Psychiatry And Law

• Instruments and Questionnaires

The Program in Psychiatry and the Law (the Program) was founded in 1979/1980 at the Massachusetts Mental Health Center (the Center) through the efforts of Paul S. Appelbaum, M.D. Its original mandate was to serve as a training program for forensic psychiatrists. Training consisted of performing, under supervision, medical-legal and ethical consultations with Massachusetts Mental Health Center staff. To date the Program has trained at least 7 Chief Residents in Legal Psychiatry and 15 Gaughan Fellows who constitute an informal nationwide group of Program associates.

In the early 1980s, the scope of this medical-legal training mandate was enlarged by the confluence of several conceptual streams, including:

1. Medical decision making under conditions of uncertainty, in the teeth of the possibility of tragic outcomes;
2. The necessity for moving from a certainty-driven mechanistic paradigm to a probabilistic paradigm of causality in medicine;
3. The unequivocal need in the medical-legal (or forensic) field for careful empirical study of medical-legal events;
4. The therapeutic alliance and informed consent as dialogue based on clinical and ethical considerations rather than on narrowly legalistic considerations;
5. The idea that ethics and the concepts of moral development represent valuable mechanisms for decision making that are older than both medicine and law and is most useful when the latter two disciplines have exhausted their possibilities;
6. An exploration of what constitutes professionalism in a large variety of decisions;
7. The dynamics of the health care provider/patient/family relationship, including an understanding of boundary questions.

What does the Program actually look like in action? In the early years, three members met on a weekly basis to pool ideas and work on drafts of articles. They served as the genesis for the present "think tank" component of the Program. The Program at present serves as a think tank, a consultation service, and a clinical research unit. Interested individuals are invited to attend, share ideas, discuss medico-legal points of interest, gain forensic sophistication, study and exchange information on a variety of concerns in both the legal and research areas and pursue research projects and publish.

The Program has grown to about 40 active participants, 20 or so meeting weekly, with some former "actives" dropping in occasionally. The e-mail discussion group has over 40 Program members. Attorneys, forensic psychiatrists, forensic psychologists, multiply degreed individuals (usually clinical and legal), psychiatrists, psychologists, research methodologists, writers, students of various disciplines participate. As a policy, the Program bars no one and invites participation without "admission requirements." Discussion centers on problematic cases, thorny conceptual issues, and empirical research conducted by participants. The opportunity to discuss key issues in the field for mutual peer enrichment has drawn practitioners, researchers, teachers, undergraduates considering forensic careers, and others to sit in and join.

One of the Program's most important structural innovations has been to include gifted writers as integral members to capture ideas spontaneously generated in brainstorming sessions and to edit successive drafts of those materials to be submitted for publication in professional journals, professional and trade books. The Program's Chief of Research helps people turn their ideas for studies and then into publishable articles--many of which are published in top peer reviewed journals in the field. As a result the Program has been a prolific source for everything from in depth research articles to "think pieces" (some unprecedented), education on risk management, and a stimulus for conceptual advances in the field. Many members have successfully worked on legislation and policy both locally and nationally.

Co-Directors

Program Secretary

Contact Person

Links

Publications

Brodsky A. A classic holds its ground: a review of Stanton Peele's The Meaning of Addiction (review essay). International Journal of Drug Policy, in press.

Brodsky A. Parents must prepare kids to pass college alcohol test. Boston (MA) Herald, August 19, 2001. (Variants of article published in Birmingham (AL) News, August 19, 2001; Knoxville (TN) News Sentinel, August 26, 2001; Portsmouth (NH) Herald, in press.)

Bursztajn HJ, Brodsky A. Captive patients, captive doctors: clinical dilemmas and interventions in caring for patients in managed health care. General Hospital Psychiatry 1999; 21:239-248.

Bursztajn HJ, Brodsky A. Competence and insanity. In J.L. Jacobson & A.M. Jacobson (eds.), Psychiatric Secrets (Second Edition). Philadelphia: Hanley & Belfus, 2001:485-498.

Commons, M. L. (2000). The power therapies: a proposed mechanism of their action, with suggestions for future empirical validation. Traumatology-e, 6(2).

Commons, M. L., & Miller, P. A. (In press). A quantitative behavioral model of developmental stage based upon the model of hierarchical complexity. Behavior Analyst Today

Commons, M. L., & Richards, F. A. (2002). Organizing Components into Combinations: How Stage Transition Works. Journal of Adult Development, 9(2).

De La Rosa, Mario R. & White, Mitzi S. (2001). The role of social support systems in drug use in Hispanics. Journal of Psychoactive Drugs (In press).

Gutheil, T.G.: Preventing "critogenic" harms: minimizing emotional injury from civil litigation. J Psychiatry Law, 28:5-18, 2000.

Gutheil, T.G.: The presentation of forensic psychiatric evidence in court. Isr J Psychiatry Relat Sci 37:137-144, 2000.

Gutheil, T.G.: Forensic psychiatrists' fee agreements: A preliminary empirical survey and discussion. J Am Acad Psychiatry Law 28:290-292, 2000

Gutheil, T.G.: Adventures in the twilight zone: empirical studies of the attorney-expert relationship. J Am Acad Psychiatry Law 29:13-17, 2001.

