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The Psychiatrist in Court: A Survival Guide
Am J Psychiatry 1999;156:486-486.
View Author and Article Information
Snellville, Ga.

by Thomas G. Gutheil, M.D. Washington, D.C. American Psychiatric Press, 1998, 118 pp., $25.00 (paper).

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For psychiatrists who find themselves in the unfamiliar, seemingly turbulent and hostile adversarial environment of the civil or criminal litigation system, the experience may be stressful at best and often profoundly anxiety provoking. The forensic expertise of Dr. Gutheil displayed in this recent publication serves as an invaluable navigational guide for passage through this unfamiliar territory. This book brings familiarity, clarity, and understanding to the basics of the legal process.

In the introductory chapter, the author defines his purpose in authoring this text as two-fold. His first objective is to assist the psychiatrist-reader to become more knowledgeable about the setting, assumptions, personnel, issues, and techniques of the court experience. Dr. Gutheil’s second objective is to demystify the court experience, thereby reducing the stress and anxiety that often accompany it. In a clear, succinct, and entertaining style, he introduces the "players": the fact-finder (judge or jury); the parties (plaintiff and defendant); their attorneys; court personnel (clerk, bailiff, stenographer); and, sometimes, the guardian ad litem. He describes the roles of these players and the relationship of the psychiatrist in various potential roles to them. Insight governing courtroom etiquette and an introduction to the Socratic method assist in the demystification of the legal process.

Dr. Gutheil illuminates the roles in which psychiatrists may find themselves involved in the courtroom experience. The distinction of the role of psychiatrist as a fact witness versus the psychiatrist’s role as an expert witness is well articulated. In this book, Dr. Gutheil emphasizes the role of the psychiatrist as a fact witness. In a companion text, The Psychiatrist as Expert Witness, also reviewed in this issue of the Journal, he addresses the ethical, clinical, and functional role of the psychiatrist as an expert witness.

The Psychiatrist in Court provides a concise, thoughtful, and sobering treatise highlighting the common pitfalls that the psychiatrist as "treater" and fact witness may encounter. Issues of subjective and objective viewpoints, the conflict between role and interest, foresight and hindsight, bias, and standards of care are addressed to enhance the reader’s knowledge of and effectiveness in the court experience.

Two particularly unnerving aspects of the legal process—the deposition and the trial—are masterfully and pragmatically addressed. Chapter 5, "Depositions and How to Survive Them," is an invaluable guide to understanding the mechanisms, content, objectives, and pitfalls of the deposition. Chapter 6, "The Trial Itself," focuses on the six Ps of trial preparation: preparation, planning, practice, pretrial conference, pitfalls, and presentation. Dr. Gutheil provides illustrations from actual cases as well as practical and sage recommendations and principles to navigate these potentially rocky areas.

This book very capably accomplishes a formidable task—it addresses a topic with which the majority of its audience has little to no formal or practical experience. Dr. Gutheil provides a comprehensive survey of the process, from the first contact through the filing, discovery, deposition, and trial phases, and then the outcome and reporting to the National Practitioner Data Bank. The totality of the text reflects a balance of conversational familiarity and focused detail to particulars essential as a guide for the novice as well as the seasoned practitioner venturing into the legal system.




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