Issues In Forensic Psychology - Psychotherapy Malpractice

ISSUES IN FORENSIC PSYCHOLOGY
Psychotherapy Malpractice

Massive reviews of data combined from different studies - known as meta-analytic reviews - demonstrate that psychotherapy is more effective than no treatment. These studies, however, have typically been done in the research settings of universities. Therefore, the outcomes obtained in research settings do not necessarily generalize to how psychotherapy is practiced in the community.
As it is practiced in community settings, the effectiveness of psychotherapy is undermined by the extent to which mental health professionals disregard relevant research. One study in particular, for example, found that less than 10% of 1100 mental health professionals, employed in community mental health centers and state hospitals, relied on any professional publications in their treatment work.
In another study, 37% of practicing psychologists indicated that nothing published in the professional literature had ever influenced their endeavors, and none of the psychologists in the study could cite any specific research which affected how they practiced.
More than 90% of another sample of psychotherapists disregarded relevant research and/or systematic decision making when: (1) choosing assessment procedures, (2) defining treatment goals, and (3) selecting treatment methods. Rather than systematically respond to the needs of their clients in a logically coherent manner, these therapists developed treatment plans that intuitively appealed to them because of their familiarity.
The extent to which psychotherapists neglect appropriate treatment planning encourages them to indulge in what is known as the "Bait-and-Switch" tactic in psychotherapy. Like some retail merchants who "bait" customers with advertisements of bargain-priced but unavailable merchandise - and then switch them to a more expensive item - therapists frequently bait distressed individuals who want to resolve a particular problem.
Clients lured into treatment via bait-and-switch tactics often learn that their difficulties are supposedly more complex than they thought. Therapy then addresses the issues of the client's life which interest the therapist, regardless of whether those interesting issues are relevant to the client's problems.
Consider, for example, a client who sought the services of a psychologist for stress related problems associated with his job. Despite the nature of the client's problems, the psychologist - responding as he did to most of his other clients - questioned him at great length about his sex life.
Effective psychotherapy necessitates that therapists undertake informed consent procedures with their clients. Appropriately executed informed consent clearly identifies the goals of therapy, and details how those goals will be realized. Informed consent should also specify both the benefits and potential adverse effects of treatment. Additionally, informed consent procedures identify alternative courses of treatment in addition to what the therapist is recommending. Finally, the recommended treatment procedures should be known to be safe and effective. Similar to the frequency with which they disregard relevant research, practicing therapists also regularly neglect to obtain informed consent from their clients.

If you are interested in learning more about psychotherapy malpractice, you may want to order any, or all, of the following publicatons authored by Dr. Campbell.

Psychotherapy and malpractice exposure. American Journal of Forensic Psychology, 1994, 12 (1), 5-41. (Order article #9, cost $10.00)

Systemic therapies and basic research. Journal of Systemic Therapies, 1996, 15 (3), 15-39. (Order article #12, cost $12.00)

Beware The Talking Cure: Psychotherapy May Be Hazardous to Your Mental Health. Social Issues Resource Series (SIRS), Upton Books, Boca Raton, FL, 1994. (Order directly from Amazon.com).

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