Gutheil, T.G.: Moral justification for Tarasoff-type warnings and breach of confidentiality: a clinician's perspective. Behav Sci Law 19:345-353, 2001

Gutheil TG, Bursztajn HJ, Brodsky A, Strasburger LH. Preventing "critogenic" harms: minimizing emotional injury from civil litigation. Journal of Psychiatry and Law 2000; 28:5-18.

Gutheil, T. G., Commons, M. L., & Miller, P. M. (2000). Telling tales out of court: A pilot study of experts' disclosures about opposing experts. The Journal of the American Academy of Psychiatry and the Law, 28, 449-453.

Gutheil, T. G., Commons, M. L., & Miller, P. M. (2001). Personal questions on cross examination: A pilot study of expert witness attitudes. The Journal of the American Academy of Psychiatry and Law. 29(1), 85-88.

Gutheil, T. G., Commons, M. L., & Miller, P. M. (2001). Withholding, seducing and threatening: A pilot study of further attorney pressures on expert witnesses. The Journal of the American Academy of Psychiatry and the Law, 29(3), 336-339.

Gutheil, T. G., Commons, M. L., & Miller, P. M. (In press). Expert witness billing practices revisited: A pilot study of further data. The Journal of the American Academy of Psychiatry and the Law.

Gutheil, T.G. and Hilliard, J.T.: "Don't write me down": Legal, clinical and risk management aspects of patients' requests that therapists not keep notes or records. Am J Psychotherapy 55:157-165, 2001.

Gutheil, T.G. and Hilliard, J.T.: "Psychiatric fish in legal waters": the treater thrust into the expert role. Psychiatric Services (In press)

Gutheil, T.G. and Stein, M.D.: Daubert- based gatekeeping and psychiatric/psychological testimony in court: review and proposal. J Psychiatry Law. 28:235-251, 2000.

Kadushin C, Kelner S, Saxe L, Brodsky A, Adamczyk A, Stern R. Being a Jewish Teenager in America: Trying to Make It. Waltham, MA: Brandeis University, Cohen Center for Modern Jewish Studies, December 2000.

Pinals, D.A. and Gutheil, T.G.: Sanctity, secrecy and silence: dilemmas in clinical confidentiality. Psychiatric Annals 31: 113-118, 2001.

Peele S., Brodsky A. Exploring psychological benefits associated with moderate alcohol use: a necessary corrective to assessments of drinking outcomes? Drug and Alcohol Dependence 2000; 60:221-247.

Peele S, Brodsky A. Informed consent: missing in action in addiction treatment. In S. Peele, C Bufe, & A. Brodsky, Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment. Tucson, AZ: See Sharp Press, 2000:130-142.

Peele S, Bufe C, Brodsky A. Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment. Tucson, AZ: See Sharp Press, 2000.
Price, M., Gutheil, T. G., Commons, M. L., Kafka, M. P., & Dodd_Kimmey, S. (2001) Telephone Scatologia: Comorbidity and Theories of Etiology. Psychiatric Annals, 31(4), 226-232.

Price, M., Gutheil, T. G., Commons, M. L., Kafka, M. P., & Dodd_Kimmey, S. (2001) Redefining Telephone Scatologia: Treatment and Classification. Psychiatric Annals, 31(5), 282_289.

Price, M., Kafka, M.P., Commons, M.L., & Gutheil, T.G. (2002). Telephone scatologia: Comorbidity with other paraphilias and paraphilia_related disorders. International Journal of Law and Psychiatry, 24, 1-14.

Saxe L, Kadushin C, Beveridge A, Livert D, Tighe E, Rindskopf D, Ford J, Brodsky A. The visibility of illicit drugs: implications for community-based drug control strategies. American Journal of Public Health, in press.

Saxe L, Kadushin C, Pakes J, Kelner S, Sternberg L, Horowitz B, Sales A, Brodsky A. Birthright Israel Launch Evaluation: Preliminary Findings (Birthright Israel Research Report 1). Waltham, MA: Brandeis University, Cohen Center for Modern Jewish Studies, August 2000.

Saxe L, Kadushin C, Brodsky A. An experiment to strengthen Jewish identity. Contact (Jewish Life Network), Spring 2001:3-4.

Saxe L, Kelner S, Kadushin C, Brodsky A. Jewish adolescents: American teenagers trying to `make it.' Agenda: Jewish Education, December 2000:3-7.

Sobel, R To Intervene or Not to Intervene in Bosnia. In Brigitte Nacos, Robert Shapiro, and Pierangelo Isernia, editors. Decision making in a Glass House. Rowman & Littlefield, 2000.

Sobel, R Constraining the colossus. Kennedy School Bulletin, Fall 2001.

Sobel, R. The Impact of Public Opinion on U.S. Foreign Policy Since Vietnam: Constraining the Colossus. Oxford University Press, 2001.

Sobel, R Immigration and identification: Interview with Alan Simpson. Migration World, Vol. 24, No. 3, Summer 2001.

Sobel, R Letter to Carew: Third World literature as revelation. Race and Class, Winter 2002.

Sobel, R., & Bursztajn, H. Ban Genetic Discrimination. Boston Globe, August 7, 2000.