Psychiatry And Law
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:
-
Medical decision making under conditions of uncertainty, in the teeth
of the possibility of tragic outcomes; -
The necessity for moving from a certainty-driven mechanistic paradigm
to a probabilistic paradigm of causality in medicine; -
The unequivocal need in the medical-legal (or forensic) field for careful
empirical study of medical-legal events; -
The therapeutic alliance and informed consent as dialogue based on clinical
and ethical considerations rather than on narrowly legalistic considerations; -
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; -
An exploration of what constitutes professionalism in a large variety
of decisions; -
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
Thomas G. Gutheil, M.D.
Harold J. Bursztajn, M.D.
Program Secretary
Michael L. Commons, Ph.D.
Senior Research Scientist
Contact Person
Thomas G. Gutheil, M.D.
Program in Psychiatry and the Law
Massachusetts Mental Health Center
74 Fenwood Road, Boston, MA 02115
Phone: 1-617-626-9659
Facsimile: 1-617-738-1736
Links
Visit The Program In Psychiatry And The Law Website at www.pipatl.org
Publications
Beahrs, J.O. and Gutheil, T.G.: Informed consent for psychotherapy. Am
J Psychiatry 158:4-10, 2001.
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.