The psychotherapist-patient privilege, a California evidentiary privilege set forth . the therapeutic relationship—including information obtained from the therapist's California courts have held that communications during “group therapy”—in. Privileged communication in the psychologist-client relationship Determining the status of privileged communications between psychologists and clients is a .. In , the U.S. Supreme Court held that communications between licensed . The therapist-patient privilege "belongs" to the patient. emotional problem, and/ or has a regular, long-term therapeutic relationship with the MHP (e.g., If the test was conducted to evaluate a patient or gather evidence in connection with a .
Johnson, the psychologist who is the director of the program.
In the letter, he confesses to committing the crimes he is charged with and states that he would like to enter the program. The prosecution obtains a copy of that letter and introduces it into evidence. When he wrote the letter, Gregory was not consulting Dr.
Johnson for help with diagnosing or treating a mental condition.
Instead, he contacted her because he wanted to enter her program to get a lighter prison sentence. Therefore, the letter is not protected by the therapist-patient privilege—and may be used as evidence against Gregory. Clarence tells a marriage and family therapist about his tumultuous relationship with his violent, abusive father. Clarence also writes a blog in which he discusses these same issues, often summarizing what he told the therapist at each appointment. Because Clarence broadcasts the content of his therapy appointments to the world, those communications are not covered by the psychotherapist-patient privilege.
However, information is still considered confidential if it is conveyed to people who are present at the therapeutic consultation to further the interests of the patient, or people to whom disclosure of the confidence is necessary to accomplish the purpose for which the psychotherapist is consulted. Irina is a recent immigrant from Russia.
She is suffering from post-traumatic stress disorder related to political violence she witnessed as a child. Irina consults with a psychiatrist about her emotional troubles.
Her English is poor, so the psychiatrist's practice supplies a Russian translator who helps her at her appointment. The therapist diagnoses Irina's problem and writes her a prescription for an anti-anxiety medication. He also informs her health insurance company of the diagnosis so that they will reimburse the cost of the appointment and medication.
Confidentiality in Clinical Psychology
The translator, the pharmacist who fills the prescription, and Irina's health insurance company will all know something about her communication with the psychiatrist. That is because all of these people were involved in supporting Irina's treatment. Exceptions to the Psychotherapist-Patient Privilege There are several common situations in California criminal law in which the psychotherapist-patient privilege does not apply—and communications with a therapist may be disclosed.
Izzy is homeless and mentally ill. He is charged with assault with a deadly weapon for trying to stab a stranger with a screwdriver. Izzy and his criminal defense attorney argue that he is mentally incompetent and cannot be tried for a crime under California criminal law. The judge in his case orders a competency hearing.
In connection with the hearing, Izzy is examined by a court-appointed psychiatrist. A licensed clinical social worker who has treated him in the past is also asked to testify at the hearing.
The results of the examination, and the social worker's testimony, are not covered by the psychotherapist-patient privilege, because Izzy voluntarily made his mental state an issue in the case. Use of therapist services for criminal wrongdoing Confidential communications between a therapist and a patient are not protected by the therapist-patient privilege if the patient sought the services of the therapist in order to: Commit a crime or tort, or Escape detection or arrest after committing a crime or tort.
Tony is the leader of a criminal street gang. He has been seeing Jennifer, a psychiatrist, for several years. One day Tony is desperate for a place to hide some guns that could be used as evidence of a gang killing. He makes an appointment with Jennifer and brings the guns to the appointment, asking her to conceal them for him. This communication between Tony and Jennifer is not covered by the psychotherapist-patient privilege, because Tony is seeking help to avoid being charged with a crime.
Disclosure of dangerous patient The psychotherapist-patient privilege also will not apply if the therapist has reasonable cause to believe that: In fact, under California law therapists are required to warn the intended victim or police if they reasonably believe that their patient is about to harm someone else.
Carl is a pedophile who has been seeing Ricardo, a psychiatrist, to treat his pedophilia. At one appointment, Carl tells Ricardo that he thinks he can no longer suppress his sexual desire for a year-old girl who lives next door to him—and that he believes he will soon act on that desire.
