Contemporary Challenges and Controversies

• Who can provide mental healthcare

  • Bachelors: substance abuse counselors, pastoral counselors
  • Masters: social workers, licensed professional counselors, licensed mental healthcare counselors, rehabilitation counselors
  • Doctoral: PhD, PsyD, MFT, EdD
• Allied professions to mental health workers


  • Physicians
  • Psychiatrists
  • Nurses
  • Nurse practitioners
• Many people get prescribed meds from their general practitioners without a follow up (55%) and many people also get prescribed meds without seeing a therapist (⅕)
• Meds work best when they are used with a therapist
• Challenges with using technology to treat patients

  • Reaching more patients
  • Issues with internet deserts
  • Protects patient privacy
  • Boundaries
  • Professional liability
  • Safety
• What are some ways that a therapist might justify having a sexual relationship with a patient?

  Saying it was true love, engaging in subtle boundary slips, incorrectly believing the therapeutic relationship does not apply outside of office, and fraudulently presenting sexual activity as a valid treatment are some ways a therapist might justify having a sexual relationship with a patient
• A sexual relationship between a therapist and patient can never be justified
• Non-sexual physical touch between a therapist and patient

  Therapists can reciprocate actions of the client, use best judgment, handshake, pat on shoulder or forearm, non sexual hug
• Dual relationship


  Having a relationship as a therapist and having another one outside of therapy
• The APA ethics code prohibits dual relationships
• Therapists should have a conversation about what to do if seeing one another outside of the office to maintain boundaries and prevent a dual relationship
• Challenges in accessibility for people with disabilities when accessing therapy

  • Physical barriers
  • Communication barriers
  • Lack of training and recognition, misdiagnosis, treatment planning
• Goldwater Rule


  A guideline that says psychiatrists shouldn't diagnose public figures they haven't personally evaluated, to maintain professionalism, patient confidentiality, and ethical standards in psychiatry
• Arguments have been made that the Goldwater Rule should be disregarded because of the available evidence on public figures