The Custody Letter and the Couples Request
Renee, an LCPC in Baltimore, has treated Dana, a 38-year-old woman with PTSD, for 16 months in weekly 50-minute sessions. Dana's divorce is final, and a custody hearing is three weeks away. Dana's attorney sends a release asking Renee to write a letter calling Dana 'a fit and stable parent' and to testify as an expert. Dana also asks Renee to begin couples sessions with Dana and her ex-husband 'to save the family,' although Renee has never met the ex-husband or the two children, has no forensic training, and has no release for the ex-husband. Renee's notes contain Dana's reports about the ex-husband's drinking and Dana's own occasional passive suicidal ideation two years ago. Dana says, 'If you won't help me, I'll lose my kids.'
1. Identify the ethical and legal problems in Renee's proposed involvement and outline the decision-making steps she should take before responding.
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Renee faces a role conflict, not just a paperwork request. As Dana's treating therapist, she has a therapeutic relationship and privileged information; as a custody evaluator or expert witness, she would be asked to offer opinions about parenting capacity, the children, and the ex-husband-people she has never evaluated. That is a multiple relationship and a competence problem. Adding the ex-husband as a couples client would create a second client with conflicting loyalties and would blur the individual treatment.
Decision steps:
- Clarify the referral question and who is asking for what.
- Obtain and read the release; confirm its scope and expiration.
- Consult a colleague, risk manager, or attorney about the dual role.
- Explain to Dana why the forensic role is inappropriate and what Renee can and cannot say.
- Offer a factual treatment summary, clearly labeled as observations rather than custody opinions, only with a valid release.
- Decline the couples work or refer it to a separate clinician; do not treat the ex-husband while treating Dana.
- Document the request, the explanation, the alternatives offered, and Dana's response.
2. Dana insists, and her attorney sends a subpoena for Renee's records and testimony. How should Renee respond?
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A subpoena is a demand, not automatic authorization to release privileged material. Renee should not ignore it, but she should not simply hand over the chart. She should contact Dana's attorney and her own attorney or malpractice carrier, assert privilege on Dana's behalf unless Dana has waived it, and release records only after a valid written authorization or a court order. If testimony is compelled, Renee must distinguish between fact testimony about treatment and expert opinion about custody. She can testify to what she observed and was told in sessions if ordered, but she should not offer a parenting-capacity opinion outside her role and competence.
She should prepare by reviewing the record, separating factual statements from opinions, and avoiding speculation about the ex-husband or children. She should document the subpoena, the privilege assertion, any authorization, and the court's ruling. If the court orders disclosure, she should comply narrowly-only the material ordered-and inform Dana of the limits of confidentiality before the disclosure.
3. What if Dana threatens to stop therapy or harm herself if Renee refuses to write the letter?
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Renee should treat the threat as clinical material and a possible safety issue, not as a reason to change her ethical analysis. She should assess Dana's current suicidal ideation, intent, plan, means, and protective factors; update the safety plan; involve emergency services or a higher level of care if risk is imminent; and document the assessment. She should explain nonabandonment: Renee is not ending treatment because Dana disagrees, but she cannot adopt a forensic role that would harm Dana or violate ethics.
Renee should offer alternatives-continued treatment, a referral for a separate custody evaluation, help identifying a forensic evaluator, and a factual summary if appropriate-and make a clear termination and transfer plan only if Dana chooses to leave. Coercion by a client does not create an exception to role boundaries. Consultation and documentation are essential because the situation combines boundary pressure, possible self-harm risk, and a legal proceeding.