Top 3 Trouble Spots for Psychologists and Therapists

Our firm sees a lot of psychologists and licensed therapists who are in trouble with the Florida Department of Health (DOH). In handling so many cases, some patterns start to emerge. As the saying goes, an ounce of prevention is worth a pound of cure, so here are the top 3 issues that we see among psychologists and therapists:

1. Improper Relationships with Clients

Most of the time, it’s obvious when the provider is having an improper relationship with a client, such as in cases with sexual misconduct (I’ve written about sexual misconduct in the therapist-client relationship HERE). However, sometimes it’s not so obvious. Our firm has seen cases where the psychologist/therapist was disciplined for getting “too close” with the client.

The Florida Administrative Code, 64B19-16.003(2) states:

“It shall constitute sexual misconduct for a psychologist, who is involved in a psychologist-client relationship, to engage, attempt to engage, or offer to engage the client in sexual intercourse or other sexual behavior. Sexual behavior includes, but is not limited to, kissing, or the touching by either the psychologist or the client of the other’s breasts or genitals.”Florida Administrative Code, 64B19-16.003(2)

The therapist-client relationship is emotionally charged by nature, so it can be hard to gauge when you’re getting “too close.”

Here are some tips to avoid making this mistake:

• Don’t over-share with your client. Especially regarding any mental health treatment that you may be receiving yourself.
• Don’t text your client. Ideally, you should be using a secure messaging system, not texting, if you need to message your client. If you do need to text, keep the conversation to procedural issues only, such as scheduling. If your client starts to discuss substantive treatment concerns, politely redirect. “That sounds very serious. We should certainly discuss it during our session next Tuesday.”
• Avoid socializing with clients outside of the treatment setting. If you discover that you and a client frequent the same place, it’s your responsibility to make sure the relationship stays professional and confidential. This could mean that you’ll need to find a different grocery store, church, gym, bar, or therapy group. Inconvenient, but it could save you from serious issues with DOH.

2. Failing to Properly Document Treatment

No one likes paperwork, but proper documentation of treatment can save your license. 

Florida law requires that you document treatment accurately and contemporaneously. That means taking good notes and filing them away soon after the treatment session has ended (same day is best). If you handwrite notes, make sure they are legible.

Note: DOH has disciplined providers for failure to document because of illegible handwriting. If you’re like me and hopelessly write in chicken scratch, switch to typing your notes.

3. Testifying in Court

If you’re a psychologist or therapist who works as an expert witness, getting complaints against your license comes with the territory. Unscrupulous lawyers and angry clients will try to wield DOH as a weapon against you.

There are ways to defend yourself, here are some tips:

• Document, document, document. Get everything in writing. From treatment notes to correspondence with lawyers, to judges’ orders.
• Be prepared. We’ve seen psychologists and therapists get disciplined for failing to properly prepare before they give testimony or write a report. Make sure you’ve reviewed all relevant documentation before you render an opinion. If the lawyer is asking you to cut corners, don’t do it.
• Stay in your lane. Don’t let lawyers, clients, or even judges pressure you into giving an opinion that you’re not qualified to give. This includes questions regarding individuals that you did not have the opportunity to evaluate.