Requirements and Implementation of Maintaining Patient Records

Summary

This article will discuss the need for psychotherapists to document the statements of patients, the techniques they use, and other aspects of their work to avoid ethical and legal problems. Elements of session notes and written informed consent will be identified. No informed consent can legitimize some actions and they will be addressed.     

How a Mental Health Professional Handles Referrals and Fees

Summary

The choice of referral and the relationship between referral sources can pose clinical and ethical dilemmas, due to the potential that the relationship between the psychologist and the referral source will interfere with the treatment relationship. Once the referral has been made, the referring psychologist must be sensitive to a second, and often a more problematic level of risk: conflicts that occur between the patient and the referral recipient. The situation becomes even more problematic when a psychologist is giving or receiving any form of compensation in connection with the referral. In addition to clouding the clinical relationship, the giving or receiving of such compensation, whether it is characterized as “referral fees” or otherwise, has important legal consequences, and may well result in license revocation proceedings or even criminal liability.     

WOMEN'S SOCIALIZATION AND THE PREVALENCE OF DEPRESSION

No abstract available for this article.     

The Angry Patient: Case and Session Presentation

Responding to patients who become angry at the therapist is difficult for many clinicians. In the case and session presented, the patient is not only angry, but devalues the therapist by not paying while asking for more frequent sessions. The therapist loses it, states she is angry, and remains insistent on the patient keeping his bills paid or reducing the frequency of sessions. The therapist is conflicted over confronting the patient with what she believes has to change in order for his symptoms to diminish—the irrational beliefs, life style, and sense of entitlement related to the personality disorder of this patient, but likely to drive him away from treatment. The therapist engages in a risky confrontation and remains unclear about the eventual benefit of this response.     

Raising Fees in Group Therapy: Some Ethical and Clinical Implications

Of all money matters in group psychotherapy, one of the most neglected in the literature is the issue of raising the fees. The premise of this paper is that there are ethical and clinical considerations to group fee increases. One consequence of the lack of attention to the subject of raising of fees is that many neophyte group leaders do not learn about its complexity. It will be argued that the raising of fees is not merely a straightforward matter of informing groups about an impending change in the amount of money that they will pay but rather, it is a knotty, emotionally charged issue with both realistic and subjective components for members and leaders alike. Further, it will be argued that the issue of raising fees in group therapy is dissimilar, in significant ways, from raising fees in individual treatment. When leaders use subjective criterion to decide an increase, then the group process may be disrupted. Suggestions for reform will be offered.     

AN ANALYST'S UNCERTAINTY AND FEAR

The motivations for choosing psychoanalysis as a profession are many and differ depending on the psychology of the analyst. However, common to most psychoanalysts is the desire to forge a helpful relationship with the individuals with whom they work therapeutically. This article presents an example of what happens when an analyst is confronted by a patient for whom being in a relationship and being helped are intolerable.     

When clients want to pay more for psychotherapy: ethical issues and implications

One ethical issue that commonly comes up in clinical practice is the negotiation of fees with clients. Although the APA Ethics Code provides standards regarding clients who are unable to or do not pay (Standard 6.04), little guidance is given pertaining to fee limits for clients who want to pay more. This issue is explored using a real case example, including the relevant ethical codes to be considered. The necessary “gray” areas of ethical decision-making are demonstrated through my own decision process. Implications for future scenarios are discussed.