Cross Examining Psych Doctors - Tip #52-Deciding Between a Psychologist or a Psychiatrist for Medical-Legal Evaluations

The major differences between psychologists and psychiatrists are their training in psychological tests and psychotropic medications.  Psychologists typically have considerably more training and experience in administering and interpreting psychological tests.  Those tests are invaluable in providing data and insights into an individual’s credibility and possible psychopathology.  If you are concerned with the diagnosis of a mental disorder, the psychologist is in a better position to provide objective data concerning the person’s psychological status by using psychological tests.  However, once you know that a person has a specific disorder that is amenable or treatable with medication, the psychiatrist is the person who can intervene to provide that care.

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation:  A Practical Guide for Attorneys and Insurance Adjusters

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the first of the “Big Fifteen.”

3. It is important for me to always win.

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the first of the “Big Fifteen.”

2. It is important for me to be perfect

Cross Examining Psych Doctors - Tip #45-Biofeedback

Biofeedback requires the use of biomechanical electronic transducers for measuring physical processes, which the individual tries to modify in order to achieve some psychotherapeutic effect.  It should be noted that biofeedback therapists are “certified” by private organizations such as the Biofeedback Society of California and the Biofeedback Certification Institute of America.  All biofeedback training has four common features.  First, in all biofeedback procedures the subject or patient is made aware of various physiological functions that they normally might not be conscious of, such as their heart rate or brainwaves.  Second, this awareness is produced by using various electronic instruments that provide measures of the activity of those systems.  Third, those measurements are provided as information or feedback to the subject or patient either visually, auditorily, or possibly in the tactile modality.  Fourth, the patient is instructed, asked to, or taught to control those functions under the assumption that gaining that control will alleviate psychological symptoms.  If all of these conditions have not been met then the patient has not received psychotherapeutic biofeedback training. 

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the first of the “Big Fifteen.”

1. It is important that everyone love me.

www.drleckartwetc.com

(844) 444-8898 

Deposing Psych Claimants: Exposing Wash-Out Reports

Psych doctors make two kinds of serious errors when writing evaluative reports for the courts. The first is failing to diagnose a disorder that is present. The second is diagnosing a disorder that is not there. Reports with these errors are called “Wash-Outs” and “Wash-Ins,” respectively.

Read More: http://drleckartwetc.com/wp-content/uploads/2016/07/July-2016-Newsletter-Final.pdf

Visit my website: http://drleckartwetc.com/Share 

Cross Examining Psych Doctors - Tip #39-Two Steps To Interpreting an MMPI

The interpretation of an MMPI, an MMPI-2 or an MMPI-2-RF is a two-step process.  The first step involves interpreting the validity scales, which are used to determine if the individual has completed the test in an honest and straightforward manner that allows for the interpretation of the remainder of the scales.  Once that hurdle has been overcome, it is reasonable to interpret the patient’s clinical scale scores, which can provide information about any possible psychopathology and the individual’s personality characteristics.  If that hurdle of the validity scales is not overcome, no statements can be made about the clinical scales or the patient’s psychological status.

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #34-Panic Disorder

A Panic Disorder is diagnosed correctly when the individual presents with recurrent and unexpected Panic Attacks.  These attacks must be shown to have been followed by one month or more of either persistent concern about having additional attacks, worry about the implications of the attacks or the consequences, or a significant change in behavior related to the attacks.  In addition, the DSM specifies that a Panic Attack is not a disorder in and of itself and is characterized by a discrete period of intense fear or discomfort in which four or more of 13 symptoms occur that develop abruptly and reach a peak within minutes.  These symptoms are: palpitations; a pounding heart or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feelings of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded or faint; feelings of unreality or of being detached from oneself; fear of losing control or going crazy; fear of dying; numbness or tingling sensation and chills or hot flushes. 

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #31-The Beck Anxiety Inventory

The Beck Anxiety Inventory is a self-report rating scale on which the individual is asked to use a 4-point rating scale to describe him or herself on 21 items that are assumed to be common symptoms of anxiety. It should be noted that this is a self-report questionnaire that has no validity scales for assessing the individual’s test-taking attitudes or credibility. Since the first responsibility of a medical-legal examiner is to determine the credibility of the individual’s self-report, this test should not be used in a medical-legal context. 

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Clinical Depression

Everybody gets depressed.  However, it is only when that depression is not normal, reasonable, understandable and expectable that it crosses the border and becomes a disorder.  There are many psychological disorders in the DSM-IV-TR that include signs and symptoms of a clinical depression.  Thus, if you are interested in the litigation of psychological claims it is important to know how depression is observable during a psychological evaluation and what to look for in a psych report to see if the author “gave away the store.”

Read more
See more from Dr. Leckart

Cross-Examining Psych Doctors - Tip #19-The Mental Status Examination (MSE)

A Mental Status Examination (MSE) produces a set of observations made by the doctor during a face-to-face meeting. An MSE should contain a description of the patient’s appearance and social behavior, observations about the patient’s credibility, statements made by the patient indicative of any possible psychopathology, observations of mood or affect, and measurements of the patient’s memory, concentration, insight, and judgment.  Without MSE data supporting the doctor’s diagnosis the report falls by the wayside.

More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross-Examining Psych Doctors, Tip #18-Check Out The Doctor's History

One of the first steps in reviewing a psych report is seeing if the doctor took a complete history of the patient’s symptoms or complaints to indicate that their diagnosis is correct. The history section is only complete once the doctor has sufficient data about each symptom's qualitative nature, including its frequency, intensity, duration, onset and course over time.

 More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters