Posted by Dr. Vollmer on August 11, 2013
Yes, Steve Lopez is a tremendous advocate for the mentally ill. His journalism has brought awareness to the problems in LA County in ways in which psychiatrists have been anemic. I have applauded him before in my posts. https://shirahvollmermd.wordpress.com/2013/07/17/mentally-ill-are-locked-up-where-are-the-psychiatrists/ . In today’s LA Times, I also agree with his main point that in the proper environment, it is both cost-effective, and helpful to patients to get quality treatment for their mental illness. I also agree that Step-Up-On Second is a model facility for the mentally ill. Yet, it is this paragraph that I am compelled to comment on.
“At Step Up, which serves hundreds of clients, Andy got counseling, he switched to a more effective medication and worked as a chef after culinary training. He also moved in with his girlfriend, social worker and therapist Kathy McTaggart. Without McTaggart and Step Up, Andy told me, he might still be in jail or worse.”
This is unacceptable. A therapist should never develop an intimate relationship with his patient, no matter what. I am confused as to why Mr. Lopez chose Andy for this story, as this last detail contaminates his point. This article could lead people to believe that if the patient can “take their therapist home,” literally speaking, then there is hope. In fact, most of the time, this boundary violation creates more mental suffering, as the playing field never balances. The image this gives to the therapeutic community is potentially very damaging. Many therapists help patients, such as Andy, develop intimate relationships with others, thereby giving them the confidence to create a life for themselves which has meaning. The therapist is that essential bridge to self-confidence and self-esteem. When the patient never gets off that bridge then perpetual dependency, and not deep self-esteem, ensues. That this worked out for Andy is not the point. The point is that Mr. Lopez should not have exposed this practice as the model treatment.