Red Flags in Psychotherapy This book delves into risks that can easily bedevil any psychotherapist and what can happen if they are ignored. Dramatic storytelling, based on actual incidents from the author’s experiences as a member of ethics committees and as an ethics teacher and consultant, explores actions that may prompt clients to fi le formal complaints. Set in the context of an ethics committee meeting over the course of a weekend, twelve psychologists face their peers who will stand in judgment. Issues include the fallout from losing one’s temper with a diffi cult client, a per- sonal disclosure gone terribly wrong, a bartering arrangement that literally falls apart, a private life revealed in a most public way, a vengeful act that sullies the reputation of an entire department, breaking confi dentiality when a client threatens harm, and the slippery slope to sexual exploitation. T he stories are absorbing, enlightening, sometimes shocking, and often stran- ger than fi ction. Narrative nonfi ction puts human faces and emotions on what would otherwise be cursory statistics. What led to the formal complaint, from the vantage point of both the complainant and the psychologist, offers insights not otherwise available unless the challenges agitating their lives leading up to the confl ict are revealed. An author’s commentary and discussion questions follow every story. Both new and seasoned practitioners, as well as those still in training, will fi nd this to be an invaluable resource. Patricia Keith-Spiegel , Ph.D., is the Voran Honors Distinguished Professor of Social and Behavioral Sciences Emerita at Ball State University, where she was the director of the Center for Teaching Integrity. She was a member of the Ethics Committee of the California State Psychological Association and was also on the Ethics Committee of the American Psychological Association for six years, serving two terms as Chair. This page intentionally left blank Red Flags in Psychotherapy Stories of Ethics Complaints and Resolutions PATRICIA KEITH-SPIEGEL First published 2014 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2014 Taylor & Francis The right of Patricia Keith-Spiegel to be identifi ed as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. Library of Congress Cataloging in Publication Data Keith-Spiegel, Patricia. Red fl ags in psychotherapy : stories of ethics complaints and resolutions / Patricia Keith-Spiegel. pages cm ISBN 978-0-415-83338-7 (hardcover : alk. paper) — ISBN 978-0-415- 83339-4 (pbk. : alk. paper) 1. Psychotherapists—Professional ethics. 2. Psychotherapy—Moral and ethical aspects. 3. Therapist and patient. I. Title. RC455.2.E8K45 2014 174.2’9689—dc23 2013012103 ISBN: 978-0-415-83338-7 (hbk) ISBN: 978-0-415-83339-4 (pbk) ISBN: 978-0-203-50611-0 (ebk) Typeset in Minion by Cenveo Publisher Services Please visit the eResources website at www.routledge.com/9780415833394 To the spirited and wise colleagues with whom I have served on ethics committees. This page intentionally left blank Contents About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix Foreword by Gerald P. Koocher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii How and why the stories came to be Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Introduction: Self-deception and Red Flags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Early warning signs that psychotherapists may be going off course Chapter 1 — Sammy Meets the Wolf . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Meet the characters who will decide the cases Chapter 2 — I’m Not Your Monkey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Loss of control with a diffi cult client Chapter 3 — Junk Yard Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Self-delusion and exploitation Chapter 4 — Rats! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 Warring colleagues Chapter 5 — The John . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 A predator at work and play viii Contents Chapter 6 — The Raid on Hollywood Boulevard. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 The professional role vs. the right to a private life Chapter 7 — Kill the Boss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111 When clients threaten physical harm Chapter 8 — Broken . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132 Bartering gone bad Chapter 9 — Baby Steps Off a Cliff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149 The slippery slope to sexual exploitation Chapter 10 — Car Crash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170 A simple disclosure with unforeseen consequences Chapter 11 — Mad FAX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181 What not to do when clients don’t pay Chapter 12 — The Star Catcher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195 The undoing of a troubled psychotherapist Chapter 13 — Vampire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214 Countertransference exploding Epilogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 A transformed Dr. Halsey goes home Appendix A: Selected Ethics Resources for Mental Health Professionals and Consumers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Appendix B: Actions Available to the Ethics Committee of the American Psychological Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 About the Author Patricia Keith-Spiegel is a winner of the California State University Trustee’s Outstanding Professor Award across all campuses and disciplines and of the American Psychological Foundation’s Distinguished Professor Award. She credits these honors largely to the power of storytelling, a technique she used through- out her 34 years of teaching ethics classes to both university students and profes- sional psychotherapists. Although she has authored many books and articles on ethical standards and practice, this is her fi rst work sharing full-length stories about how ethics complaints arise between psychotherapists and clients or others with whom they work, and how they are eventually resolved. The stories are adapted from actual incidents. Dr. Keith-Spiegel is the Voran Honors Distinguished Professor of Social and Behavioral Sciences Emerita at Ball State University where she was Director of the Center for Teaching Integrity. She was also Professor of Psychology at the California State University, Northridge, and a Visiting Professor of Psychology at Harvard Medical School. She was a member of the Ethics Committee of the California State Psychological Association and served six years, two terms as Chair, on the Ethics Committee of the American Psychological Association. She and her husband currently reside in San Jose, California.