discipline summaries
Email messages that Dr. Muirhead exchanged with five
patients obtained in the College’s investigation appear to describe romantic and/or sexual relationships
between Dr. Muirhead and these patients. The patients
deny actual sexual contact.
Independent experts retained by the College opined
that Dr. Muirhead failed to maintain the standard of
practice in many respects, including the following:
• ecordkeeping with inadequate progress notes; some
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files failing to contain basic information such as address or birthdate; the patient’s family history, history
of psychiatric disorder and developmental history,
diagnosis or treatment plan; there were no complete
mental status examinations recorded;
• n one case, the chart note was inaccurate and misI
leading with regard to suicidal intent;
• id not adequately explain or obtain informed conD
sent and document this for his challenging form of
therapy;
• requently told his female patients that if they allow
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themselves to be close to him and feel strong feelings
as well as physical sexual arousal, this would improve
the result or outcome of their therapy. This is an unusual technique and overstated. There is no evidence
that this amount of closeness is either necessary or
sufficient to have a good outcome; Placed excessive
pressure on patients for positive feelings, affection and
sexual and physical sensations of arousal. Sometimes
the pressure for closeness was demanded with the
threat that without it, therapy would stop;
• aw many patients who knew each other. He did
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ask them not to talk about therapy with one another
but they did. This complicates the resistance and the
competitiveness for love that patients feel, especially
when he commented to patients that those who are
very close to him do well and those who are not close
to him do not do well;
• n six cases, exchanged emails with patients which
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characterize an intimate, loving relationship rather
than a therapeutic relationship, with inappropriate
self-disclosure by him;
• ngaged in inappropriate contact with some patients
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outside therapy;
• ccasionally talked to his patients about other
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patients and had one patient type his response to a
College complaint made by another patient;
• ngaged in unacceptable boundary crossings and
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violations, including hugging patients, signing his
emails “Love H”, borrowing money from patients,
visiting patients in his home or theirs, telling patients
they are very special, and engaging in inappropriate
self-disclosure to patients;
• n his email exchanges, the interactions characterize a
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personal relationship more than a therapeutic one. He
does not firmly indicate that this is not and never will
be a personal relationship. This is a failure to maintain boundaries and a failure in knowledge of clinical
practice guidelines for psychotherapy;
• Asked patients to delete their emails with each other;
• n respect of one complainant, he failed to mainI
tain the standard of practice in his assessment, in his
medical records, in failing to establish an alliance, in
his selection of the type of therapy, and in his failure
to obtain informed consent. In addition, he inappropriately offered to meet the patient outside the office,
told the patient to delete emails from him and gave
her his cell phone number;
• n respect of three patients, he failed to maintain the
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standards of fam