Question/Answer Corner: What’s On Your Mind?
Q: You receive a call asking for therapy services for a child client. The parent who calls informs you that he/she is considering divorce and wants to make sure his/her child gets into therapy in advance of the split between the parents. You think this is a wise thing for the parent to do – will you take the new child client?
A: It depends upon whether or not you like going to court and just, in general, being involved in divorce and custody litigation, even from the sidelines. While you may admire the parent’s wish to engage the child in therapy prior to the upheaval of the parents’ divorce, you should really ask yourself if you want to get involved. This is – by definition and my experience defending mental health professionals – a HIGH-RISK case. How thick is your skin? Is your liability insurance premium paid? Are you willing to be dragged into an ugly matter (it may not be, but statistically probably will be) and perhaps having to defend a grievance in the worst case scenario?
None of these horrors may come to pass, but when I get this type of call, I say that I would prefer referring the parent to a mental health professional who does not mind court involvement. Then, make sure you find some folks for referrals who really do enjoy this type of litigation involvement. There are some out there and they will welcome the referral. It might just keep you happier this year if you pass along the hot potato. Do not feel guilty about doing so, if that is what you choose.
Remember, clinical practice in this litigious age requires clinicians to be aware and more self-protective than back in the old days (dinosaur age??). So, do what you have to do to keep yourself mentally healthy and emotionally centered for all your clients, your family and friends, and yourself. Managing new referrals to weed out the high-risk variety can help in this process and prevent burnout. Good luck!
Recently, I had a new experience, which many of you probably have had or have had something similar: knee surgery. I apparently tore my meniscus – hey, before this event, I didn’t even know what a meniscus was (or how to spell it). But, in training my rescue dog with a million pivots to help her get the idea that when we walk, it is the “loose leash” method, rather than the “tugging me along” method, I believe I ripped the old meniscus. That pivoting, combined with hoisting myself over the baby gate and up and down the deck stairs a million times for the new golden pup to become housebroken, was apparently enough to give my knee a real challenge – one that I lost!
Other blog posts you might be interested in:
DORA: What’s On the Various Boards’ Radar?
I try to attend all the public Board meetings of all the Mental Health Boards: Social Work, Professional Counselors, Psychologists, Marriage & Family Therapists, Addiction Counselors, and Registered Psychotherapists. Each month, this section will address current issues that arise in various Board meetings that may seem helpful for practicing clinicians.
For this month, I attended the Psychology Board meeting and stayed through most of the Board reviews of the grievances against psychologists. They are reviewed in two sections: (1) those that were immediately referred for investigation upon the Board’s receipt of the Complaint, and (2) those that are on initial review, meaning that the Board issued a letter to the licensee upon receiving the Complaint asking for a response, but didn’t refer the matter to an investigator. In the first category, out of 6 grievances that were sent to investigation, 4 involved allegations of sexual misconduct. All of these went to Executive Session for consideration of sanction. The other grievances in this category – investigation – involved allegations of fraudulent billing and unlicensed person holding himself out to be a licensed psychologist. The fraudulent billing matter concerned the provision of couples therapy, but billing one of the spouses’ insurance using her diagnosis. That matter was sent out to a billing expert for opinion.
