Against HIPPster Regulation

Consider this post a rant-by-proxy: I owe the basic idea for it to my therapist wife, Alison, but the issue occurred to me independently (though not with such clarity) a few years ago, after I took a professional ethics course for my counseling degree.

Psychotherapy is an odd vocation that’s hard to categorize in a straightforward way. A therapist is in some respects like a teacher, in some respects like a friend, in some like a parent, in some like a religious minister, and in some like a physician. But at the end of the day, therapy is a sui generis activity with its own internal standards and internal goods. Therapy may resemble pedagogy, friendship, parenting, spiritual counseling, and medicine in some respects, but isn’t any of those things. Nonetheless, the powers-that-be have decided nowadays that psychotherapy is a form of medicine, or if that strains credulity, that it ought to be medicalized as much as possible.    Continue reading

Questions About the Parkland Shooting (1): Whatever Happened to Patient Confidentiality?

The Parkland shooting seems to be one of those “tipping point” events that–like Ferguson in the case of the abuse of police power–may well change the trajectory of the debate over guns and gun control in the United States. At this point, it seems premature to come to any definite conclusions, whether about the shooting, or about what follows from its having happened the way it did. What seems more obvious to me is that far too many questions are going unasked. Here’s the first of several posts devoted to questions provoked by the shooting and the response to it–this first one provoked by the ease with which journalists seem to have gotten their hands on psychiatric or quasi-psychiatric reports having to do with the shooter’s state of mental health.

A question for people in social work/law enforcement: is there a legal/ethically legitimate way of getting hold of an adult welfare report by some equivalent of a Department of Children and Families as described in the article linked to just above? Or is journalistic reporting on the Florida DCF report on Nikolas Cruz based on a confidentiality-violative leak? Here’s some typical reporting on the release of the report, which is described as “confidential” in the same breath as it’s described as a matter of public record. Continue reading