Dahlia Discord, MSW, has been treating Melissa Malfunction for anxiety and mild depression in the aftermath of an automobile accident. Ms. Malfunction has been out of work for 3 months and recieves disability insurance payments. The insurer has scheduled her

Dahlia Discord, MSW, has been treating Melissa Malfunction for anxiety and mild depression in the aftermath of an automobile accident. Ms. Malfunction has been out of work for 3 months and recieves disability insurance payments. The insurer has scheduled her for a disability case review, and Ms. Malfunction has asked Ms. Discord to complete a disability evaluation form and possibly testify as an expert in support of her claim before an administrative law judge. Ms. Discord would like to support her psychotherpay client but is not certain she can objectively support Ms. Malfunction’s claim that she is totally unable to work at any job for emotional reasons.

Psychotherapists are often asked to write letters of various sorts in support of their clients but must take care not to compromise their professional integrity. Ms. Discord should not allow herself to be manipulated into making a recommendation or evaluative statement that she cannot in good conscience, support. At the same time, she does not want to disrupt the rapport with her client. One possible solution would involve advising Ms. Malfunction that although she cares deeply about her welfare, Ms. Discord cannot take on the role of an independent evaluator to determine disability. Ms. Discord could also agree to write a letter with the clients consent, that documents her work with Ms. Malfunction, the symptoms reported by the client, her diagnostic impressions, an estimate of the level of symptom severity, and other treatment information. However the letter should include only accurate information and should avoid commenting specifically on Ms. Malfunction’s abiloty to work for qualifications for disability. Those recommendations should be left to other mental health experts who do not have preexisting or ongoing therapeutic relationships with her.