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Related Experiment Videos

The therapist as representative payee.

A W Brotman1, J J Muller

  • 1Erich Lindemann Mental Health Center, Massachusetts General Hospital, Boston 02114.

Hospital & Community Psychiatry
|February 1, 1990
PubMed
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When therapists manage patient finances via representative payeeship, treatment compliance improves and hospitalizations decrease. This financial oversight, while impacting the therapeutic relationship, offers significant benefits for severely impaired individuals.

Area of Science:

  • Mental Health Services
  • Clinical Psychology
  • Healthcare Administration

Background:

  • Therapist involvement in patient finances through representative payeeship presents unique challenges.
  • Managing patient accounts requires addressing administrative, ethical, and transference issues.

Purpose of the Study:

  • To explore the effects of therapists assuming financial control of patients via representative payeeship.
  • To examine administrative, ethical, and transference/countertransference dynamics in this context.

Main Methods:

  • Case examples from an urban outpatient community mental health center were utilized.
  • Analysis focused on administrative, ethical, and transference/countertransference issues.

Main Results:

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  • Designating the institution as payee with a clinician managing the account improved patient outcomes.
  • Treatment compliance increased, hospitalizations decreased in number and length, and housing situations improved for most patients.
  • Despite potential impacts on the therapeutic relationship, benefits often outweighed liabilities for impaired patients.

Conclusions:

  • An institutional payee approach with clinician management is favored.
  • Therapeutic financial management can significantly benefit severely impaired patients.
  • Careful consideration of ethical and transference issues is crucial when implementing payeeship.