In the second category – initial review – some of the more interesting the matters involved the following issues:
(1) Facebook posting by a therapist where political comments were made voicing the opinion that if someone had a mental health disorder, he/she should not be in public office. The Complainant took offense and filed a grievance. The Board dismissed the Complaint reasoning that the FB account was the therapist’s personal account and the Complainant was a “friend” on that account, but not personally involved. I am not sure if the Complainant was a client or not. Just heed this warning: Although this matter was dismissed, be careful about how you use social media and do not allow your clients to “friend” you;
(2) two of the grievance involved therapist serving as a court-ordered evaluator for a Parental Responsibility Evaluation (PRE) and there ensued a discussion between the Board members and the Assistant Attorney General about how the Board should first consider the allegations in the Complaint to determine whether the licensee has committed any violations of the Rules or Mental Health Practice Act and not worry about the jurisdiction issue until later. Of course, that makes little sense, and is a veering from how the Boards were formerly advised; that is, if there is no mental health practice, but rather only a court-ordered function, the Board’s formerly were told by the AAG that they did not have jurisdiction over those PRE or CFI cases because the courts were in charge of the them since the licensee was appointed to serve the court and provide court with recommendations. Now, the AAGs have decided that all Complaints concerning PRE work must be examined for violations first and the AAG told the Board, “if there is a jurisdiction issue, I will let you know.” I think this is wrong and a usurpation of the Board’s functioning, but they went along with it;
(3) Complainant alleged that therapist didn’t respond timely enough to a request for a report for court – but C. only gave 5 days notice for the report and therapist was on vacation so C. got vacation responder via email and didn’t like it, so filed a Complaint. This was dismissed;
(4) breach of confidentiality allegations – this matter was referred to Office of Behavioral Health (OHB) that regulates facilities because the Board had concerns (valid ones, I think) about the process in this agency of revocation of Release of Information that allowed the confidential patient information to be released in this case even though the client had revoked the ROI;
(5) allegations that therapist had advised client about how to withdraw money without his wife being privy to such withdrawals so that client could spend down couple’s money without wife’s permission – the Board found the allegations to lack support and dismissed matter; and
(6) therapist saw client, then wrote up treatment plan that included diagnosis and emailed it to client for review and comment and said they would discuss at the next session – client was upset about diagnosis and never returned, then filed grievance. Board saw cultural issues (was a low-income clinic) and also thought that the therapist lacked sensitivity about how the information might be received. HEED: do not send clients diagnostic or treatment information, but rather review such with them in a face-to-face session. Most therapists would not do this, but in this technological age, it might seem ok. But, it is never a good idea and even if clients want copies of their files, which under HIPAA they have a right to, have the client come into your office for the review so that if there are questions/concerns about something you have written in their file, you can assuage their concerns – and avoid a grievance!!
Training/Legal Consultation For Clinicians/Agencies
Deb has been providing training for high risk clinical situations and legal involvement of the therapist for groups here in Colorado. Deb consults with agencies to help therapists prepare for deposition or trial testimony, or to handle a subpoena request for clinical records.
Deb is available to meet with individual therapists who need risk prevention consultation and/or with groups of any size for any type of self-protective, clinical practice in this litigious age. Deb will be working with a staff group of around 70 in April 2017. She can custom tailor training to your particular agency or small group with questions submitted in advance by participants, if desired.
Deb will be presenting a 3-hour seminar to SungateKids, Colorado Child Advocacy and Abuse Services entitled:
Self-Protective, Ethical Practices for Clinicians to Handle High-Risk Clients and Legal Involvement
For more information, contact Steffanie Walstra, Clinical Coordinator, at firstname.lastname@example.org.
Deb will be doing another 3-hour Beyond Ethics training in New Orleans on June 2, 2017 entitled:
Ethical, Clinical Practice in the Electronic Age
What people said about my most recent seminars:
- “Ms. Henson is extremely knowledgeable and delivery was excellent!” – (Participant, 2.17.17 Seminar)
- “Fantastic! Great information.” – (Participant, 2.17.17 Seminar)
- “Excellent presentation. The materials was well researched. The presenter is very knowledgeable.” – (Participant, 2.17.17 Seminar)
- “Excellent presentation – engaging and knowledgeable. Thanks, Deb!” – (Participant, 2.17.17 Seminar)
- “Excellent: presenter and content.” – (Participant, 2.17.17 Seminar)
- “I always enjoy your trainings. I appreciate your flexibility in regards to discussing audience members’ concerns/experiences.”
- “My third seminar with you — you are great! Keep on teaching this class…”
- “Always great! Thank you! Wish you had more throughout the year… You are engaging and positive.”
- “Excellent! I could not think of anything to improve on this workshop. Keep doing what you’re doing.”
- “Excellent presentation. Very informative and well thought out frame work. Thanks Deb!”
- “Presenter was engaging, knowledgeable, and very thorough.”
- “Nice work! Very interesting, especially when examining specific case studies.”
Deb’s Clinical Practice
(1) Referrals being accepted for women’s therapy group. Good candidates include women between ages approximately 35 – 60 who are undergoing a significant life transition, such as (a) loss of job, (b) major health issue, (c) divorce or death of partner, or (d) depression/anxiety that you believe group work would help. Client would continue in individual therapy with referring therapist – group would only augment clinical work. Group will meet in the evening at Deb’s Lakewood office.
(2) Deb will be teaming up with a trauma Yoga instructor who offers Trauma Sensitive Yoga for survivors – both a teen group and a women’s group. We will be offering short-term (probably 6-week) groups starting in the New Year. These groups will be structured around providing a safe space for survivors of any type of trauma. Here is the blurb about the group:
Certified Trauma-Sensitive Yoga Instructor Rachel Stroud and Therapist Deborah M. Henson, LCSW are collaborating to offer two 6-week Trauma-Sensitive Yoga Workshops. One workshop is aimed towards teens who have survived or are enduring any type of trauma and the other is geared towards women trauma survivors. If you are a trauma survivor or know of someone who could benefit from this type of workshop, we’d love to hear from you so we can come together to find a 6-week slot that works for the majority. Please email Rachel Stroud at email@example.com or call at 405-640-5132 to express interest and to collaborate meeting times.
