Part 3: Fitness for Duty and Mental Health

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Thanks Theresa.

There are a number of thoughts flashing through my head. First, I am not certified nor trained to do an FFD evaluation. I think that might settle the issue as far as I’m concerned. I would refer it out if necessary.

But I think that it might be more effective to try and avoid going into an FFD scenario in the first place. It is not a direction one would typically see a missions agency headed, both because of qualifications and philosophy. I talked with my Forensic Psychology specialist about the qualifications. He indicated that these were the industry standards:

1. Post-doctoral training in Forensic Psychology;

2. Being Board Certified in Forensic Psychology, i.e. ABPP or other organizational entity;

3. Minimum years of experience i.e. 3 years performing FFD; and

4. Having training and experience in specific area of FFD i.e. Violence Risk Assessment by adult

Other than my friend, I don’t know of any other psychologist working in missions who has this level of certification. Perhaps, Theresa, you have a different perspective?

At Link Care, we regularly dialogue with agencies about their specific referral questions. We try not to have referrals forced or coerced. Sometimes we accomplish this by talking with the possible client first about what the treatment process would entail. This may involve discussing confidentiality, length, and possible outcomes. And then, our community-oriented therapeutic process really helps people get to the heart of their issues. We encourage communication with the mission so that if needed, reconciliation is possible. I think we avoid conflict by getting as much information as we can, and by turning away those folks who are balking at receiving counseling services. I have asked our Clinical Director, Phillip Collier, Ph.D., to comment on this as well.

From Dr. Collier:

In years past we have had situations where clients were referred to Link Care for treatment, and at the end of the process, the organization (which in some cases paid for the treatment) expected us to make a decision regarding the individual client’s fitness to return to ministry. Unfortunately, in some cases, this created some ill will from such organizations when we did not see that as our role.

To avoid these miscommunications, we have prepared a document for organizations and ministry leaders that makes clear our role as providers of treatment to their members. n this document, we clarify for the organization how and what information can be communicated, and the limitations of those communications. One of the initial challenges is helping organizations understand that what they communicate to us must also be communicated to the client.

In this document, we inform organizations of the importance that they:

• Communicate directly with the client and Link Care. Prior to sending intake information to Link Care, they need to send a copy to the client for their review and approval.

• Communicate clearly any concerns or questions they have regarding the treatment or progress of the client directly to the client, and inform them that they are sharing their concerns with the client’s therapist.

• Understand that the therapist must obtain the client’s permission to communicate with the organization prior to responding to any questions or concerns that it has.

• Understand that the client has a right to know specifically what information the organization is requesting from the therapist, and must give permission prior to the release of any information.

• Communicate clearly any concerns or questions they have regarding the treatment or progress of the client directly to the client, and inform them that they are sharing their concerns with the client’s therapist.

• Understand that Link Care Center does not make specific recommendations regarding employee retention or return to service.

• Notify the Executive Director/CEO if the organization feels there is a safety concern for the client. In these situations, there can be exceptions to the rules of confidentially, because the safety of the client is a concern.

This document has been extremely helpful for us in avoiding miscommunications with organizations and keeping good relationships.

There are times when organizations make referrals because they are dealing with a very difficult employee, and are seeking someone to help evaluate and intervene. In these cases, we attempt to educate ministry leaders that our role as a treatment program precludes us from engaging in this process.

We have found that through this proactive process, we are able to avoid misunderstanding with ministry leaders regarding the services we provide.

Last Note from Dr. Lindquist:

In summary, the mission agency needs to have clear position descriptions, an organizational code of community and interpersonal behavior grounded in biblical values, and the process to follow through on disagreements. This will probably deal with most problems before they get to an FFD process.

Does that make sense?