The professional liability of behavioral scientists: An overview

Issues regarding the question of what constitutes malpractice by psychologists, psychiatrists, and other mental health professionals, are reviewed. The legal concepts of negligence, professional liability, and causation are explained and related subjects including the duty of mental health professionals and what constitutes a breach of that duty are discussed and illustrated. Guidelines for avoiding legal jeopardy are also presented.     

The admissibility of expert testimony regarding malingering and deception

This article discusses the legal admissibility of expert testimony and the ability of mental health professionals to detect malingering and deception among defendants. A legal analysis of the admissibility of expert testimony regarding malingering and deception in formal legal proceedings is presented. Some guidelines are provided to help mental health professionals and attorneys determine the admissibility of evidence they intend to introduce. Although psychologists and psychiatrists currently have a limited ability to identify accurately malingering and deception, expert testimony about the genuineness of a defendant's mental illness is likely to be held admissible for both practical and evidentiary reasons. In contrast, evidence about a witness' credibility is rarely admissible. In addition, psychologists are ethically obliged to recognize their limitations in making representations about their skills.     

The development of the Minnesota Multiphasic Personality Inventory

The Minnesota Multiphasic Personality Inventory (MMPI) was constructed at the University of Minnesota before and during World War II. In its developmental phase, the MMPI was conceputalized as an efficient way of detecting psychiatric disturbance. The test's construction was made possible by atypical cooperation between psychologists and psychiatrists, within the context of a crisis in the U.S. public mental health care system. The MMPI was designed to meet the diagnostic needs of psychiatrists. As such, it represented the operationalization of medical hegemony. However, the interpretation of the MMPI shifted significantly after the war, reflecting organizational reform in clinical psychology and changing professional relationships between psychologists and psychiatrists.     

Bias and expert testimony of mental health professionals in adversarial proceedings: A preliminary investigation

The role of mental health professionals testifying as expert witnesses has been the subject of increasing criticism. Cases in which opposing experts reach different conclusions are dismissed as “battles of the experts” and psychologists and psychiatrists are described as “hired guns.” This preliminary, analogue study examined the degree to which the opinions and testimony of mental health professionals may differ according to which side retains the expert. Results provided some support for the proposition that mental health professionals' testimony may vary according to the side by which they are retained.     

Health Beliefs,Religious Values,and the Counseling Process: A Comparison of Counselors and Other Mental Health Professionals

A. E. Bergin (1985) studied the religious values and beliefs of mental health professionals and the relationship of those values to the counseling process. This study replicated Bergin's research with a sample of professional counselors. Differences were found in each of 10 beliefs areas and 10 values areas between the total sample in both studies. Within-group differences revealed greater similarities between professional counselors and social workers and marriage and family therapists and greater differences between counselors and either psychologists or psychiatrists. Implications for counseling and counselor training are discussed.     

An experimental analysis of the civil commitment recommendations of psychologists and psychiatrists

Legal and nonlegal factors influencing the civil commitment recommendations of psychologists and psychiatrists separately and as a whole were investigated using an experimental design. One hundred and seventy-six psychologists and psychiatrists made recommendations for or against commitment for a series of clinical vignettes wherein the five facets of commitment criterion, legal committability, clinical treatability, alternative resources and presence of psychosis were systematically varied. Results revealed that all facets contributed independently and in combination to the commitment decisions of participants as a whole. It was concluded that mental health professionals may utilize a variety of types of information, beyond the relevant legal criteria, in making actual decisions to initiate civil commitments.     

Education and Mental Health: New Directions for Interaction

Traditionally, mental health workers (psychiatrists, psychologists, and social workers) provide diagnostic evaluations and individual or group psychotherapeutic or casework treatment. With the advent of the community mental health movement, a new role model, that of “mental health consultant,” has emerged. This paper outlines the functions of the “mental health consultant” in the Job Corps program as a way of highlighting the functions of the mental health professional working in this new way. Educational, training, and work programs may be enriched by mental health consultation, and the new directions for interaction between education and mental health are described in this paper.     

