On wearing two hats: role conflict in serving as both psychotherapist and expert witness

Strasburger, Larry H.; Gutheil, Thomas G.; Brodsky, Archie

doi:10.1176/ajp.154.4.448

Cited by 216 publications

(21 citation statements)

References 29 publications

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“…In 2011, Christopher et al showed in a comparative study the importance of not fulfilling both duties towards the same individual, even in the civil domain, in order not to be drawn into a dual-agency conflict [ 62 ]. Depending on the type of function he fills, the position of the forensic psychiatrist towards the patient and towards society is not similar [ 18 , 63 ]. As a consequence, his ethical priorities are not identical [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

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Forensic psychiatry, one subspecialty with two ethics? A systematic review

Niveau

Welle

2018

BMC Med Ethics

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BackgroundForensic psychiatry is a particular subspecialty within psychiatry, dedicated in applying psychiatric knowledge and psychiatric training for particular legal purposes. Given that within the scope of forensic psychiatry, a third party usually intervenes in the patient-doctor relationship, an amendment of the traditional ethical principles seems justified.ResultsThus, 47 articles, two book chapters and the guidelines produced by the World Psychiatric Association, the American Association of Psychiatry and the Law, as well as by the Royal Australian and New Zealand College of psychiatrists, were analyzed. The review revealed that the ethics of correctional forensic psychiatry and those of legal forensic psychiatry do not markedly differ from each other, but they are incongruent in terms of implementation.MethodsIn an effort to better understand which ethical principles apply to forensic psychiatry, a chronological review of the literature published from 1950 to 2015 was carried out.ConclusionThe ethics of correctional forensic psychiatry are primarily deontological. The principle of justice translates into the principle of health care equivalence, the principle of beneficence into providing the best possible care to patients, and the principle of respect of autonomy into ensuring confidentiality and informed consent. The ethics of legal forensic psychiatry are rather consequentialist. In this latter setting, the principle of justice is mainly characterized by professionalism, the principle of beneficence by objectivity and impartiality, and the principle of respect of autonomy by informed consent. However, these two distinct fields of forensic psychiatry share in common the principle of non maleficence, defined as the non collaboration of the psychiatrist in any activity leading to inhuman and degrading treatment or to the death penalty.

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Section: Discussionmentioning

confidence: 99%

“…From an ethical perspective, a psychiatrist may satisfy both functions of legal forensic and correctional forensic psychiatrist, but cannot fulfill simultaneously the two duties on the same individual [ 18 , 63 ]. Legal Psychiatry and correctional psychiatry are distanced from one another by ethical principles.…”

Section: Discussionmentioning

confidence: 99%

Forensic psychiatry, one subspecialty with two ethics? A systematic review

Niveau

Welle

2018

BMC Med Ethics

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“…When evaluating a claim for financial compensation for psychological injury, legal decision makers often rely on information provided by a psychological expert (Cutler & Kovera, 2011 ). Although several authors have argued that therapists should refrain from engagement in forensic evaluations (e.g., Strasburger, Gutheil, & Brodsky, 1997 ), this is usually a psychologist or psychiatrist who treats the victim for his or her psychological injuries. Only when information from a therapist is lacking or doubted, an independent psychological expert is consulted.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Reliability of Expert Evidence in Compensation Procedures: Are Diagnosticians Influenced by the Narrative Fallacy when Assessing the Psychological Injuries of Trauma Victims?

Kunst

Wiel

2016

Psychol. Inj. and Law

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The current study investigated whether mental health practitioners are influenced by the narrative fallacy when assessing the psychological injuries of trauma victims. The narrative fallacy is associated with our tendency to establish logical links between different facts. In psychodiagnostic assessments, this tendency may result in overdiagnosis of mental disorders when psychological symptoms can be attributed to a traumatic event. Consequently, legal decision makers may be at risk of awarding compensation for psychological injuries which are not severe enough to justify financial reimbursement. To explore this topic, we asked Dutch mental health practitioners whether they would assign a diagnosis of mental disorder to fictitious symptoms of psychological injury. Each participant was presented with two vignettes. The first vignette described symptoms in terms of a generalized anxiety disorder; the second in terms of a major depressive episode. The vignettes varied in the cause (trauma versus cause not specified) and severity (near threshold of DSM diagnosis versus below threshold of DSM diagnosis) of the symptoms. Results indicated that participants more often assigned a diagnosis of mental disorder if the psychological symptoms had been caused by a traumatic event than if that had not been the case. Further analysis of the data suggested that this difference was due to the high numbers of assigned diagnoses of posttraumatic stress and acute stress disorder in the trauma conditions. It was speculated that participants filled in missing information to justify the assignment of such diagnoses, for example by imagining symptoms of intrusion and avoidance.

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“…The situation is delicate because the forensic field differs from many other areas ( Rogers, 2000 ). For example, in a clinical field, a “inadeguate assessment” can be corrected afterward by psychologists or by others, but within forensics, the technical advice cannot be modified subsequently, and can therefore mislead the judge, with serious consequences for the freedom or the health of a third party ( Greenberg and Shuman, 1997 ; Strasburger et al, 1997 ; Wiener et al, 2002 ). From this we can understand the foregone conclusion of how important it is to have a strong commitment to the epistemological framework, and be explicitly aware of the assumptions and expectations underpinning the methods used ( Walker and Woody, 2011 ; McAuliff and Bornstein, 2012 ; Iudici and Renzi, 2015a ).…”

Section: Introductionmentioning

confidence: 99%

The Clinical Assessment in the Legal Field: An Empirical Study of Bias and Limitations in Forensic Expertise

et al. 2015

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According to the literature, psychological assessment in forensic contexts is one of the most controversial application areas for clinical psychology. This paper presents a review of systematic judgment errors in the forensic field. Forty-six psychological reports written by psychologists, court consultants, have been analyzed with content analysis to identify typical judgment errors related to the following areas: (a) distortions in the attribution of causality, (b) inferential errors, and (c) epistemological inconsistencies. Results indicated that systematic errors of judgment, usually referred also as “the man in the street,” are widely present in the forensic evaluations of specialist consultants. Clinical and practical implications are taken into account. This article could lead to significant benefits for clinical psychologists who want to deal with this sensitive issue and are interested in improving the quality of their contribution to the justice system.

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On wearing two hats: role conflict in serving as both psychotherapist and expert witness

Cited by 216 publications

References 29 publications

Forensic psychiatry, one subspecialty with two ethics? A systematic review

Forensic psychiatry, one subspecialty with two ethics? A systematic review

Evaluating the Reliability of Expert Evidence in Compensation Procedures: Are Diagnosticians Influenced by the Narrative Fallacy when Assessing the Psychological Injuries of Trauma Victims?

The Clinical Assessment in the Legal Field: An Empirical Study of Bias and Limitations in Forensic Expertise

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