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Malpractice & Licensing Pitfalls for Therapists (Abstract)

Edited from an article by Brandt Caudill, Esq., this 2004 list of common problems which lead to actions against LICSWs and other mental health professionals including self disclosure, dual relationships, incorrect diagnosis, “true love,” etc. Brandt Caudill, Jr., Esq., is a California defense attorney specializing in defending complaints against mental health professionals. I have noted in italics how each area is handled in Washington law.

“Evidence-Based Practice” and “Relationship-Based Practice” Paradigms (Abstract)

This 2005 article summarizes the difference between “evidence-based practice” and “relationship-based practice” and why the former is appealing when developing public policy, but may have a negative impact on the core of clinical practice, the therapeutic relationship. While EBP may have a useful role in the practice of medicine, the application of EBP to mental health treatment more often has a chilling effect on successful outcomes.

How HIPAA Standards Have Changed Mental Health Privacy and Security Practices (Abstract)

Clinicians who do not use insurance or send information electronically to billing services sometimes feel HIPAA standards do not apply to them. However, these standards are becoming the de facto standard for all mental health clinicians, whether they are ‘covered entities’ or not. This 2004 article summarizes the areas of HIPAA standards that have differed from previous best practices on confidentiality that all mental health clinicians may want to consider including development of Notice of Privacy Practices, Business Associate Contracts, Psychotherapy Notes and Medical Records, Privacy Policies and Procedures, Security Assessment, etc.

Psychoanalysis and Psychoanalytic Psychotherapy – Practice Principles (Abstract)

This 2004 article contains some basic principles which almost every school of psychoanalytic thought and practice endorses, with varying degrees of emphasis. While many of these principles are used by other forms of psychotherapy, these concepts can be seen as the cornerstones of psychoanalysis and psychoanalytic psychotherapy today. They include making the unconscious conscious through the patient verbalizing any body sensations, thoughts, fantasies, or feelings which occur during treatment hours, dreams, and slips; understanding which leads, through empathy with traumatic experiences, deficits, and internal conflicts, to resolution of conflicts and completion of developmental tasks; dealing with transference manifestations, which are displacements of thoughts and feelings towards the analyst from important past figures; dealing with counter transference manifestations which are displacements of thoughts and feelings from the analyst’s past relationships as well as representing responses to what is happening in the relationship with the patient; the maintenance of the analytic ‘frame’; and the development of the treatment alliance between the patient and analyst.

HIPAA Standards and Psychoanalytic Practice: Privacy of Patient Material – Review of the Literature (Abstract)

HIPAA (Health Insurance Portability and Accountability Act) Federal privacy standards for health care patient information went into effect on April 14, 2003. These standards created new procedures for protecting electronically-transmitted patient information, with special protections for Psychotherapy Notes. While these standards may in superficial ways change how analysts disclose patient information, HIPAA has also caused heightened attention to how psychoanalysts have handled protection of patient material. For instance, should the analyst publish or present patient material, even disguised, without seeking patient consent before publishing or presenting, and risk upsetting the patient? Can the analyst comply with state and Federal disclosure requirements regarding potential harm to self or others without causing harm to the patient? What factors does the analyst consider to make decisions in these areas? This 2004 article considers the ways analytic thought has addressed these questions and how HIPAA may influence the variety of conclusions that have been reached.

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Laura W. Groshong, LICSW​