Street onto stamps continue ( giving a thank you counsels moots with good lawyers, solid qualifications, scrupulous ethics, and openness to peer review all help protect respectable experts from being accused of professional impropriety, and from contributing to unfair judgements and case resolutions. Return to Current Table of Contents. Behaviors That Get Psychiatrists, Psychologists, and Psychotherapists into Trouble Psychiatrists' Risk Management Services, which manages a liability insurance program for members of the American Psychiatric Association, recently published 20 Surefire Steps to Increase Risk of Malpractice Suit or Board Complaint. I won't plagiarize from that article, but the topics are well known to attorneys, and should be familiar to all mental health professionals. I have collapsed the list, omitted a couple of items, added one or two, reworded the concepts a little, and expanded the target audience a bit, since most of the points aren't limited to psychiatry. The original article can be read on 32 of the 2, issue of Information about PRMS can be obtained at Remember, these are the opposite of what mental health clinicians should do. When a collaborative treatment relationship with other clinicians employ a hands-off, arms' length approach. 't exchange information regularly with the other professional. 't discuss treatment approaches. 't have any prior agreement about care or professional roles. 't bother to learn anything about the other clinician's qualifications. Assume the other treater knows when to contact you. Spend 15 or 20 minutes with the patient every few weeks or months, sign the prescriptions, and move on. Have with a patient. Have with a former patient. Terminate a patient and then have Have drinks with a patient and promise yourself you won't have Spend a lot of time talking with a patient about yourself or your own interests. When you feel sexual or other inappropriate feelings toward a patient, tell the patient and ask if the patient feels similarly. Do not seek competent consultation if the impulse to act on such feelings is getting really strong. Prescribe medications by telephone when you 't know the patient well or have not conducted a suffucient evaluation. 't bother to document the call. Prescribe without establishing recommended baseline laboratory values documenting a thorough discussion of potential effects, potential side effects, and the patient's consent; and recording the name, number, dosage schedule, and clinical rationale for each prescription or change prescription. Clinicians: Does the above make you nervous? Do you want to email me and complain that your schedule, or the clinic which you work, forces you to do some of these things even though you know better? Do you think managed care has changed the standard of care the U.S.? Remember that you, not the clinic administrator or insurance company, are responsible for the quality of your care and for meeting the relevant standard of care when working with patients. Return to Current Table of Contents. Child Custody Evaluations: There Are Rules! I am amazed at the way mental health professionals and some courts address one of the most important kinds of litigation we have, that which determines the development and safety of children when their parents divorce or separate. Family court judges and family lawyers should know that there are at least three fundamental requirements for a child custody evaluation: This usually means a fully-trained, forensically-experienced child psychiatrist or child psychologist. Family counselors, ordinary psychotherapists, and general psychiatrists and psychologists simply have not had the years of special child and adolescent training and experience necessary to understand children's issues, family interactions, and the child custody process. Although Dad's or Mom's therapist, the children's counselor, or a family psychiatrist-friend offer fact testimony, each has indelible bias, has often not received all the relevant information, almost always has a conflict of interest, and usually doesn't understand the forensic process and its implications. Courts should not rely on his or her report or testimony for expert opinions When one or more family members is truly unavailable for interview, that fact should be highlighted any report or testimony and the possible effect on the expert opinion should be explained. After allowing for lack of knowledge about what makes adequate evaluation money is probably the most common reason for breaking these rules. Complete evaluations by qualified professionals routinely cost thousands of dollars. They take time. Courts and litigants have to look outside their communities for specialists who meet both clinical and forensic criteria. Tough. The child's interests are the point here, not the parent's, court's or state's pocketbook, feelings, or convenience. To act otherwise is to put children danger of suffering even more than they must when their parents separate or divorce. A recent article by Stephen P. Herman, M.D., a New forensic child psychiatrist, provides excellent summary of one of these fundamentals, evaluators who 't assess all parties Issues of the can