I have to pay to have him testify against me? Pshaw.

April 14, 2006 12:09 PM

TherapyContractModificationFilter: The contract my shrink wants me to sign has a paragraph saying that if he is asked to testify in a court case involving me (even if it's for the other side), I have to pay him. I'm not inclined to sign such a contract. Is such a clause anywhere near normal?

"If the psychologist is asked to testify in a court case involving the client, the client will pay the full $120 per hour fee for the psychologist's time in preparing to testify, traveling to and from court, and testifying in court, as well as the psychologist's travel and overnight lodging fees if the court hearing occurs more than 100 miles from [city]. This will be the case even if the psychologist is called to testify by another party." (emphasis added)

Basically, I'm not going to sign that, and I will ask to strike it from the contract. But am I being an ass for doing that, and will I have difficulty finding someone who doesn't have such a requirement? I have no problem if it only applies to testifying on my request, but creating a legal obligation to pay for the actions of others seems like a really bad idea.

Followup questions OK, I will find a way to respond if necessary.

posted by anonymous to law & government (27 answers total)

That sounds ludicrous. I don't think you're being an ass at all.
posted by rwatson at 12:23 PM on April 14, 2006

I'm ignorant about how this works, but why would you need a contract to see a psychologist? You go, you talk to him, you pay him. I don't see that there's any 'contract' required.

This guy sounds shady to me. If contracts are the norm in this business, then it's a messed-up business.
posted by Malor at 12:24 PM on April 14, 2006

Hell no don't sign! Jeez. And how can he testify for the other side? Don't you get confidentiality? Is this in the states?
posted by small_ruminant at 12:29 PM on April 14, 2006

Don't sign that contract. Don't sign any contract with any pyschologist besides the normal one. "Here's your check."

Maybe you could ask him why a contract is necessary? Take a look at the contract. Is this court case thing the meat of it? If so, I think you've found your reason.
posted by jon_kill at 12:29 PM on April 14, 2006

I find it troubling that the contract even contemplates the idea that the therapist would testify in court about a client.

What happened to therapist/patient confidentiality? If you, as the client, choose to waive it so that the therapist can testify on your behalf, then you can make those arrangements then. Otherwise, your therapist should be protecting your confidentiality.

Not only are you not an asshole for balking at this clause, I'd say you need to find someone else you can talk to who won't willingly rat you out.
posted by ambrosia at 12:33 PM on April 14, 2006

Erm, here's a direct question you need to simply ask, to his face: "Has any lawyer or litigant contacted you about me?" Ask it several ways, so no evasion is possible.

I've never heard of such a thing and would never sign that. Regular witnesses receive modest compensation for their time (and must testify). Expert witnesses receive a sum negotiated beforehand, and can ask whatever they think their time is worth, subject to not getting the job, of course.
posted by jellicle at 12:52 PM on April 14, 2006

Confidentiality contracts (which state that the shrink can contact authorities if he/she believes you are a danger to yourself or others) are the norm. This? A joke. Find somebody else.
posted by moira at 12:59 PM on April 14, 2006

I've heard of shrinks' records being subpoenaed for court cases. A friend last month had a marriage counselor's notes from years prior subpoenaed. Unfortunately this type of thing does happen, despite confidentiality concerns. So the therapist is not crazy - this is a legitimate problem. Even if they can't ask him about what went on in session, they could talk about the fact that you were going, your attendance, they could ask you to read his notes to the court. Some judges allow stuff like this.

But you still don't have to sign the contract or give him your business. Tell him you're not agreeing to it. If he wants your business he'll just have to assume the risk.
posted by Marnie at 1:21 PM on April 14, 2006

A therapist is obligated to protect your confidentiality, but there are certain limits, and one of those is responding to a subpeona. I've never heard of anything like this, and I'm a therapist. I've (rarely) heard about therapist contracts which are signed, but not too often. Mostly they are word of mouth stuff: I'll treat you, it's your responsibility to attend treatment, you will be required to pay for sessions missed for which you do not give me 24 hours notice of cancellation, that kind of stuff.

While I don't think I would sign such a contract, I can think of several legitimate reasons why the therapist might ask you to do so, reasons that are certainly more about protecting him, but which are for your benefit as well. Basically, I therapists frequently find themselves in situations where they are asked to vouch for their patients in one way or another, in everything from workplace issues to marriage, custody and sexual violence issues. Patients can sometimes be very manipulative about this kind of vouching. Sometimes that vouching takes to form of testifying in court. Perhaps this man has been subpeoned one too many times, losing time from work and money in the process, and has decided to include something that would allow him to get paid. Don't forget that therapists in private practice do not make money with which to pay their office rent or health insurance or mortgage or anything else if they are not seeing patients. And yet they cannot refuse a subpeona. On the other hand, and this is something I talk with many of my patients about although I am not in private practice, it's not really a good idea to have your therapist up on the stand testifying in open court about any issue. It can get very messy very quickly, and although patients want it, it's a good idea to help them to think seriously about it before they insist. Perhaps the stance on fees is an attempt to discourage patients.

