A Joural article review:Recommendations for Risk-Management Practices

Reviews a journal article: Kennedy, P. F., Vandehey, M., Diekhoff, G. M., & Norman, W. B. (2003). Recommendations for Risk-Management Practices. Professional Psychology: Research & Practice, 34(3), 309.

Debra Roberts                                    COUN 501 Journal Summary #1

Jimmy Kyle Myer                  October 29, 2008

Kennedy, P. F., Vandehey, M., Diekhoff, G. M., & Norman, W. B. (2003). Recommendations for Risk-Management Practices. Professional Psychology: Research & Practice, 34(3), 309.

 

Are you at risk for having an ethical complaint or malpractice suit filed against you? Four professionals in the Psychology Field,  Kennedy, Vandehey, Diekhoff,  & Norman identified eight reasons why health professionals should be concerned and provide ten recommended simple risk-management practices that can be implemented to reduce the likelihood of a successful outcome in regard to a complaint.

The first reason why clinicians should be concerned about receiving a complaint or being a party to a suit discusses the effects on clinicians. It is very stressful and emotionally draining to deal with. The business and home life are both affected.  Many who had dealt with a complaint experienced emotional, physical, sexual and marital problems to name a few. 

The second is in regard to the time factor.  Having to deal with a complaint or malpractice suit can result in many hours taken away from a practice.

The third reason found that due to a complaint an ethical review or state board might monitor or restrict a practice. A serious complaint might result in probation, losing one’s license, required psychotherapy as well as suffering relations with fellow colleagues.

The fourth is money related, there are financial costs and practitioner’s liability insurance might be affected. If there is no insurance, settlement amounts would have to be paid out of pocket.  The average that was paid to plaintiffs was around $70,000. The other fees that were paid were for psychological consultation and legal costs that ranged from $0 to roughly $33,000. 

1.      Clinicians might lose their insurance or the premiums could be increased if found guilty.

2.      Income is affected when clinicians name is removed from insurance panels.

3.       Negative experiences are reported by practitioners who had received complaints.  Many said they were handled in an abusive and unfair manner and treated as though they were already found guilty. 

4.      Most of the clinicians who had complaints filed against them were found to be innocent of any wrong doing.

Even though they were found to be innocent consider all the grief they were forced to endure. Therefore it would be wise to be familiar with ways to deter the complaints. The following suggestions were derived from a Texas pilot study done on day-to-day risk-management practices as well as profession related literature.

The references they provide are not in depth and the details of how they found the information is vaguely stated. The authors reviewed professional literature in their field and identified  8 very good points that would be of great interest and great importance. It was discovered:

1.      Risk-Management workshops need to be attended on a semi-regular basis due to new laws and standards being enforced.

2.      Include treatment contracts that outline fees, practice standards, confidentiality agreements and other important legal information. Make sure they are agreed to and signed by the client.

3.      Include a suicide assessment for all new clients.

4.      Note diagnosis code and update if it changes. Report information properly to insurance companies, 7% of complaints handled by the APA is related to fees and insurance (p. 310).

5.      Well written and thorough session notes that include diagnosis, treatment plans and progress notes are vital.

6.      Read and assess client files prior to sessions. This practice will refresh a clinician’s memory and bring important information to the forefront that can be beneficial during their session.

7.      Call all no show appointments, reschedule and document.

8.      Document when therapy comes to an end and note any referral sources provided.

9.      Dual relationships are not ethical and should be avoided especially when elements of power come into play.

10.  Collaborate with a colleague on tough cases especially any involving suicide ideation. Keep detailed notes in regards to whom you spoke to and what was discussed.

The first thing I noticed in regards to this article is, one of the authors was from my home state of Texas. But I chose to read this article because I am responsible for helping manage a counseling office and it appealed to my customer service mentality. Just the other day one of the clinicians in our office shared she was “scared to death” of receiving a complaint and the article is directly related to that subject.   Since joining this class and reading the ethics textbook I realized our therapists were not following all the suggested guidelines. Due to this article I discovered where loop holes in our practice are and where changes need to be made.

I plan on presenting this review during our next supervision session and recommending that the suggestions in this article be implemented. The first recommendations I will make will be in regards to including a suicide assessment as well as having a more detailed informed consent and confidentiality clause. I plan on doing research and finding examples on both that can help benefit our office.  This article has proven to be very helpful and informative and I have no doubt the therapists in my office will be grateful for the wisdom I will be able to share because of it. The risk-management practices recommended in the article will be helpful to a Texas counseling office and hopefully prevent complaints and malpractice suits.

Author's Note

Written for an Ethics class my second semester of Grad School at Liberty University