I wish it had happened only one time, but unfortunately, that wouldn’t be the truth. Several dozen times over my career, I’ve been asked to assess a case for a business, school or lawsuit in which someone from the mental health community has written a letter on behalf of a client. That letter, too frequently, has turned out to be a disaster.
One letter I reviewed for a company in a lawsuit was from a psychologist. The clinician wrote a two-page letter full of her feelings about the client, but it did not address in a simple sentence the one thing requested by the employer. The letter couldn’t have been worse.
(Author note: Some information has been changed in each of these cases to protect the identities of those involved.)
In another case, also a lawsuit, the plaintiff’s clinician stated that she had “never” suffered from depression, which was a point of contention in the suit. There is no way this clinician could have supported that statement unless she had been the person’s clinician since birth.
One of my colleagues was about to provide a letter to the court on behalf of his adult male client. The man had been his client for some time as my friend helped him through the early stages of divorce. The man’s attorney asked for a letter stating that the man was a good father.
As was the case in the previous example, my friend couldn’t have truly known whether the man was a good father. He had never worked with the man’s children or observed him in a parenting role. Beyond that, my friend had no expertise in child custody. Testimony here would have been a huge mistake.
And here is one more example: A clinician agreed to give a deposition for her adult female client. The clinician had worked with the woman for a very long time and knew her well. She wanted to help the woman, who had sued her employer for harassment and disability. The clinician presented no doubt that returning to the workplace would have been damaging to the woman’s trauma recovery.
However, at the deposition, the attorney for the employer cornered her, and the clinician was forced to admit she had no real training in trauma, no experience in workplace disability, and had only the woman’s word for what had occurred — facts that became even more clear in the deposition.
As a result, the client lost her lawsuit against the employer and, even worse, felt betrayed by her clinician and withdrew from therapy.
It is because of situations such as these that many clinicians choose not to do this type of advocacy for clients. While we are bound by counselor ethics to be our clients’ advocates “when appropriate” (see Standard A.7.a. of the 2014 ACA Code of Ethics), our ethics do not specify how we are to do that. If you choose not to engage in court, school or workplace advocacy, it should be stated in your informed consent.
As my vignettes above illustrate, there are many hazards associated with advocacy, but those risks alone shouldn’t stop you. If you choose to advocate for your client, here are three simple rules.
Rule 1: As was presented by Jean Peterson in a 2017 article for Counseling Today, you must be clear whether you are “testifying” (either in court or in a business setting) as an expert witness or as a fact witness. As an expert, you can provide an opinion, but it must be based on your expertise (see Rule 2). As a fact witness, you are testifying only to what occurred. For example, “The client has kept all appointments as required by the employer.”
Rule 2: Never step outside your area of expertise and training. If you have expertise and are called as an expert witness, state your case. But if you are asked about something that requires you to move outside that area, do not comment.
Rule 3: If you are going to provide a letter or deposition for a client as their advocate, always get the opinion/oversight from someone with experience. Having legal counsel would be wise as well.
Summary: Most of the mistakes made in the anecdotes in this article are related to two issues. First is that we want so much to help our clients that we don’t think about the ramifications of what we might be getting into. Second, most clinicians don’t have any training in advocating for clients, and CE opportunities in this area are rare. As a result, most clinicians simply don’t know what they are doing. So, be careful.
Salivanchuk Semen/Shutterstock.com
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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.
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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.
Professional ethical guidelines for counselors in the State of Ohio if nowhere else, makes the distinction between providing therapy for a client and offering an assessment or evaluation, making the clinician’s role in that case that of an examiner.
The problem develops when the clinician in question becomes both therapist and examiner–the ethical boundary is breached. The clinician cannot ethically provide both services, certainly not at the same time.
Good call Lenny. Clearly you were well trained in Ethics!
Thank you for the timely reminders regarding professional boundaries, expertise and competence, as well as the impact of emotional connections with clients who seek professional advocacy. While wanting to support our clients, clinician’s often stray over the line toward “expert” rather than “fact” witness roles. As a clinical supervisor, I often remind therapists to remember “How do we know what we know?” Was it witnessed directly, or just “reported” to us. That particular distinction is often a helpful reminder of where our boundaries lie.
I am so thankful for this article. I have been searching and searching for information that will help me understand my scope, how to advocate for a client, who has asked me to write a letter on her behalf. I am still trying to find information about the consent documentation needed: Do I create a consent doc that specifies that the client consents to me writing the letter and bullet point the facts to be in the letter, such as appointment dates, type of counseling (e.g. CBT etc.) goals, progress etc. and the consent includes sending the letter to her lawyer? But then what about the lawyer presenting the letter in court? Is that then a consent between the client and the lawyer? How do I control how the information is used? What does a letter as an advocate look and sound like as a fact witness? I tried to consult with a family lawyer who said he needed to know about the case – can’t do that as I don’t have consent to give information about the case. I just need to know the proper and protective way to do this! This article really helped me and I really wish I had access to additoinal information.
ACA members can get advice and guidance from ACA’s ethics department on professional issues like the situation you’re facing.
Contact ACA’s Ethics and Professional Standards Department by emailing ethics@counseling.org.
I took my 11yr old daughter to a LPC because she was having problems with her relationship with her father.Her father admitted that he had been an absent father for the last 7 yrs of her life by his choice. My daughter’s LPC testified in our custody trial for her father and against me the mother. First you should know that my daughter’s father became a patient of the same LPC after my daughter was her patient. Which I objected to but the LPC continued to see him as a patient.. the LPC testified that since I looked tired during one appointment that she thought I was on drugs. My lawyer immediately told me that it was over that I just lost custody and he never questioned the LPC. I found out after court that the LPC had just gotten her licence that year and my daughter was her very first client.. None of that info was testified to in court. I honestly don’t understand how someone can testify on her opinions and not facts. The LPC did other unethical things that would take to long to explain. Can anyone please advise me if I have a legitament reason to make a complaint.