Abstract
In their recent Analysis and Commentary article Bursztajn and colleagues argue persuasively that to provide comprehensive independent medical evaluations (IMEs), forensic psychiatrists must take into account the managed care context of a claimant's case. The author of this article agrees with that assessment, but adds that another significant problem in his practice occurs when disability claimants who have severe disabling personality disorders resist psychotherapy and when, as is often the case, there are no experienced psychotherapists available to provide the needed treatment.