Rachel & Deb are passionate about helping trauma survivors navigate through their healing journey and offering a safe place for them to heal from the deep places where trauma is held within the body. Trauma-Sensitive Yoga provides survivors with the opportunity to heal from the source, empowering them with renewed relationships with their bodies.
- Learn how to connect with your breath, mind and body to provide calm and safety within
- Learn techniques to help release stress, tension and anxiety
- Find connection, strength and support with others in a safe setting
- Learn to process your trauma & healing through movement, optional group sharing, journaling and mindfulness.
Trauma is different for everyone. The exact same traumatic event can, and likely will, affect individuals differently. Trauma can be, but it not limited to:
- PTSD of any kind
- Childhood trauma
- Sexual trauma
- Surviving a natural disaster
- Surviving/witnessing an attack
- First responders holding trauma from their first-hand accounts on the job
- LGBTQ processing/marginalization/discrimination/questioning…etc.
- Emotional/spiritual/physical abuse or trauma
- Death of a loved one and/or close encounters with death
- Surviving an accident
- Surviving or witnessing anything horrific and/or traumatizing
(3) Deb offers family counseling to those who have a LGBTQ kid or family member of any age coming out. If sufficient referrals come forth, Deb will start a multi-family group, which is very potent for families who feel isolated as in these situations. For more info, please call or have the family member call Deb at 504.232.8884. Deb is also a new Board member for PFLAG and will be assisting with the support groups in the near future, including the family and significant other support groups.
(4) Post-Divorce Facilitation – if any of your clients are considering divorce or have recently gotten divorced, I am available to help facilitate the process between the parents with the co-parenting of their children. It takes a new headset to become successful, non-conflictual co-parents, especially when the baggage of divorce litigation is hanging heavy over their heads. If you want more information about the co-parenting facilitation, feel free to email or call me or have the interested client contact me.
(5) Deb’s therapy office in Lakewood (Green Mountain area) is available for reasonable subletting by day, half-day, or evening. A couple evenings have been taken, but some remain as do a few days or half-days. Please check out her listing on Craigslist Denver or call her for more info or to schedule a time to visit the office. 504.232.8884
Legal Services Offered
- Legal Representation & Consultation for grievances (complaints) to licensing boards and/or malpractice lawsuits
- Training & Consultation for Clinicians and Agencies (e.g., respond ethically to subpoenas while protecting yourself and your clients; identify high-risk clients and situations to avoid client disciplinary complaints and harm to clients or third parties)
Deb Henson is an Attorney and LCSW (Tulane School of Social Work, MSW) in private practice in Denver and New Orleans, specializing in mental health licensing defense. She represents clinicians in DORA grievances (CO) and licensing board Complaints (LA) and regularly consults with clinicians in both states to help them deal with legal and clinical conundrums, such as: (1) the receipt of subpoenas for records or testimony; (2) the escalation of high-risk clinical situations; and (3) other sticky ethical wickets that arise in clinical practice. Deb helps clinicians develop self-protective, clinically sound and legally proper strategies for risk prevention.
Deb also maintains a clinical practice in Denver, with an office in the Green Mountain area of Lakewood. Through that private practice, Deb offers individual and couple therapy, and work with LGBT individuals and families. Call her for more information about clinical services or to schedule an appointment: 504.232.8884.
Deb has been presenting half- and full-day seminars on “Avoiding Ethics Complaints and Malpractice Lawsuits” or “Legal and Ethical Issues in Clinical Practice” around the country through PESI, Inc. for over 7 years and presenting for many CEU groups in Louisiana and Colorado. She also has lectured for Tulane School of Social Work Continuing Education and the University of Texas School of Social Work (Austin) Continuing Professional Development program, and for many other clinical and counseling groups. Deb started her own training biz — Beyond Ethics, LLC — in 2009. Contact Deb for group presentations to agency staff and/or private practice consultation groups.
Deb can be reached through her law and social work web site: www.deborahmhenson.com or through her training web site: www.beyond-ethics.com. Deb can also be emailed at firstname.lastname@example.org or email@example.com. And, you can use the old tried and true method of calling her at 504.232.8884.