Nine risk management lessons for practitioners.

Taube, Daniel O.,Scroppo, Joe,Zelechoski, Amanda D.
Practice Innovations, Oct 04 , 2018

Abstract

Risk management is an essential skill for professionals and is important throughout the course of their careers. Effective risk management blends a utilitarian focus on the potential costs and benefits of particular courses of action, with a solid foundation in ethical principles. Awareness of particularly risk-laden circumstances and practical strategies can promote safer and more effective practice. This article reviews nine situations and their associated lessons, illustrated by case examples. These situations emerged from our experience as risk management consultants who have listened to and assisted many practitioners in addressing the challenges they face on a day-to-day basis. The lessons include a focus on obtaining consent, setting boundaries, flexibility, attention to clinician affect, differentiating the clinician’s own values and needs from those of the client, awareness of the limits of competence, maintaining adequate legal knowledge, keeping good records, and routine consultation. We highlight issues and approaches to consider in these types of cases that minimize risks of adverse outcomes and enhance good practice.

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Being aware of basic legal parameters can help clinicians to avoid making errors in this complex arena. Yet clinicians are not usually lawyers and tend to have only limited legal knowledge. This gives rise to a risk of assuming more mastery than one may have.

Indeed, research suggests that a range of professionals, including psychotherapists, overestimate their capabilities and competencies, even in areas in which they have received substantial training (Creed, Wolk, Feinberg, Evans, & Beck, 2016; Lipsett, Harris, & Downing, 2011; Mathieson, Barnfield, & Beaumont, 2009; Walfish, McAlister, O’Donnell, & Lambert, 2012).

New Jersey Psychology Practice Revealed Patients’ Mental Disorders in Debt Lawsuits

By Charles Ornstein
ProPublica, Dec. 23, 2015

When a New Jersey lawyer named Philip received legal papers last year informing him that his former psychologist’s practice was suing him over an unpaid bill, he was initially upset they could not work out a payment arrangement outside of court.

It was only later, Philip said in an interview, that he scanned the papers again and realized something else: The psychology group to which he’d confided his innermost feelings had included his mental health diagnosis and treatments he received in publicly filed court documents.

The greatest fear of many patients receiving therapy services is that somehow the details of their private struggles will be revealed publicly. Philip, who requested his last name not be used to protect his privacy, said he felt “betrayed” by his psychologist. He worried that his legal adversaries would find the information and try to use it against him in court.

“It turned my life upside down,” he said.

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Emerging Ethical Threats to Client Privacy in Cloud Communication and Data Storage.

By Samuel D. Lustgarten
Professional Psychology: Research and Practice, Apr 27 , 2015. http://dx.doi.org/10.1037/pro0000018

Abstract

In June 2013, Edward Snowden released top-secret intelligence documents that detailed a domestic U.S. spying apparatus. This article reviews and contends that current APA ethics and record-keeping guidelines, the Health Insurance Portability and Accountability Act, and the Health Information Technology for Economic and Clinical Health Act do not adequately account for this new information and other emerging threats to client confidentiality. As psychologists bear the responsibility for being informed, protecting and maintaining client records, and preventing breaches, it is vital that the field establish specific best practices and present regular security updates to colleagues.

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Unfortunately, on top of data-mining practices, most cloud storage and communication providers do not provide adequate information about data-retention policies. Google's Drive cloud storage service for personal users (not Google Apps) offers no specific data-retention policy (Google, 2014c). This amorphous data-retention policy stands in contrast to APA's (2007) record-keeping guidelines, which suggest that client records and data may be destroyed after 7 years in the absence of superseding legal requirements. It also calls into question a practitioner's ability to maintain and provide confidentiality and proper informed consent when using certain corporate providers. Moreover, it is questionable whether practitioners could ever believe that records had been deleted if the cloud provider did not clearly and publicly state its data-retention standards.

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University of Oregon Employees Under Investigation for Misconduct in Rape Case

By Richard Read
The Oregonian
Originally posted May 8, 2015

Six University of Oregon employees, including a vice president and the school's interim top lawyer, are under investigation for alleged misconduct in the handling of therapy records of a student who says she was gang-raped by three Ducks basketball players.

The Oregon State Bar is investigating complaints against interim general counsel Douglas Park and associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating complaints against four people, including Robin Holmes, the university's vice president for student life, who is a licensed psychologist.

Jennifer Morlok, a senior staff therapist identified in legal correspondence as the clinician who counseled the woman, filed all the complaints.

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