Incompatibility of Forensic and Therapeutic Roles - Essay Example

Incompatibility of Forensic and Therapeutic Roles Mental health specialists can frequently be invited to participate as forensic experts in litigation. Such engagement would demand from professionals serving dual roles and fulfilling dual responsibilities. Although such combination of roles is often viewed as acceptable, numbers of specialists argue that it will create a considerable conflict of interests and lead to negative outcomes. The given paper provides an account of arguments proving that forensic and therapeutic roles differ in fundamental ways which makes their successful combination impossible as far as fulfillment of one role is possible when the other is compromised. To start with, it is essential to differentiate between the responsibilities of two specialists under consideration in order to further realize incompatibility of their roles. A therapist is a person hired by a patient or a family of a patient with the aim of helping one to deal with a range of possible psychological problems by means of counseling and psychotherapy. In contrast, a forensic consultant or expert witness is invited by a representative of a legal process, such as judge or attorney to provide evaluations needed to aid criminal investigation. (Strasburger, Gutheil & Brodsky, 1997) As such, the main goal of forensic psychology is not to benefit a patient, but provide the legal case with information that would be helpful in resolving the issue. To this can belong the need to evaluate mental state of individuals with the focus on their competence, such as competency to stand trial and be executed, or evaluating their parental capacity or that of hold criminal responsibility. (Greenberg & Shuman ,2007) Services provided by each of the specialists are mutually exclusive to the great extent. Therapists are expected to be dedicated to the patients, taking their needs as the priority. The quality of their relationships is likely to be supportive, emphatic, and accepting. In contrast, expert witnesses serve their goal of providing assistance to the court and do not consider welfare of patients as a factor that can somehow influence their behavior. (Greenberg & Shuman ,2007) Correspondingly, forensic experts would normally distance from patients and prefer detached manner of collaboration. As a whole, while a therapist pursues “the medical goal of healing, forensic expert is required to work “towards the legal resolution of disputes”. (Strasburger, Gutheil & Brodsky, 1997)Therefore, the given difference would expose a specialist, who is trying to fulfill the two roles at the same time, to mutually exclusive choices concerning the nature of relationships with patients and priorities in work. A preferred decision will influence both objectives and outcomes of the services provided by an expert. A special attention should be paid at the fact that a therapist and forensic expert would have not only quite distinct but also mutually exclusive purposes in their work. To realize this, one has to think of who can be identified as a client in forensic and therapeutic scenarios. According to Heltzel (2007), a client is a party who pays for the service and, importantly, who can expect certain liability from the expert, such as working towards client’s benefits. A therapist’s client is a patient who can expect from his/her psychologist promotion of healing and improving quality of life by offering services related to behavior change, enlarging, personal responsibility, self-care, awareness, and other. (Covell & Wheeler, 2006; Heltzel, 2007) In contrast to therapist, who aims at the psychological purpose, forensic expert views representatives of the legal and court system, who in their turn serve society, as clients. Thereof, forensic expert fulfills social purpose. Realizing this distinction is important as a specialist trying to fulfill therapeutic and forensic roles would, ideally, have to find a balance between serving individual and a society, which is impossible due to several implications. Firstly, to meet therapeutic standards of care, a professional must value confidentiality when working with patients, which contradicts the purpose of forensic experts. Following the ethical code a therapist is expected to maintain confidentiality of a patient which belongs to the central principles of psychotherapy and a patient can expect them to be fulfilled when agreeing to be involved in therapist-patient relationships. (Heltzel, 2007) However, forensic counselors are obliged to break confidentiality and release their records upon the request of the legal representatives. (Hugaboom, 2002) According to Strasburger, Gutheil & Brodsky (1997), “a patient who puts his or her mental condition at legal issue and waives privilege, losses privacy” and it can undermine the previous confidential relationships with psychotherapist. The following constitutes a considerable argument against the idea of combining the two roles as far as, again, their specifications contradict one another and an attempt to mix them would necessarily demand to compromise objectives of either of the roles. Furthermore, exposure of anonymous information about psychotherapist can also be a cause of an end of the existing relationships with a patient. As it is explained by Strasburger, Gutheil & Brodsky (1997), anonymity that “aids in the development and interpretation of transference” and helps to make “clinically useful projections onto the therapist” is likely to be compromised by the legal procedure. Namely, it is impossible to predict the reaction of a patient on his/her therapist witnessing about both the testimony and clinician’s personal information, professional background, or character. Subsequently, there are enough reasons to predict that it would be impossible to reestablish proper and effective patient-therapist relationships with the patient after meeting the requirements as a forensic expert. Secondly, providing forensic testimony a therapist becomes involved in a situation in which he/she can cause harm to a patient. Ethical principles and code of conduct of psychologists contains that in their