Mental Health Professionals Need to Know How To Handle Difficult Patients – Part 1

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Psychologists, mental health counselors, social workers, and other psychotherapists, because of the nature of their professions, will often encounter difficult, abusive, or obsessive clients/patients. It comes with the territory. The clients or patients to whom they are expected to provide treatment and therapy to, often suffer from mental disorders, personality disorders, or illnesses.

Although it is traditional for many mental health professionals to refer to “clients” instead of “patients,” we will use the term “client/patient” in this blog.

First, Protect Your Own Privacy.

You should safeguard your own privacy and the security of your office, staff and family.

Obtain a telephone number and line dedicated exclusively for your office or practice. Do not give out your cell phone number or your home telephone number. Make sure your office staff, receptionist and colleagues know not to ever give out your cell phone number. Make sure that your own cell phone number is masked or blocked for those times when you may use it to call clients/patients.

Do not allow your home address to be published whenever possible. You can request that telephone carriers and directories not list your home address. Check Internet and online directories to make sure your home address is not available online. List only your office address or a post office box on your official Department of Health Licensure forms. Under no circumstances give out or allow your home address to be give to clients/patients.

Your Professional Time Is Valuable: Require Clients/Patients To Pay For It.

You are a professional. You are supposed to be paid for your time.

Yet, over and over again, I consult with therapists who have only seen a client/patient for a few paid sessions, but are spending countless additional hours talking to the client/patient on the telephone, responding to client/patient e-mails and text messages, or attending to problem situations caused by the client/patient.

I recommend that at the very first encounter with the client/patient, you explain to the client/patient that you expect to be paid for your time. Explain that insurance carriers and other third party payers do not pay for the time you may spend:

1.    Talking to the client/patient or the client’s/patient’s family or other
professionals on the telephone;

2.    Responding to client/patient e-mails, letters or text messages;

3.    Completing forms for the client/patient, including insurance forms, disability
applications, request for information, etc.; or

4.    Time you expend on other tasks the client/patient requests, such as court
appearances, meetings with others, or any acts the client/patient asks you to
perform to assist them.

Make sure that the client/patient understands that he or she will have to pay for these separately out of his or her own pockets. Have the client/patient sign an acknowledgment form (similar to a Medicare ABN: Advance Beneficiary Notice) stating that he/she understands they will be billed for these and the client/patient is expected to pay. Include this in your client/patient financial agreement.

Click here for a form you may consider adopting for your use.

Keep a lookout for part 2 of this blog. Part 2 will include scenarios in which a client/patient can abuse a professional relationship and how you as the mental health professional can appropriately handle such incidents.


Have you ever experienced a strained relationship with any of your clients/patients? Do you have a difficult, abusive client/patient? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
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