Red Flags in Psychotherapy

Stories of Ethics Complaints and Resolutions

Patricia Keith-Spiegel

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781135053253
• Topic: Psicologia
• Subtopic: Psicologia clinica

This book delves into risks that can easily bedevil any psychotherapist and what can happen if they are ignored. Dramatic storytelling, based on actual incidents from the author's experiences as a member of ethics committees and as an ethics teacher and consultant, explores actions prompting clients to issue formal complaints. Set in the context of an ethics committee meeting over the course of a weekend, twelve psychologists face their peers who will stand in judgment. Issues include the fallout from losing one's temper with a difficult client, a personal disclosure gone terribly wrong, a bartering arrangement that literally falls apart, a private life revealed in a most public way, a vengeful act that sullies the reputation of an entire department, breaking confidentiality when a client threatened harm, and the slippery slope to sexual exploitation.

The stories are absorbing, enlightening, sometimes shocking, and often stranger than fiction. Narrative nonfiction puts human faces and emotions on what would otherwise be cursory statistics. What led to the formal complaint from both the vantage point of the complainant and the psychologist offers insights not otherwise available unless the dynamics of their private lives leading up to the conflict are revealed. An author's commentary and discussion questions follow every story. Both new and seasoned practitioners, as well as those still in training, will find this to be an invaluable resource.

one

SAMMY MEETS THE WOLF

 

 

 

 

 

Among the most endearing individuals to grace my life are those with whom I served on ethics committees. Somehow, often after a period of lively discussion and occasional flying sparks, we were able to make decisions we believed to be fair while maintaining respect for due process as well as protecting the public to the limits of our authority.

The setting for weaving the stories together is a weekend meeting of the League of California Psychologists Ethics Committee. Dr. Sammy Halsey, the newly elected member, has much to learn about how accusations of unethical conduct play out. We follow Sammy and his vivacious and more experienced colleagues as they grapple with complaints lodged against twelve psychologists. In that short period Sammy emerges with an increased understanding of ethics, his profession, the human condition, and himself.

The anticipated message was aglow in Sammy Halsey' email inbox. He crossed his fingers on both hands, leaned his head back and closed his eyes tight for a few seconds before opening the message from Dr. Victor Graham.

 

Dear Dr. Halsey,

We are pleased to inform you of your election to the LCP Ethics Committee. The next meeting will be held on March 16th and March 17th at our headquar-ters in Reseda. Please plan to arrive the previous evening as we start early the next morning. Details will be sent soon from Mrs. Peggy Aldridge, our LCP office administrator.

Congratulations! We look forward to meeting you.

Sincerely,
Victor Graham, Ph.D.
Chair, Ethics Committee
League of California Psychologists

 

Sammy hoisted both arms in a victory salute while a thrill trickled down his spine like a bamboo rain stick.

“I can help root out the bad apples, the clever psychopaths who cheated their way in, and those once-whole practitioners who slid down a slope into debauchery,” he declared out loud.

Sammy proudly announced his new position as a watchdog to Wesley Huntsman, a psychologist with whom he shared an office in downtown Santa Cruz.

“Sammy, you've been in California for only a year,” Wesley said, laughing. “You have no idea what' in store for you. Things are not always as you expect them to be.”

Wesley' response was not quite what Sammy expected. Vulnerable clients who come for emotional healing only to be gored instead must be avenged. He would willingly commit to becoming a zealous adjudicator of careers deserving to falter, his way of serving God and country.

March 15, 7:35 p.m.

Sammy settled into his seat on the 8 p.m. commuter flight out of the Monterey Peninsula Airport destined to arrive in Los Angeles forty minutes later. He opened his briefcase and scrambled for a magazine. A small stash of business cards tumbled into the aisle, only to be quickly retrieved by an attractive young woman who was about to take the seat across from his.

“Dr. Samuel Halsey, Psychologist,” she said, glancing at the cards before passing them back. “That' quite a racket, getting paid a buck fifty a minute to be entertained by loons.” Her disarming smile let Sammy know it was a friendly barb. But she did seem familiar with psychotherapy, though not apparently in a good way.

“Are you a mental health professional?” Sammy asked, knowing her answer would unlikely be in the affirmative.