Presidential Address: Team Science Across Disciplines: Advancing CBT Research and Practice on Hoarding

This presidential address focuses on the recent history of research and practice on hoarding disorder (HD) as a potential model for coordinating interdisciplinary teams of professionals within and outside mental health fields to advance scientific efforts to understand and resolve mental health problems. To identify, assess, and intervene with clients who have HD, psychologists, social workers, psychiatrists, and other service professionals are needed, including those in public health, housing, medicine, aging and protective services, fire, safety, and animal protection. Research findings and practice methods developed by many of my colleagues highlight the various skills of these diverse disciplines and fields. Of particular interest are multimethod assessments and CBT interventions that span individual, group, and family treatments, delivered in the office, at home and via the web by mental health and other professionals, as well as peers. Outcomes are positive, but there remains much work to do to improve understanding and intervention outcomes.     

Violence: incidence and frequency of physical and psychological assaults affecting mental health providers in Georgia

Threats to the physical safety and psychological well-being of mental health professionals present serious problems, according to 1,131 licensed mental health professionals in the state of Georgia. The professionals included clinical social workers, marriage and family therapists, professional counselors, psychiatrists, psychologists, and social workers. From a total of 6,431 surveys sent out, 1,131 (18%) were returned. The results revealed 2.696 separate accounts of 14,120 acts of physical or psychological assaults committed by 8,292 perpetrators. The results also showed that 61% of the respondents had been victimized in violent acts of a psychological or physical nature and that 29% had feared for their lives at least once during their professional careers. These data are consistent with other research that indicates that 6 out of 10 professionals will be assaulted during their professional careers.     

Violence: Incidence and Frequency of Physical and Psychological Assaults Affecting Mental Health Providers in Georgia

Threats to the physical safety and psychological well-being of mental health professionals present serious problems, according to 1,131 licensed mental health professionals in the state of Georgia. The professionals included clinical social workers, marriage and family therapists, professional counselors, psychiatrists, psychologists, and social workers. From a total of 6,431 surveys sent out, 1,131 (18%) were returned. The results revealed 2,696 separate accounts of 14,120 acts of physical or psychological assaults committed by 8,292 perpetrators. The results also showed that 61% of the respondents had been victimized in violent acts of a psychological or physical nature and that 29% had feared for their lives at least once during their professional careers. These data are consistent with other research that indicates that 6 out of 10 professionals will be assaulted during their professional careers.     

The APA and deafness

Until the 1960s, people who were Deaf and mentally ill lacked access to psychological treatment. Few mental hospitals and clinics had interpreters available, and few psychologists and mental health professionals had knowledge of sign language. Major court decisions and federal laws have effected change, culminating with the Americans With Disabilities Act of 1990. This legislation gave people who are Deaf the right to equal access to mental health care as well as a host of other opportunities they had been previously denied. New access laws allowed Deaf students to become educated as psychologists, and a number of hearing psychologists who knew sign language entered the field of deafness. These two groups assumed vital roles within the American Psychological Association in addressing the issue of mental health access for people who are Deaf. ((c) 2006 APA, all rights reserved).     

Genetic testing and psychology. New roles, new responsibilities

Advances in genetics and genetic testing promise to catalyze a fundamental change in the practice of medicine. Psychologists have much to offer as psychotherapists, researchers, educators, and policymakers to a society heavily influenced by the genetic revolution. To make the most of new opportunities available to mental health professionals in genetics, psychologists must know basic genetic principles and learn what is new about 21st-century genetics. The core competencies for all health professionals developed by the National Coalition for Health Professional Education in Genetics are related in this article to the significant roles psychologists can play in helping individuals with genetic concerns to cope with vulnerability, optimize family interaction, and improve health behaviors.     

Pratiques de psychologues dans un service de santé mentale intégré dans la communauté urbaine: Vers une définition des rôles du « psychologue communautaire »

During the last 20 years, the psychiatric care organisation has undergone important shifts by transfer of devices and professionals from hospital to the city. At the same time, the position/status of people living with mental health problems changed from the patients alienated by their pathology to the position of citizens actors of their health. The daily practice of mental health professionals has to adapt to these evolutions, shifting from a relatively institutional role to a community role. In order to illustrate this evolution, this article presents the daily practice of clinical psychologists working in a mental health service completely integrated in the city, founding member of a European network of good practices in community mental health. Their activity is divided between clinical work, research-action, mental health promotion and networking. These examples are used to question the emergence of a new profession: Community psychologist.     

