This excerpt is from “How to Survive and Thrive as a Therapist: Information, Ideas, and Resources for Psychologists in Practice by Kenneth S. Pope, PhD, ABPP, and Melba J. T. Vasquez, PhD, ABPP, published by APA Books (copyright 2005 by the American Psychological Association). Some of the other chapters are: Who Are You and What Is Important To You?; Income, Expenses, & a Business Plan; Creating Strategies for Self-Care; Finding an Office; Finding an Attorney; Finding Professional Liability Coverage; Thinking Through Your Policies & Procedures; Preparing a Professional Will; Finding Clients & Referral Sources; Using Computers & the Internet; and Avoiding Pitfalls in Psychological Assessment. Individual copies may be ordered from the American Psychological Association (1-800-374-2721). Due to space limitations, only 7 steps from the chapter are presented here. These 7 are by no means a comprehensive list but they do emphasize some essential steps that are sometimes overlooked in the stress and shock of being subjected to a complaint.

It happens. A client, former client, or someone else files a formal complaint against you. What now? Here are some considerations you may find helpful.
Don’t Panic

Okay, most of us are going to panic. But then take some deep breaths and do whatever you have to do to think clearly. The decisions you make -- what you do and avoid doing at this point -- are crucial. (And avoid letting panic drive or determine the steps you take.)

Consult Your Attorney First

It’s amazing how many psychologists forget this step or experience irresistible impulses to maneuver around it. After opening an envelope to find out that a formal complaint has been filed with the licensing board, a psychologist may figure that by quickly submitting a clear timeline, the relevant documents, and a clear explanation, this unfortunate misunderstanding can be resolved immediately. Receiving notice that a malpractice suit has been filed, a psychologist may hope that asking the client to come in for a free session so that all this can be worked out “without all these lawyers” is the best way to reach a positive resolution and convince the client that a suit should never have been filed in the first place.

Responding to a formal complaint before consulting an attorney can lead to needless disasters. An attorney can help guide you through the minefields of formal complaints. In part, this is because you, as a psychologist, are moving into a different realm. Good attorneys are knowledgeable about the complex legislation, case law, and court customs that govern malpractice actions. Attorneys experienced in licensing and ethics hearings can interpret the numerous rules and procedures that the psychologist is now subject to and are familiar with the particular norms and customs of the state or provincial licensing board and ethics committee. In part, the attorney can serve as a guide because he or she has another perspective than you since the attorney is not the object of the complaint. That perspective can he crucial. As the old aphorism has it: The person who represents him- or herself has a fool for a client.

The attorney can show you the pitfalls of certain actions that can otherwise seem to make sense. A psychologist who has not consulted an attorney may talk to colleagues about the case, talk to the opposing attorney, write letters to various people mentioning the case, and blow off steam about the case within earshot of others. Only later will he or she discover that these oral and written statements are not privileged information and are introduced as evidence through testimony and exhibits.

Your attorney may give you strong advice, perhaps an authoritative list of dos and don’ts, but a good part of what an attorney does is to lay out options and tell you what is and is not known about each option. This enables you to make informed decisions about what you want to do and what you want the attorney to do. For example, the attorney can make you aware of the circumstances, if any, under which you can discuss the case with a supervisor, consultant, colleague, friend, family member, or anyone else and have the discussion remain confidential and privileged. As another example, the attorney can explain the consequences of you declining a settlement offer from the plaintiff in a malpractice suit.

Notify Your Professional Liability Carrier

Your professional liability policy may include a requirement that you notify the company immediately not only if you are sued but also if you have reason to believe you will or may be sued. Regardless of the fine print of such requirements, however, it makes sense to let the carrier know if you become aware of a possible or actual formal complaint. The carrier may give you specific guidance and, under certain circumstances, provide you with an attorney even if a suit has not yet been filed against you. (Chap. 5 discussed petitioning the company to assign the attorney you customarily work with to handle your case, even if that attorney has not previously worked for the carrier.)

Who Is Your Attorney’s Client?

The answer may seem obvious: You are your attorney’s client. But if your insurance carrier is paying the attorney, it is worth assessing the degree to which the insurance carrier’s interests may diverge from your interests. For example, what if the insurance company approves only a very limited discovery, hoping to hold down expenses? What if the carrier believes it makes sense financially (i.e., it is in their financial interests) to settle a case that you believe is bogus and would be decided in your favor were it vigorously defended? The settlement of such a case --which could become a matter of public record -- could be devastating to your career, particularly if a substantial portion of your professional time is spent serving as an expert witness.

In some rare circumstances, if you (or you and the attorney) are unable to persuade the carrier to litigate rather than settle the case or provide you with the kind of extensive discovery and vigorous defense you believe you are entitled to, it may he worth considering hiring a separate attorney with your own funds to press your claims with the carrier.

Is the Complaint Valid?

When someone files a formal complaint against you, it’s natural to feel hurt, angry, and attacked. Moreover, malpractice trials are adversarial proceedings that can understandably generate much anger and emotional heat. Before that process gets too far under way, take some time to consider whether you actually did what you’ve been accused of doing. Setting aside defensiveness, rationalization, counterattacks, and the fact that the charges may be considerably overstated or wrong in some details, is there any truth to the allegation that you did something you should not have done or that you failed to do something you should have done?

Being relentlessly honest with ourselves under these circumstances is anything but easy. Acknowledging to ourselves that we may have done something wrong may seem self-destructive, indulging a tendency to “beat ourselves up” when we need all our survival skills to rescue our reputation and career. But holding as firmly as possible to the reality of what actually happened -- not what the flattering and self-justifying revisionism of memory can create in place of the facts -- may enable us not only to respond effectively to the complaint but also to survive the process in a way that is the very opposite of self-destructive.

Recognize How the Complaint is Affecting You

A formal complaint can be a devastating experience. A malpractice suit or other formal complaint can bring all of the following and more into the life of a psychologist:

• A numbing shock that suddenly reputation and career may be at stake
• A sense of betrayal that someone we tried to help has turned against us
• Fear of uncertainty and the horrors in store for us (will we have a practice, a reputation, or a license when this is finally over?)
• Reflexive self-blame, assuming that we must have done something terrible or else we would not he in this fix
• Embarrassment, imagining that our colleagues now think the worst about us
• Self-doubt: If we did so bad with this patient that we wound up in court, what if our other patients sue us?
• Depression
• Suspicion of our other patients (Are they going to sue us?) and colleagues (Who can we trust to talk this over with?)
• Anxiety about what’s going to happen, about all the unknowns, about being deposed and cross-examined, about who will be in the courtroom during the trial (the media?), and on and on
• Obsessive and intrusive thoughts, finding it hard to think about anything else
• Insomnia, tossing and turning, thinking endlessly about what’s happened and what may happen
• Catastrophizing, seeing only the most horrible possibilities unfolding
• A loss of appetite or taking in too much food, alcohol, or other substances in response to the stress

Our view is that for some psychologists, being sued can bring on reactions similar to PTSD. If we can be rigorously honest about our reactions to a a formal complaint, we are in a better position to address those reactions constructively and realistically.

Get the Help and Support You Need

As you monitor your reactions to the complaint process, realistically assess what help, if any, you need in dealing with these reactions. Some psychologists return to therapy or seek it for the first time. Some reach out to friends, colleagues, and family. An attorney’s guidance can be invaluable in ensuring that what you say to others doesn’t unintentionally become part of the case against you. Ethics experts in your state may be able to provide you and your attorney with additional consultation.

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