Many years ago, a noted psychiatrist (Irving Schneider) wrote about the three images that people hold of someone who does human service work (especially those in the field of psychiatry) (Schneider, 1977). These people can be cast as those who can perform miracles (Dr. Good) or as someone who is ineffective (“soft treatment”) and perhaps even foolish in trying to do good (Dr. Dippy). However, there is also the assumption that human service professionals are powerful manipulators of human emotions and behavior. They are cast as Dr. Evil and are feared, especially if they have an advanced degree. Those with a medical degree are most likely to be threatening (since they can manipulate body as well as mind and heart).
These considerations leave us with a sense that social status is an irrational dynamic when it comes to assigning this status to those in the human service fields. We set status for most people based on their wealth, earning power, and position in the organizational hierarchy. These criteria don’t work very well when it comes to assistance with the messy affairs of the human mind and heart. While the hierarchy of those in the field of mental health is pretty much dictated by the medical profession and reinforced by the American Psychological Association and other professional associations in the mental health field, there remains irrationality in the fears and hopes of those seeking these services.
Legal and Professional Privileges
When we move psychological and most human services out of the office and into the courthouse, there are several formal privileges accorded those who are practicing with a license—and especially those who hold a doctorate.
Confidentiality
First, there are important protections against the loss of confidentiality boundaries. Aside from the Tarasoff provision, those doing mental health work usually are not required to divulge confidential information from their work with a client/patient if required to appear in court. This typically includes those doing school counselling. In the case of nonclinical work, the protection is a little less clear. An organizational consultant or person doing life or organizational coaching might be required to report on what they observed regarding illegal actions taken in an organization with which they have worked—though there could be a battle in court about the consultant’s or coach’s rights and obligations. Those doing assessments are also likely to find that they must report on their findings, especially where a defendant is pleading that they are not responsible for their actions because of mental illness, cognitive incapacity, or emotional breakdown.
In addition to that which doesn’t have to be conveyed in a courtroom, there are those matters that can be conveyed. Those with a license—and especially those with an earned doctorate typically have the right to offer hypotheses about the state-of-mind and motive of a defendant. They are often brought into the courtroom precisely for their “expert” opinion. By contrast, a “nonqualified” person is discouraged or even prevented from expressing their opinion about a defendant’s psychological condition.
The astute lawyer representing the other side of the argument is likely to say something like: “Who do you think you are making these outrageous assumptions. You are not a licensed therapist!” The judge is likely to throw out or ask the jury to disregard these “nonexpert” hypotheses. Conversely, it is common for both sides to offer expert-based testimony—thus often negating the validity of either set of observations (and demonstrating once again that “shrinks” are working in an area where there is no “truth” or “reality”—there is only Dr. Dippy or an easily-bought Dr. Evil.)
