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Biomedical subjects

Thomas G Gutheil

Publications and source records attributed to Thomas G Gutheil.

14 recordsLinked to original sources
PubMed2003

This couldn't happen to me: boundary problems and sexual misconduct in the psychotherapy relationship.

Drawing on their own consultative experience illustrated by case vignettes and with support from the professional literature, the authors discuss the perennial problematic issue of boundary violations and sexual misconduct, aiming at an audience of both experienced and novice clinicians. The authors review the difference between boundary crossings and boundary violations and stress the therapist's responsibility to maintain boundaries. Therapist risk factors for violations include the therapist's own life crises, a tendency to idealize a "special" patient or an inability to set limits, and denial about the possibility of boundary problems. Factors exacerbating patient vulnerability, such as overdependence on the therapist, seeking therapy to find an intense relationship or even "true love," and the acceptance by childhood abuse victims of an abusive therapy relationship, are discussed. Consultation and education-for students and for clinicians at all levels of experience-and effective supervision are reviewed as approaches to boundary problems.

Confidentiality↗
PubMed2003

Stress and the forensic psychiatrist: a pilot study.

What are the sources of perceived occupational stress, and how troublesome are they to forensic psychiatrists? To examine these questions 1,800 90-item questionnaires were sent to the membership of AAPL. The questions explored what experiences forensic psychiatrists found most stressful and the degree of stress experienced. Three hundred seventy-two questionnaires were returned. On average, individuals rated the stress in their overall forensic practices as relatively low. Certain situations, however, were found to be highly stressful. Five of the most stressful aspects of forensic practice in this sample were: (1) fear of not being able to defend an opinion during cross-examination (63%); (2) fear of the prospect of disclosure of one's own content-related personal history (53%); (3) working with short deadlines (49%); (4) testifying while physically ill (43%); (5) stress from a retaining attorney's attempts to coerce an opinion (43%). An awareness of these matters may give guidance to people who are considering becoming forensic psychiatrists and may facilitate the management of stress.

Conflict, Psychological↗
PubMed2003

Avoiding ipse dixit mislabeling: post-Daubert approaches to expert clinical opinions.

Recent Supreme Court decisions emphasize the need to regulate the admissibility of expert testimony by means of standards that require opinions to go beyond ipse dixit--that is, that are based on more than the fact that the expert said it. The authors discuss subtextual themes underlying this issue and suggest approaches to attaining expert clinical opinions that reduce the likelihood of being mislabeled as ipse dixit contributions. The approach involves providing substantiation of testimony by offering a reliable methodologic basis for communicating the relevant opinion in a thoughtful and intellectually rigorous manner. A model is offered, emphasizing a process approach to opinion formulation and reformulation prior to deposition and trial. This approach addresses not only the Supreme Court's current focus on moving expert opinion beyond ipse dixit, but also such concerns as possible distortions of an expert opinion in the adversarial process. Since judicial determinations may vary depending on many factors, however, even the most careful process of opinion formulation cannot guarantee admissibility. The article assumes a general familiarity among forensic readers with the Federal Rules of Evidence and the recent series of Supreme Court decisions in this area.

Expert Testimony↗
PubMed2002

Non-sexual boundary crossings and boundary violations: the ethical dimension.

The ethical principles relative to nonsexual boundary issues derive from the first principle of respect for the dignity of the patient. Using a case vignette, the authors have explored the mutual derivation and inter-relations of these principles, with clinical approaches to patient care. Clinicians should be aware of the ethical underpinnings of sound therapeutic techniques that manifest respect for the patient.

Guidelines as Topic↗