“No, but I went through a rough spot a while back and saw a shrink. A psychiatrist. Didn't help me at all. He was so distracted and cancelled our appointments often. I decided to dump him. His name is Dr. Lettman. Do you know him?”

Sammy did indeed know Alvin Lettman, M.D. Al and his wife were among the first to welcome Elizabeth and him into the Santa Cruz mental health community soon after they arrived from Indiana to be closer to their two adult sons in San Jose. Al was ill even then, but his remarkable spirit kept him more active than many of his physically-fit peers. Now gone for six months, Sammy recalled how Al became pale, almost translucent, as the chemo wore him down. Sammy even suggested Al suspend his practice to enjoy friends and the beach until he regained his strength, knowing deep down his vitality would never return. But Al adamantly refused, insisting his patients needed him whenever he was able to make it into his office.

“Yes,” Sammy said to the pretty woman across the aisle. “I knew Al Lettman rather well. You must have been seeing him when he was very ill. He passed away last September.”

“Oh, my God!” she gasped. “He never said anything. I thought he was naturally skinny with pasty skin,” her voice breaking. “I just imagined he had better things to do than to care about me. I left a message saying I was done with him, and I wasn't polite. Now I feel guilty.”

Sammy assumed Al had been forthright with his patients, even preparing them for the inevitable and referring those who required longer-term therapy to colleagues.

“He should have said something,” Sammy muttered as the American Eagle commuter plane revved its engines and sputtered towards the runway.

This brief interlude with the pretty woman whose name he never caught made him aware of what he could confront over the next couple of days. A psychotherapeutic relationship requires the clarity of mutual understanding. Yet sometimes the client and therapist might as well be speaking in languages neither fully comprehends.

March 15, 9:05 p.m.

After an uneventful flight into the Los Angeles International Airport, Sammy stood on the busy island in front of the terminal. The endless stream of vehicles zipping by created a foul-smelling draft. “Nothing like Muncie, Indiana” he thought to himself, wondering how people could adapt to such unrelenting traffic and the stench of exhaust fumes. Almost half an hour later the Flyaway Service bus lumbered up to the curb to take passengers into the San Fernando Valley. Dr. Zev Levin, an Ethics Committee member who lived near the LCP office, would meet him at the Van Nuys terminal and drive him to a motel.

As Sammy stepped off the bus, he couldn't help but spot a small man with a large grin and a hand-printed sign reading “Looking for Sam” taped to a Dodger' baseball cap. Sammy waved and smiled, although he had expected to meet a far more austere-looking individual.

“Welcome to the land of cars and smog—our slogan is ‘If you can't see it, don't breath it,’” chirped Dr. Levin, slapping Sammy gently on the back. “Let' get your baggage and go for a drink. I'll fill you in before dropping you off at the Midnight Roach Motel where we so generously store our out-of-town members.”

“Sounds good, Dr. Levin, or do I call you Zev?” Sammy asked, hoping Dr. Levin was kidding about infestation.

“Call me Wolf. Zev means wolf in Hebrew. I like having the name of a wild animal. Makes me look taller.”

Wolf pulled up to the Blue Bubble Bar, a small pub on Ventura Boulevard. Inside were plastic spheres stuck to the ceiling and blue lighting that made everyone look seriously ill. Wolf wriggled his way up onto a stool.

“I like this place,” Wolf said glancing up at the ceiling. “The drinks aren't mostly water. Sam, name your poison and save us a place in the back where we can talk.”

“Gin and tonic. With ice.”

“Got it. My treat. You pay next time.”

Sammy settled into a small booth farthest from the buoyant chatter of patrons perched at the bar. He instantly liked Dr. Wolf Levin, even though he was almost the opposite of how he imagined an ethics committee member to be. Wolf was unceremonious and chatty and didn't seem to take himself too seriously. He guessed Wolf to be 45 or so, about the same age as himself. And despite his short stature, maybe five feet three inches, his personality created a much larger presence.

“Here ya go Sam.” Wolf hoisted up his glass of whiskey neat as if preparing a toast. “Welcome to the keepers of the rules. I thought you might want to know a little more about who will be in the bullpen tomorrow. Yes?”

