Geffner v. Board of Psychology

Majority - Edmon, P. J.

No, Dr. Geffner did not violate the American Psychological Association's Ethical Standards as alleged by the Board of Psychology, because a genuine emergency existed, his consultation attempts were reasonable, his report's recommendations were within the scope of an emergency assessment, and the duty to warn was not triggered. The court reversed the trial court's judgment, finding its conclusions unsupported by the evidence or law. Regarding the issue of parental consent (Ethical Standards 3.10 and 9.03), the court found that a "true emergency" existed, contrary to the trial court's determination. It noted that the Board's own expert, Dr. Davidson, characterized the situation as "emergent" and involving "risk factors." The court applied an objective test for an emergency, focusing on whether facts "establish the existence of an exigency of 'so pressing a character that some kind of action must be taken.'" The court reasoned that 12-year-old children expressing persistent suicidal and homicidal ideations tied to an upcoming visit with a parent clearly presented an emergency. The delay in evaluation was due to mother's attempts to find other therapists and Dr. Geffner's coordination, not a lack of exigency. The family court order requiring notification of emergency medical treatment to the other parent after treatment did not mandate prior consent from both parents for an emergency assessment. On the failure to consult the children's therapist (Ethical Standard 3.09), the court emphasized the standard's language: "When indicated and professionally appropriate." This language grants psychologists professional judgment and discretion. The Board's expert, Dr. Davidson, incorrectly asserted that consultation is always required, effectively ignoring the discretionary modifiers in the standard. Dr. Geffner's reliance on mother's representation of the therapist's unavailability, in an emergency focused on risk, was deemed within professional judgment given the standard's wording. As to exceeding the scope of an emergency risk assessment, the court disagreed with the finding that Dr. Geffner's recommendation for "no contact with father" constituted a long-term custody recommendation. The court reasoned that this recommendation was a direct expression of his medical opinion that contact with father was the trigger for the children's suicidal and homicidal ideations, and thus, eliminating this contact was essential to mitigate immediate risk. This was substantively no different from stating an imminent risk if the children saw their father, and was therefore within the bounds of an emergency assessment focused on safety. Finally, concerning the alleged delegation of a duty to warn father (Ethical Standard 3.04), the court found no violation. Ethical Standard 3.04 requires taking "reasonable steps to avoid harming" and "to minimize harm where it is foreseeable and unavoidable." Minor N.'s specific threat (hiring an out-of-state hitman, abandoned due to flaws) was not shown to represent "foreseeable or unavoidable" harm. Drs. Roeder, Ajami, and Geffner agreed there was no realistic risk if the children had no contact with father. Dr. Davidson's interpretation, requiring warning regardless of foreseeability, was deemed inconsistent with the standard's plain language. Furthermore, the court found no duty to warn under Tarasoff v. Regents of University of California, as there was no evidence that either child posed a serious danger of violence to father. Dr. Geffner's report merely stated father "had to be told" of the feelings, not that mother was obligated to do so, and this was important for father as a parent with joint legal custody to understand the children's distress, not because of an imminent threat.