Ricardo notifies the police and the girl's parents about what Carl has told him. Several years later, Carl is charged with lewd acts with a child for molesting a different child. In Carl's trial, Ricardo may testify about what Carl had said to him about his neighbor—because Ricardo previously revealed that information in order to protect the girl from harm.
Child crime victim; child abuse or neglect There are several additional exceptions to the psychotherapist-patient privilege that come up in California criminal cases. First, the privilege does not prevent psychotherapists from disclosing certain confidential communications if: The patient is a child under the age of sixteen 16 ; and The psychotherapist has reasonable cause to believe that the patient has been a victim of a crime and disclosure of the communication is in the child's best interest.
And thanks to ABa law passed intherapists are also required to report any clients whom they know or reasonably suspect have viewed or downloaded child pornography. Waiver of the California Psychotherapist-Patient Privilege Like other evidentiary privileges in California law, the psychotherapist-patient privilege can be waived by the patient.
This means that the patient can make the privilege disappear, by either disclosing a significant part of the privileged communication, or consenting to the disclosure of the privileged communication by anyone else. When psychotherapist required to claim [psychotherapist-patient] privilege. Proceeding to determine sanity of criminal defendant. Patient dangerous to himself or others.
When psychotherapist required to claim [psychotherapist-patient] privilege, endnote 1, above. In group therapy sessions, the presence of other patients is okay -- the privilege still exists. The MHP's file and case notes will be privileged if the underlying sessions on which they are based are privileged.
They have no independent privileged status as the intellectual property or work-product of the therapist. If the test was conducted to evaluate a patient or gather evidence in connection with a legal proceeding, it is not generally privileged.
The raw data or scores created by tests such as the MMPI are only privileged if the results of the test are privileged. Despite the fact that raw scores can be misleading, the Rules of Evidence provide that facts or data in a particular case upon which an expert bases an opinion must be disclosed if the opinion itself is disclosed. Even if a session is privileged originally, the privilege does not apply in child abuse cases.
In most states, a mental health professional must report acts of suspected child abuse to law enforcement officials. Mental health in issue in a case. The privilege does not apply in cases in which the patient's mental health is itself a direct legal issue.
Examples include child custody cases, civil commitment hearings, hearings concerning a defendant's competency to stand trial, and civil cases where the plaintiff seeks damages for emotional injury. The privilege does not apply in litigation between two people present at a single counseling session, e. Disputes between patient and therapist. The privilege does not apply if the patient sues the therapist for malpractice, or the therapist seeks a restraining order against a former patient, etc.
The privilege does not apply if the patient is using the session in furtherance of an ongoing or future crime or fraud. Discussions ofpastcrimes or wrongdoing are privileged, but not discussions of plans for future crimes or violence. In other words, much of what you see on "The Sopranos" would not be privileged.
The famous case of Tarasoff v. Rules of thumb The exact contours of the privilege varied state-by-state. However, the following rules of thumb may help. If lawyers need it, they'll get it. It's not the therapist's decision. The lawyers and the patient have to worry about whether to assert the privilege, and a judge will decide whether the therapist does or does not have to testify.
Making these decisions is not the responsibility of the therapist. When the privilege is lost If some or all of privileged material has already been disclosed, this may or may not affect the continuing privileged nature of the material. The law is not concerned with who knows the information, but with whether it can be used at trial. If another patient from a group session goes around telling people about what happened at the session, it is not a waiver of the privilege for the other patients.
privilege evidence confidentiality psychiatrist psychologist therapist patient
If the therapist goes to a cocktail party and after a few drinks, says, "Talk about crazy people, I had a weird session the other day, blah blah blah," it does not waive the privilege. The patient's communications are still privileged. If a member of the therapists's staff calls a friend and says, "You'll never guess who's in there talking about his extra-marital affairs -- Bill Clinton! How to handle requests for confidential information There is a difference between confidential information and privileged information.
The fact that information should be kept confidential because it is in the best interest of the patient is legally irrelevant. Lawyers operate under fixed rules of evidence and pretrial procedure that are created and enforced by lawyers and judges who have probably know nothing about the therapist-patient relationship and don't care about the ethical guidelines of the APA.