ethics provide? I am not sure if you are a psychologist or other mental health professional. It is hard to provide specific advice without knowing more about your concerns (what kind of harm are you concerned about? Who are her patients? Adults? Kids?) and the setting in which you work. I would hope you could raise the issue with her, and work together with her and perhaps HR to make any adjustments necessary to protect the public. This sounds like a tough situation.
 
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biomom

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We are masters level providers. She has had three xxxx and has an xxxx disorder. She does therapy with adolescents. I’m not sure how to know if she is impaired. I’ve suggested she get therapy. I also told her to take a leave of absence which offended her.
 
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Heist

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We are masters level providers. She has had three recent suicide attempts and has an eating disorder. She does therapy with adolescents. I’m not sure how to know if she is impaired. I’ve suggested she get therapy. I also told her to take a leave of absence which offended her.
Can report to therapy board and let them decide. Client safety is paramount
 
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biomom

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Thanks. I looked over the ACA code of ethics on impairment and I agree.
 
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borne_before

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Snitches get stitches jk. I think it’s time to get the board involved especially if you tried to get her to take a leave.
 
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BuckeyeLove

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I've often wondered, how does a psychologist (or mental health professional) go about documenting that they have in fact taken that initial step to reach out to the clinician first? Is it just taken at face value by the respective board?
 
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WisNeuro

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I've often wondered, how does a psychologist (or mental health professional) go about documenting that they have in fact taken that initial step to reach out to the clinician first? Is it just taken at face value by the respective board?

If anything even smells remotely like litigation of ethics, I make sure there is a paper trail. I'd be archiving e-mails. Even if the e-mail is to ask to set up a phone call or such.
 
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WisNeuro

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It is all over Facebook, so there’s that.

I believe Buckeye was referring to how the concerned individual documented that they spoke with the possibly impaired individual. In our ethics code, we are supposed to attempt informal resolution prior to board complaints, except in the cases of imminent or irreparable patient harm.
 
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futureapppsy2

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It's really important here to distinguish between the presence of a mental or physical illness and actual impairment of practice. Plenty of people with considerable illnesses can continue to function very well at work.
 
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WisNeuro

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It's really important here to distinguish between the presence of a mental or physical illness and actual impairment of practice. Plenty of people with considerable illnesses can continue to function very well at work.

Very true. Also, the set points and what constitutes fitness to practice varies quite a bit across the spectrum in healthcare. What makes a cardio-thoracic surgeon unfit to practice vs a therapist is vastly different. Additionally, some occupations have very circumscribed parameters, such as FAA evals. This is where consultation with someone who practices in the fitness for duty realm may come in handy.
 
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biomom

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That’s really why I asked the question. I don’t know how to determine whether her personal issues represent impairment.
 

PsyDr

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Most boards are a bunch of dummies.
That’s really why I asked the question. I don’t know how to determine whether her personal issues represent impairment.

Realistically, that’s not your problem. Your state and counselors board has some rules about that. Look them up. I’m guessing it’s a “see something , say something” scenario, like every other mandated reporter scenario. You are reporting a concern, not reporting an impairment. The board and its agents (including the professional doing the ffd) are responsible for determine if there is impairment.

Do the Nancy Grace, “I’m asking if this reportedly suicidal counselor might be impaired!” I’m not saying he/she is! I’m just asking questions!”.

it’s stupid, but that technique has been vetted by many many many Ivy League attorneys.
 
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dcpsychdoc

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Most boards are a bunch of dummies.


Realistically, that’s not your problem. Your state and counselors board has some rules about that. Look them up. I’m guessing it’s a “see something , say something” scenario, like every other mandated reporter scenario. You are reporting a concern, not reporting an impairment. The board and its agents (including the professional doing the ffd) are responsible for determine if there is impairment.

Do the Nancy Grace, “I’m asking if this reportedly suicidal counselor might be impaired!” I’m not saying he/she is! I’m just asking questions!”.

it’s stupid, but that technique has been vetted by many many many Ivy League attorneys.

It actually is your problem if you know or suspect an impaired professional could be harming clients. You need to act. How and when and where are not always easy questions to answer. But it most certainly is our ethical responsibility to protect patients from harm.
 

DynamicDidactic

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It actually is your problem if you know or suspect an impaired professional could be harming clients. You need to act. How and when and where are not always easy questions to answer. But it most certainly is our ethical responsibility to protect patients from harm.
I think that’s why @PsyDr said realistically. Theoretically, definitely a problem. Realistically, may be not.

Though, as others have said, I would contact the board.
 
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psych.meout

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It actually is your problem if you know or suspect an impaired professional could be harming clients. You need to act. How and when and where are not always easy questions to answer. But it most certainly is our ethical responsibility to protect patients from harm.
That's not what he said. His point is that determining impairment isn't their problem, reporting the issue is.
 
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PsyDr

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It actually is your problem if you know or suspect an impaired professional could be harming clients. You need to act. How and when and where are not always easy questions to answer. But it most certainly is our ethical responsibility to protect patients from harm.

Oh really? Prove there is harm. Harm. Not substandard care. Not a lack of help. Making someone worse. Worse than the natural history of the diagnosis. Prove that the specific professional service are empirically capable of causing said harm. Now prove that this proposed diagnosis the professional suffers from is capable of causing said harm. Now prove that this absolutely knew that this was happening or that you had material knowledge that this was happening.

or you could just make an uneducated guess using terms you don’t know about.
 
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dcpsychdoc

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Oh really? Prove there is harm. Harm. Not substandard care. Not a lack of help. Making someone worse. Worse than the natural history of the diagnosis. Prove that the specific professional service are empirically capable of causing said harm. Now prove that this proposed diagnosis the professional suffers from is capable of causing said harm. Now prove that this absolutely knew that this was happening or that you had material knowledge that this was happening.

or you could just make an uneducated guess using terms you don’t know about.

I was pointing out that if you suspect patients are being harmed, it is your responsibility to take reasonable steps to determine if that is the case. How that is done will vary and be determined by many factors. It may be that the only thing that happens is that one contacts a supervisor or HR or a licensing board. Or it may be that you consult with colleagues and decide on no further action. Those are all examples of doing something.

Doing nothing is not an acceptable course of action.
 

dcpsychdoc

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I was pointing out that if you suspect patients are being harmed, it is your responsibility to take reasonable steps to determine if that is the case. How that is done will vary and be determined by many factors. It may be that the only thing that happens is that one contacts a supervisor or HR or a licensing board. Or it may be that you consult with colleagues and decide on no further action. Those are all examples of doing something.

Doing nothing is not an acceptable course of action.

Ah! I see! I was referring to reporting, not determination of whatever the impairment is. Apologies for that misunderstanding. I initially read your response as it not being your problem at all.
 
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dcpsychdoc

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or you could just make an uneducated guess using terms you don’t know about.[/QUOTE]

Well that’s a bit salty . I see my mistake and responded. But yikes, man.
 

biomom

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I talked with her again last night. She is taking time off and is getting help. Thanks for everyone’s thoughts.
 
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