work they should “take reasonable steps to avoid and minimize harming clients and others with whom they work.” (Heltzel, 2007) In contrast, providing forensic testimony is not directed at preserving beneficence of the patient, but conducted for the sake of legal procedure. Subsequently, when invited as an expert, a therapist by his/her actions can cause harm to the patient revealing facts without any regard of the legal consequences it would bring. (Greenberg & Shuman ,2007) As a result, a person subjected to evaluation can suffer in terms of affected self-esteem, loss of social status, liberty, or even life. The following is also true for the informed consent, which should be preserved by a therapist and forensic expert, yet, an attempt to acquire it for therapeutic and forensic goals would force a specialist to take two inconsistent and mutually exclusive positions. Therefore, a therapist’s duty of non-maleficence and acting on behalf of patient’s well-being would inevitably stay in a conflict with the duty of forensic expert to give truthful and accurate testimony. Apart from that, the fact that the two roles cannot be successfully combined is also proved by the range of adverse consequences that can be generated. For instance, analyzing implications of therapeutic and forensic roles for sex offender specialists, Covell & Wheeler (2006) argue that a failure to maintain separation can threaten success of a therapy in a variety of possible ways, such as undermining willingness of clients to provide information that could be used for either therapeutic “intervention or accurate evaluation”. (Covell & Wheeler, 2006) The lack of client’s trust as well as intentional desire to fabricate therapist’s opinion can play their role, in this context. A negative outcome of the attempt to perform forensic and therapeutic roles can be a professional failure and inability to fulfill all the requirements of a role. The nature of psychotherapy demands investigation of meaning and evaluating narrative truth while forensic aims at facts without regarding any biases and misconceptions of a patient. “The achievement of an insight – one of the major goals of psychotherapy is not a fact-finding mission and cannot be reliably audited by an external source.” (Strasburger, Gutheil & Brodsky, 1997) It appears that while a therapist would work towards comprehension of patient’s subjective perception of reality and his/her inner state, a forensic examiner must aim at making objective evaluations. Otherwise, the court would not possess enough plausible data and evidences to decide a case. Putting it in other words, findings and evaluations of a therapist would have little or no value for the legal process that strives for objectivity and facts – essential properties of a proof. Moreover, being invited to accomplish forensic goals, a therapist can oversee important aspects of patient’s testimony and “fail to diagnose malingering.” (Strasburger, Gutheil & Brodsky, 1997) A shift from skeptical and questioning attitude to emphatic and believing would be the cause of the failure. Moreover, the need to preserve demands of both roles can put too much pressure on a therapist, which he/she can be unable to successfully put up with. Requirements and laws that guide behavior of specialists who fulfill dual roles vary from state to state. It includes also envision of conditions that demand to testify against client, such as when it is impossible to avoid causing harm to third parties otherwise, and allow not to. The last touches upon the cases when the information to be disclosed is privileged, meaning it was shared confidentially as a part of therapist-client relationships. (Hugaboom, 2002) It follows that a therapist must be able to adequately analyze the possible consequences of information he/she possesses and make decisions regarding testifying against client or on his behalf, what information should be disclosed and what should not. By this, every decision must follow ethical and legal standards for the therapist not to be accused of either breaking the law or professional guidance. Such circumstances may bring negative outcomes, including unfair detention of a patient and imprisonment of a therapist. (Hugaboom, 2002; Covell & Wheeler, 2006) Although under different circumstances a specialist may face the need or requirement to overtake both roles at the same time, a sufficient amount of scientific literature provides a strong rationale for avoiding such endeavors. Forensic and therapeutic roles are incompatible and an attempt to juggle with them would eventually lead to a list of adverse effects. Among the expected ones should be named significant decrease of efficiency of either one of the roles or both, which is caused by initially opposite objectives of forensic and therapeutic roles and their different implications. It appears that a specialist would be forced to resolve professional and ethical dilemmas and make mutually exclusive choices. The following is, obviously, inconsistent with the need to perform dual roles. Great amounts of scientific literature stress and provide strong ground for maintaining distinction between forensic and therapeutic roles. References Greenberg, S., & Shuman, D. (2007). When worlds collide: Therapeutic and forensic roles. Professional Psychology: Research and Practice, 38(2), 129–132. Strasburger, L., Gutheil, T., & Brodsky, A. (1997). On wearing two hats: Role conflict in serving as both psychotherapist and expert witness. The American Journal of Psychiatry , 154(4), 448-456. Heltzel, T. (2007). Compatibility of therapeutic and forensic roles. Professional Psychology: Research and Practice, 38(2), 122–128. Hugaboom, D. (2002). The different duties and responsibilities of clinical and forensic psychologists in legal proceedings. Undergraduate Review: A Journal of Undergraduate Student Research , 5(4), 25-32. Retrieved from http://fisherpub.sjfc.edu/cgi/viewcontent.cgi?article=1121&context=ur Covell, C., & Wheeler, J. (2006). Revisiting the ‘irreconcilable conflict between therapeutic and forensic roles’: Implications for sex offender specialists. American Psychology-Law Society, 26(3), 7-10. . Read More