Handling clients with mental health conditions
Expert Dr. Naresh Verma advises on how lawyers can navigate challenging behaviours with their clients.
The Australian Specialist Hub (ASH) is a national provider of medico legal assessments covering all areas of independent experts as well as a special interest in experts for Total and Permanent Disability (TPD) Claims.
ASH will be running a number of seminars with Dr Naresh Verma regarding lawyers managing clients with mental health conditions. Dr Verma is a dual-qualified practising Occupational Physician and Psychiatrist who provides weekly medico legal clinics for the ASH. His dual specialisations provide him with the expertise and experience to provide balanced and evidence-based assessments that consider the person’s health status and occupational background. In addition, his MBA allows him to understand the perspective of the employer and business.
We sat down with him to discuss two of commonly asked questions that will be further expanded on into a series of seminars.
Q: What are the key differentiators between a Forensic Psychiatrist and a General Psychiatrist?
A General Psychiatrist is an expert at general psychiatric conditions without a specific discrete area of special practice. A forensic psychiatrist is an expert in assessing and treating forensic patients. They frequently work in the prison system and often do medico legal work.
Q: Do you have any advice for lawyers managing clients suffering from mental health conditions?
It is important to acknowledge and not ignore the transference ( how the client feels about you) and your own countertransference ( the emotions you feel ) towards the client. For example you may remind the client of someone who they had a negative experience with in the past and this may be reflected in how they behave towards you, which is their transference. In turn you may experience emotions such as anger, fear or sadness in your interactions with the client due to their behaviour or what they say which is your countertransference. It is important to keep a check on those feelings and discuss them with your peers or with a friendly psychologist/psychiatrist. This will help you manage these emotions when you are dealing with your client, which in turn will ensure that your judgement and decision making is unaffected when you are providing legal advice to them. If this countertransference is difficult to manage for you, there may be a risk of professional boundaries being blurred or your service being adversely affected. If this happens it may be better for the client to consult another lawyer.
Repeated experiences with clients of negative transference and countertransference can have a cumuluative effect and may result in you developing a very harsh or critical attitude towards them and your profession, resulting in burnout and time away from your practice.
One of the most effective ways to manage this dynamic is to be very clear about boundaries with clients. For example being helpful and empathetic but also firm when you provide advice. It is also very important that clients understand what acceptable behaviour is in the client/lawyer relationship. You may for example need to set limits on frequency of contact by letting them know that contact should be only during business hours and not excessively frequent. It is also very important to make it clear to the client that unreasonable demands by them on you or behaviour such as verbal or physical aggression are unacceptable under any circumstances and will mean you cannot help them and they have to find another lawyer. A sign in your office about aggression being unacceptable may be helpful in communicating this.
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About the author:
Dr Naresh Verma
Consultant Psychiatrist and Consultant Occupational & Environmental Physician
MBBS (UNSW) FRANZCP FAFOEM (RACP) MBA (AGSM)
Dr Naresh Verma is a dual-qualified practising Occupational Physician and Psychiatrist who provides weekly clinics for the Australian Specialist Hub (ASH). Dr Verma is accredited as a Permanent Impairment Assessor in AMA 4th and 5th edition impairment guidelines, and provides psychiatric whole-person impairment (WPI) ratings.
Dr Verma frequently assess cases involving:
- PTSD and trauma-related conditions
- Complex psychiatric conditions
- Personality disorders
He completed his first specialisation in Occupational and Environmental Medicine and worked as an Occupational Physician for NSW Police, Fire and Rescue NSW, Defence, and in private practice. As a result, he has vast experience in managing and assessing safety-critical and safety-sensitive workers and workers in most other areas such as education, retail, process work and the trades. Occupational Medicine also involves being an Environmental Physician which gives him the experience of managing environmental hazards and risks, as well as risk communication.
Dr Verma qualified as a Psychiatrist in 2019 and worked in the public hospital system as a general psychiatrist as well as St John of God Hospital, Burwood and Gordon Hospital. This allowed him to manage the more acutely unwell psychiatric patients.