“Absolutely,” replied Sammy, wincing upon taking the first sip. “Yikes, you are right about the drinks. Do they even put in tonic?” Wolf smiled as if to say “I told you so.” Sammy knew he dare not finish it lest he wake up with a headache or worse. He needed to be prepared to impress the others who protect the public from wrongdoers.

“OK, here goes,” said Wolf, licking his lips. “Let' start with our fearless leader, Dr. Victor Graham. He' a rock, keeps us on task, or at least tries to. We sometimes get like fish floating about aimlessly, bumping into each other, not going up for air. But Victor reels us in when we become swept up in some off-topic current or act like piranhas.”

“Sounds good,” said Sammy, reflecting back to Wesley Huntsman' warning about what was in store for him. “How about the others?”

“OK, next the ladies,” Wolf responded. “Stella Sarkosky is the grand old dame. You can figure her out just by her white hair piled high enough to make her look like the tallest person in the room, well now except for you. That you must be over six feet will piss her off. Be nice. She comes up from Del Mar. When she speaks, she expects us to listen. She' a wise soul, trained as a lay analyst. Sigmund Freud' daughter, Anna, was apparently one of her friends. We will be lucky if she reminds us of that only once.”

“Looking forward to meeting Stella. Should I stand stooped over?” Sammy asked in jest.

“Wouldn't hurt,” Wolf chuckled. “Next, Charlotte Burroughs is the kid of the group with no more than 32 birthdays to her name. She' a staff psychologist at a big clinic in San Bernardino. I forget the name. She became a new member last year and picked up on this role fast. She is a good soul but has a mouth on her if riled up, which is advantageous because Stella would take her over otherwise.”

Sammy nodded. “OK so far,” although he was already getting a different picture from what he expected of his new colleagues.

“Next, Ted Bates is our token humanistic psychologist. He' our own Rodney King, just wants everyone to get along. He usually gives both the accuser and the accused the benefit of the doubt, which can work out well when it works. But the debates can get sharp when one or the other has clearly been wronged. Thankfully we almost always reach a consensus, although most of the time someone has to compromise their position. Often enough it' Ted.”

“Finally, Archie Wittig is an African American in his early sixties I would guess. He doesn't speak up as often as the others, but when Archie chimes in he' always on target. He has a private practice linked up with a health maintenance organization.”

“Sounds like a good group,” said Sammy, wishing he could find a more inspiring response while struggling to realign the apparent reality with his preconceived notion of joining a board of stern, solemnly-focused individuals.

“You'll see soon enough. Let' finish our drinks and get you to the motel. We meet for breakfast at 7:30 a.m. sharp at Ting' Cafe on Reseda Boulevard, just a block from your room and a stone' throw from the LCP office. You'll get acquainted with the whole gang, then off to our first case.”

two

I'M NOT YOUR MONKEY

All psychotherapists will experience at least one client they find abrasive. The psychologist in the first story fails to set early limits on his client's hostilities and mismanages his negative feelings, resulting in a furious climax.

Dr. Roger Pegoris could not have received the letter requiring him to justify his fitness as a psychotherapist on a worse day. The washing machine overflowed the night before. He had yet to dry out the cat's bed and gather up the soaked contents of three slumped-over paper bags containing a week's worth of garbage. No soothing hug awaited him after a long day of listening to clients' spill out their emotional anguish. Jeannie would be in Missouri for yet another week tending to her terminally ill mother. Worse still, their 18-year-old son would walk through the door any minute after what was originally planned as a six-month crusade through the mid-section of South America des...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• About the Author
• Foreword
• Preface
• Acknowledgements
• Introduction: Self-deception and Red Flags
• Chapter 1 — Sammy Meets the Wolf
• Chapter 2 — I'm Not Your Monkey
• Chapter 3 — Junk Yard Therapy
• Chapter 4 — Rats!
• Chapter 5 — The John
• Chapter 6 — The Raid on Hollywood Boulevard
• Chapter 7 — Kill the Boss
• Chapter 8 — Broken
• Chapter 9 — Baby Steps Off a Cliff
• Chapter 10 — Car Crash
• Chapter 11 — Mad FAX
• Chapter 12 — The Star Catcher
• Chapter 13 — Vampire
• Epilogue
• Appendix A: Selected Ethics Resources for Mental Health Professionals and Consumers
• Appendix B: Actions Available to the Ethics Committee of the American Psychological Association
• Index