Everyone who thinks this is just an egregious contract should keep in mind that when a patient first comes to see you it can be very hard to know where the involvement will lead. You certainly can't refuse to treat a patient who comes to you initally for some minor depression or work related issues and who later develops intense suicidality or begins to go through a messy divorce. The contract under discussion at least allows the therapist to try and assert control over this one aspect of treatment which can be both really disturbing and very costly. Which is not to say that I condone it. One of the reasons I wouldn't sign myself is because I would wonder if the therapist's attempt to control this boundary in this way was indicative of a general lack of finesse. But that's just me.
posted by OmieWise at 1:31 PM on April 14, 2006 [1 favorite]

I think you should ask to waive this clause, but I sympathize with the Dr. who is trying to protect himself by including it. He's a professional who works for an hourly rate. If his hours are going to used up in court just because he was associated with a particular patient, someone should be paying for his time.
posted by chudmonkey at 1:54 PM on April 14, 2006

"Everyone who thinks this is just an egregious contract should keep in mind that when a patient first comes to see you it can be very hard to know where the involvement will lead."

In light of OmieWise's relevant professional opinion, and not being a therapist or health professional myself, I still respectfully say it's bogus for a therapist to expect a new client to sign a contract, testimony clause or no.

I wouldn't let that guy become my service provider, simply. There is nothing that prevents a therapist from terminating his or her relationship with you at any time, and vice versa, and as such, a service contract is moot.
posted by pineapple at 1:56 PM on April 14, 2006

Generally speaking, Marnie is right. We live in a litigious society and the psychologist is just covering his/her bases. Running a practice is not cheap - overhead costs, malpractice insurance, etc. If a psychologist is subpoenaed to appear in court, that's a good chunk of his/her day thrown out the window. If the psychologist didn't charge you, the burden would just reappear in higher session fees for his/her other patients.

But I do agree with you, that you should NOT be legally held to pay for the actions of others. If an adversary subpoenas your psychologist to testify, then HE should be the one forking the money over, not you. My advice? Find another psychologist. And keep reading the fine print:-)
posted by invisible ink at 1:59 PM on April 14, 2006

There are too many therapists out there who will NOT make you sign such a thing. I'd go find one.
posted by konolia at 2:14 PM on April 14, 2006

I've seen several therapists since my late teens or early 20s, and I've never been asked to sign something like this.
posted by scody at 2:18 PM on April 14, 2006

And how can he testify for the other side? Don't you get confidentiality? Is this in the states?

A psychologist is not a psychiatrist and is not a medical doctor, so confidentiality is less cut and dried and more changeable from state to state.
posted by phearlez at 2:22 PM on April 14, 2006

Don't sign anything -- with or without that clause. Find another mental health professional. This person is a disgrace. Report him/her to the state licensing authority to see if this violates any rules and regs of professional conduct. And if this dufus is ever involved in a case where s/he is issued a supoena by the state, he can defy it at his own peril.

I can't believe that a person who is so worried about covering their ass in this tacky fashion could really help someone. Kick him/her to the curb ASAP. If you have it in you, tell them why in no uncertain terms.
posted by bim at 2:52 PM on April 14, 2006

Generally a client will be asked to sign a disclosure agreement which spells out the conditions of the relationship, e.g., that it is professional, non-sexual, spells out therapist credentials, how to contact state licensing board if there is a problem, limits of confidentiality. There is no confidentiality for intent to self-harm, explicit intent to harm others, or child or elder abuse. Therapists are mandated reporters re these areas, and confidentiality does not obtain. Knowing many therapists over many years I've never heard of a contract re court costs. The agreement with the therapist up front may address cancellation, no-show, and payment policy issues, but of course the client is free at any time to terminate therapy. If you like your therapist, discuss this odd court clause with him or her. Soundcs like it would be hard to enforce if he or she wrere called to testify for some reason, but testimony for therapists is normally with regard to dept of human services custody cases or mental health evaluations for criminal justice clients. sounds a bit odd to me.
posted by madstop1 at 3:55 PM on April 14, 2006

I've never seen a therapist or psychiatrist that has asked me to sign any kind of agreement. I can maybe understand him asking you to sign an agreement that indicates the only possible ways he would have to break his confidentiality (harm to yourself, harm to others, subpoena by a court/judge).

