Thomas G. Gutheil, MD

Evaluating a new framework for evaluating undue influence and its implications for elder abuse and human trafficking cases.

How can we more effectively evaluate undue influence? Here are methodologies and findings for research into a new framework that may help victims of undue influence find justice.

How can we evaluate undue influence to get justice for victims of cults and other exploitation situations?

Candid examples from psychotherapy and supervision makes this book by Jerome S. Gans, MD, a useful and enjoyable book for mental health professionals.

What 6 things are important to keep telemedicine practice running smoothly?

When meeting patients online, mental-health practitioners must confront a host of issues.

The points summarized in this pocket guide-drawn from actual cases-recur repeatedly as problems for practitioners.

Cases that come to our attention as malpractice claims, ethics claims, or Board of Registration complaints raise the question: why did the treating clinician not terminate the treatment before things got so out of hand?

Psychotherapists have fiduciary power and-from a risk management perspective-the clinician must act in a manner in which misconduct cannot be inferred. In terms of boundary violations, some preventative measures (like psychodynamic education) can be taken.

Here we address some of these problems of meaningless phrasing, empty shells, and template-distorted recording in an attempt to improve clinical documentation for both clinical care and risk management.

In this podcast, Dr Thomas Gutheil talks about a key challenge facing psychiatrists. . . valid medical record keeping. Here: important tips from an expert based on an article he coathored with Dr Robert Simon.

Here is a “pocket guide” for clinicians drawn from actual cases. With some modification, the list could become a patient information sheet or office policy.

This letter constitutes my formal resignation from the American Psychiatric Association.

The issue of self-disclosure in psychotherapy is one of complexity and some evolution.1-16 Most discussions about the practice refer to boundary questions because self-disclosure by the therapist to the patient is a boundary issue. Self-disclosure has, of course, a number of dimensions, including clinical, therapeutic, technical and-in some cases-legal or regulatory. Despite the rich and interesting clinical issues relating to self-disclosure (outlined in Gutheil and Brodsky1), the focus of this article is on the ethical aspects of self-disclosure.1,15,16 Of necessity, the discussion centers on the more exploratory forms of psychotherapy, such as dynamic therapy, rather than on behavioral therapies, co-counseling, substance abuse treatment, or pharmacological treatment.

I am writing to correct several inaccurate assertions in the essay, “The American Psychological Association and Detainee Interrogations: Unanswered Questions” (Psychiatric Times, July 2008, page 16), by Kenneth S. Pope, PhD, and Thomas G. Gutheil, MD.

News accounts and court records of detainee interrogations in such settings as the Guantnamo Bay detainment camp and the Abu Ghraib prison have sparked controversy over involvement of mental health professionals and behavioral scientists. Authors of articles in medical, psychological, legal, and scientific journals have struggled with complex ethical questions about psychiatrists and psychologists who participate in planning or implementing detainee interrogations.

In the historical context of American psychiatry, the concept of boundaries is a relatively recent development.1 Freud reportedly analyzed some patients while walking along the river Danube, gave patients gifts, and was known to share a meal with a patient.

What are the qualities of forensic psychiatry? In reviewing the basis on which forensic psychiatry is defined as a specialty or, more accurately, a subspecialty of psychiatry, the author discusses the altered relation between physician and "subject," the consultative role in relation to the legal system, and the areas of specialized knowledge and skills that attend the field.

What is a psychiatric expert and how does their role differ from that of the clinician? What must you consider before deciding to serve as an expert witness?

It is relatively recent that boundary issues in clinical practice have attained professional awareness, although some early concepts portended the issue. Several decades ago, for example, the term boundary violations referred almost exclusively to what we now term sexual misconduct.