The Mental Health Professional in Court: A Survival Guide

Although forensic psychiatrists actively consider opportunities to interface with the legal system, most psychiatrists dread thinking about courtrooms and lawyers. Drs. Gutheil and Drogin seek to diminish the terror of court by using knowledge as the “antidote to unreasoning fear” (p xiii). The text is a revised and expanded version of Gutheil's well-received 1998 book, The Psychiatrist in Court: A Survival Guide. As the authors state in the Preface, you can indeed read this helpful guide “between the arrival of the subpoena and your pending appearance in court” (p xiv).

The book is written for professionals whose knowledge about going to court is essentially limited to popular culture examples. Although not primarily intended for forensically trained psychiatrists, the book has much to offer early-career forensic psychiatrists and would make excellent required reading for general and forensic psychiatry residents. The authors' guiding principles, which include brevity and practicality, are contained in 11 easy-to-read chapters and 3 informative appendices. Gutheil and Drogan use an informal and lighthearted tone to make the guide both accessible and soothing (p xiv). While reading the book, I could clearly envision Dr. Gutheil in his “Never Worry Alone” tee shirt speaking to a group of early-career psychiatrists.

Each main chapter contains subsections that narrow the focus and ends with summarizing key points and references. Many chapters contain useful tables, such as “The ‘Six P's’ of Trial Preparation” (p 79). The book contains a plethora of real-life examples and word-for-word courtroom exchanges that further clarify and elucidate important concepts. Several of these illustrations are humorous in support of the overall anxiety-alleviating tone of the book. Brief chapters and boldfaced key terms facilitate gleaning information that is most relevant to a particular situation or question.

The first three chapters review basic concepts, including types of witnesses, licensing board complaints, ethics complaints, and common legal situations that trigger malpractice lawsuits (suicide, boundary violations and sexual misconduct, breaches of confidentiality, and treatment strategies). Highlights of these chapters include the subsections titled “Subjective-Objective Distinction” (pp 5–6) and “The Psychology of Litigation” (pp 12–14). Later chapters describe legal proceedings, handling interrogatories and depositions, and tactics used by attorneys that can result in an adverse outcome for the poorly prepared psychiatrist.

Chapter 7, which advises the reader about helpful legal resources, starts by humorously comparing the courtroom to France: “a mildly hostile, mildly intolerant, chauvinistic foreign country where they dress and speak quite differently” (p 51). The authors describe the value of seeking input from a forensically trained mental health professional, the roles of courtroom personnel, basic courtroom rules, subpoenas, privilege, and confidentiality. Later chapters explain the trial and all its phases, paying particular attention to trial preparation and self-presentation, including appropriate attire. The remarks about using graphics and flip charts to illustrate key concepts are useful, but may be a little advanced for the nervous psychiatrist who is an infrequent visitor to the courtroom. Readers are reminded to take care of their health and to avoid social isolation, while being mindful of conversations that could be discoverable in court. The appendices contain useful information, including a legal glossary, recommended readings and Internet support, and a summary of the civil litigation process.

A short time after I started reading the book, a nonforensic colleague sought my support. She had been called to testify as a fact witness in the criminal case of one of her patients. I immediately thought she was the perfect example of this guide's intended audience, and I offered the book to her as a resource. Between mid-morning and the end of the work day, she read the relevant sections and returned the book to me. When I asked her impressions of the guide, she responded, “It's forensic psychiatry for the rest of us. It provides enough information about how the legal system runs to help those of us who do not regularly interface with the courts feel more informed and comfortable.” That is an excellent summation of this guide's purpose and value.

• © 2014 American Academy of Psychiatry and the Law