Clinician Discipline Board Misconduct Decisions: A Study of Linguistic Differences

This study was designed to investigate findings of misconduct against social workers, MFTs, and licensed counselors by employing a retrospective cross-sectional analysis of a linguistic corpus created from a randomized convenience sample of final determinations of disciplinary actions across eight states. The most frequent terms and collocates were assessed for five categories (family, substance, finance, sex, friend, and recordkeeping). Word counts are reported for each category. Collocate maps for the most frequent word in each category were produced. The results in all categories but recordkeeping were notable. In particular, among the friends and sexuality categories, “relationship” was the word with the highest frequency. This suggests the foundational nature of the therapeutic relationship is relevant to both clinical outcomes and to the occurrence of misconduct. For substance terms, the frequency of “alcohol” suggests that alcohol is more connected to findings of misconduct than is any other individual substance. Further, the collocates in the friends and sexuality word categories suggest that misconduct is frequently related to intimate relationships. Additionally, the nuclear family context of the collocates of the most frequent terms in the family word list are reflective of misconduct occurring in the context of the nuclear family relationships. One implication of this study is a recognition that clinical work within families is a specific area of heightened risk for professional misconduct. A second implication is that ongoing supervision and consultation to support healthy clinician self-care activities and to address protective strategies to avoid the risks of developing inappropriate clinician/client relationships is of vital importance.