The Effect of Honduran Counseling Practices on the North American Counseling Profession: The Power of Poverty

A team of researchers consisting of counselor education professors and doctoral‐level counseling students conducted interviews with Honduran mental health professionals, including counselors, psychologists, pastors, community developmental specialists, and psychiatrists. The purpose was to understand the counseling process and profession that exists in a developing economy. The results are focused on the pervasive effects of poverty on the profession, the training of counselors, and the nature of counseling interventions.     

Mirror mirror on the ward: who is the unfairest of them all? Reflections on reflective practice groups in acute psychiatric settings

Consultant psychiatrists in medical psychotherapy, adult psychotherapists, child and adolescent psychotherapists and clinical psychologists increasingly complement their direct therapeutic activity with applications of their psychotherapeutic thinking in acute mental health work through facilitating reflective practice groups for staff working in mental health teams. The authors offer their reflections on facilitating National Health Service reflective practice groups using the metaphor of a mirrored dialogue between patient and professional, and professional and institution as a basis for informing the development of reflective practice for colleagues. Their reflections are based on working on three acute in-patient wards, in a crisis resolution team and in community mental health teams. They describe the practicalities of setting up and facilitating reflective practice groups, and offer insights into some of the issues that arise in reflective practice groups. They conclude that these groups are mutually beneficial in forging links between psychotherapy professionals and professionals working in other disciplines and areas of mental health. Facilitating these groups often requires a challenging adaptation of technique, which will not suit all psychotherapists, as well as a wider understanding of organisational dynamics and the interplay between clinicians and management.     

VA Puget Sound Telemental Health Service to rural veterans: a growing program

The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.     

Negotiating Discourses: The Dialectical Identities of Survivor-Therapists

The psychiatric survivor movement is a political movement dedicated to fighting for human rights in the mental health system. People who identify as psychiatric survivors have experienced human rights abuses in the mental health system. A small number of psychiatric survivors have chosen to reenter the system as mental health professionals, and the current project focuses on the experiences of people with this dual-identity. The primary goal is to facilitate further dialogues between psychologists and the survivor movement by exploring the implications of identifying with both discourses. I interviewed five survivor-therapists, and asked how their identities as psychiatric survivors influence their approaches to therapy, and the nature of the relationship between these two identities.     

Das Image von Psychologen, Psychotherapeuten und Psychiatern in der Öffentlichkeit

This is a systematic review of studies about the public image of or attitudes toward mental health professionals, particularly psychologists, psychiatrists, and psychotherapists (including psychoanalysts) on the basis of computerized medical and psychological databases (PsycLIT, Pub Med, Google Scholar) and their cross-references with 43 new articles. It is an update of an older meta-content analysis of the same topic (N= 60 primary studies) which analyzed studies, published between 1948 and 1995. Data about their perceived social status, field of activity and clinical expertise, their sex/gender and physical appearance, personality and social interaction (especially those between therapists and clients), their work setting and about differential effects are presented. It becomes obvious that there exists a “shrink”-stereotype, which refers equally to psychologists, psychotherapists and psychiatrists, and which differs from the stereotype of physicians. The appearance of the “shrink” stereotype is male and psychoanalytically influenced (looking as Sigmund Freud in the setting “couch”). The stereotypes of “shrink’s” personality are partially idealisations (warm, intelligent, understanding parental figures) and partially very negative images (the neurotic; the dangerous, manipulative abuser). Public image of “shrinks”, research deficits, methodological problems, and sex/gender issues are critically discussed.     

The mental health care revolution. Will psychology survive?

Managed mental health care, which encompasses a wide variety of approaches, is a response to precipitous increases in health care expenditures, particularly as they relate to mental health care. The shift from what seemed certain to become a national health insurance program only 15 years ago to the profit-driven corporate health care industry of today is truly revolutionary. These profound changes are beginning to have a major impact on the independent practices of psychologists. In this article, psychologist practitioners are exhorted to recognize this new development in the marketplace. Data are cited that show the rapid shift from free choice care to various forms of managed care, and practitioners are urged to participate in shaping the changes that are now in process in order to develop a humane and effective system of mental health care.