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Board of Psychology draws criticism over proposal to access psychotherapy records without patient consent
Summary
The Board of Psychology told lawmakers it sometimes cannot pursue investigations because patients decline to release therapy records; the board proposed an exception to psychotherapist–patient privilege for investigations, drawing sharp opposition from professional groups and lawmakers.
Doctor Leah Tate, president of the California Board of Psychology, described recent regulatory and procedural reforms and raised an issue under debate: a proposed narrow exception to psychotherapist–patient privilege to allow the board to access records for certain investigations.
"Currently, the records that we receive are kept confidential," said Sandra Monterrubio, enforcement manager for the Board of Psychology, who noted the board relies on statutory protections (citing "Evidence Code 1040" and "Government Code 7923.6" in testimony) and protective redaction practices when cases proceed to prosecution. She said, however, the board sometimes closes cases for "insufficient evidence" when a complainant refuses to release records needed to review allegations such as bias in custody evaluations or allegations of sexual misconduct.
Why it matters: The proposal pits two competing priorities: investigators' ability to gather evidence in cases alleging serious professional misconduct, and patients' privacy and autonomy over psychotherapy records. Several professional associations told the committees they oppose weakening privilege; some committee members also expressed concern.
Opposition from professional groups: Testimony included written and oral opposition from the California Psychological Association and the California Association of Marriage and Family Therapists. Dr. Elizabeth Winkelman (California Psychological Association) said the board's staff can already obtain records via subpoena and civil court review, a process that, though time-consuming and costly, "ensures judicial review to determine if the needs of the investigation outweigh patient privacy considerations." She said the board reported only four cases in four years closed because of a patient's refusal to release records, and argued the proposed exception is unnecessary.
Board rationale: Board witnesses said the current subpoena process can take over a year and cost tens of thousands of dollars, and that some complaints (for example, alleging bias in child custody evaluations) require test data and notes to assess whether practice standards were met. The board asked the committee to consider options that would allow investigators access to certain records for investigation while retaining privacy protections in public files.
Other Board of Psychology items: The board also described fee changes to address structural shortfalls, implementation of continuing professional development (CPD) requirements (including four CPD hours devoted to cultural diversity and social justice), and changes to foreign degree evaluation processes for applicants trained outside the United States and Canada. The board reported an increase in registered psychological associates to 1,853 and described changes allowing inactive status without counting toward registration time limits when supervision is disrupted.
Next steps: Committee members signaled the issue of privilege will draw follow-up discussions. Some members said they are not amenable to a statutory change that bypasses judicial review absent clearer evidence the current subpoena process cannot be made more efficient.