But paying him for being in court involving you? Absolutely not. And the fact that he asked you to sign this is a huge red flag. Walk away now.
posted by meerkatty at 4:14 PM on April 14, 2006

This is a very interesting question. We employee a number of psychiatrists and other licensed mental health professionals and have never heard of this. However, it does not appear outrageous just a little excessive. I would consider the the following in making a decision:
1) Did your presenting problem(s) suggest that there might be an increased probability of litigation--child custody dispute, abuse (sexual or physical), pending criminal charges, etc.
2) Are you anticipating , or involved in, civil litigation that might require expert testimony: wrongful discharge, disability claim , employment discrimination, claims for damages (psychological), etc.
If you are involved in the former it would seem reasonable for the therapist to specify his/her expectations. this can be extremely time consuming and contentious.
If it is the latter I would want to negotiate that his/her fees be recovered from insurance, settlements, fees for providing expert testimony, court costs etc. It really depends on what the problem is (are), the therapists standing as an expert witness and the the probability of associated litigation. For the run of the mill mental health or adjustment issue(s) it seems excessive.
posted by rmhsinc at 4:39 PM on April 14, 2006

red faced--employ not employee
posted by rmhsinc at 4:42 PM on April 14, 2006

On it's face, it doesn't seem this contract either unethical or illegal. It doesn't reduce any of your patient-therapist rights, it simply says "any costs I incur as a result of the doctor patient relationship are your responsibility." Nothing wrong with that. That you became aware of the clause before you signed suggests that the degree of disclosure, and your degree of sophistication, were together sufficient so that there was no abuse in trying to slip the clause past you.

However, you would not being an ass to strike the term from the contract, because it is pretty aggressive, and people are always free to negotiate the financial aspects of a medical relationship. Maybe he'll counter by increasing your rate by $5 a session for the added risk he's retaining. Any therapist who'd ask for an aggressive clause like that, and then act offended if you tried to pencil it out, is an asshole. And if he tried to therapy-speak you into accepting the term you've rejected as somehow good for your course of treatment, well, then you've got a hell of an ethical complaint on your hands.
posted by MattD at 4:51 PM on April 14, 2006

Being called to testify in court is annoying. One of my old profs used to charge $1500 an hour for the in-court time. Lawyers paid him, too.
posted by ikkyu2 at 9:38 PM on April 14, 2006

I can see the therapist's point; it must be unpleasant to lose time due to a subpoena, and courts are not efficient. Subpoenaed witnedsses get minimal compensation, as opposed to hired "expert witnesses." But I think it's a cost of being in that business, and you should not have to pay for it. I would probably not want a therapist with this aggressive an attitude.
posted by theora55 at 8:14 AM on April 15, 2006

I'm wondering if a contract term like that is even kosher with the various codes of ethics that would apply to the shrink's licensure and accreditation in the profession. Not from a confidentiality perspective (MattD's correct point) but from coercing-patients-into-unconscionable-contract-terms-as-a-condition-of-medicial-treatmemnt perspective.

I would cross it out with a pen, sign the contract, and return it. If the shrink refuses to deal with you after that, you probably don't want to continue the relationship.
posted by Mid at 9:30 AM on April 15, 2006

Whoa, people are totally overreacting!

One kind of situation anticipated by such clauses (which I believe are not that unusual) is where the *patient* has put his or her mental state at issue in litigation, and so the therapist is called to testify. For example, if the patient is in a car accident and sues for emotional damages--perhaps having panic attacks or something like that--then the person being sued has the right to subpoena the patient's therapist to see if the anxiety disorder predated the accident. Since it's the patient seeking the benefit, then it seems proper for the patient to pay for the therapist's testimony.
posted by footnote at 1:28 PM on April 15, 2006

footnote, thinking up anecdotally legitimate reasons that a therapist might be justified in hoping to recoup expenses doesn't have anything to do with the fact that this just isn't standard practice for mental health professionals.

We're not advising the psychologist, we're advising his potential patient.
posted by pineapple at 5:57 PM on April 15, 2006

It's not an anecdote at all -- it's probably the most common situation where a therapist would be called to testify against his own patient. If the poster wants to strike it out, fine, but it would be dumb to jump to conclusions about the therapist on the basis of one more or less reasonable contract term.

Plus, a random google suggests that this seems to be a common contract term -- see here, p. 3, para 5; and here , p. 3, first full para.
posted by footnote at 3:44 PM on April 16, 2006