Attorney Articles | Sometimes Its What You Dont Say

Articles by Legal Department Staff

The Legal Department articles are not intended to serve as legal advice and are offered for educational purposes only. The information provided should not be used as a substitute for independent legal advice and it is not intended to address every situation that could potentially arise. Please be aware that laws, regulations and technical standards change over time. As a result, it is important to verify and update any reference or information that is provided in the article.

Sometimes Its What You Dont Say

By Michael Griffin, JD, LCSW, Staff Attorney; Learn how the therapist's opinion, regardless of whether it is documented in a report, expressed on the witness stand, or written in a letter, can have a powerful impact on the person's life.

“Sometimes, It’s What You DON’T Say…”
The Therapist
March/April 2013
Michael Griffin, JD, LCSW (CAMFT Staff Attorney)
Reviewed November, 2022 by Michael Griffin, JD, (CAMFT Staff Attorney)

Many members consult with the Staff Attorneys regarding many issues, one common issue involves patients asking providers to write a letter. This is so common, it would be unusual for a CAMFT attorney to go more than a few days without hearing, “My client asked me to write a letter...”

Therapists are asked to write letters for a variety of reasons, some more important than others. More often than not, a request for a letter is really a request for the therapist to provide his or her professional opinion or recommendations regarding the client. Because a request for a letter sounds fairly innocuous, however, compared to a request for recommendations from a mental health professional, the gravity of writing a letter is not always evident. In reality, the therapist’s opinion, regardless of whether it is documented in a report, expressed on the witness stand, or written in a letter, can have a powerful impact on a person’s life.

A therapist who fails to consider the possible consequences of writing a letter runs the risk of a malpractice lawsuit, ethics complaint, or a disciplinary action by the therapist’s licensing board. Fortunately, a therapist can minimize the likelihood of encountering such events if they first take the time to determine whether it is appropriate to comment on a particular topic or issue.1 Depending on the circumstances, the therapist may decide not to comment on an issue or to offer any recommendations in a letter. Or, they may decide to request additional information from the client, prior to reaching a decision. Of course, the therapist would also be free to provide the requested letter, if they determine it’s appropriate.

The Right to Say “No”
Occasionally, a therapist will remark that they didn’t realize that it was possible to say “no” to a client’s request. As a general rule, a therapist is entirely free to decline such a request. There is no legal or ethical “duty to write a letter” and a client’s request, in itself, does not obligate a therapist to act in a particular manner.

High Risk Scenarios
One of the most challenging situations occurs when a therapist is asked to provide their recommendations concerning a child or adolescent client, whose parents are engaged in family court litigation.

A parent may ask the child’s therapist for a letter shortly after bringing the child to therapy. In this situation, some therapists will decline the parent’s request, stating that they are unfamiliar with the child and therefore unable to offer an informed opinion.

Other therapists state they do not write such letters as a matter of policy, or, they may inform the requesting parent that they do not wish to become involved in the client’s legal matters. In response, the parent may “up the ante,” explaining that the letter is needed for an important legal action which concerns the child, or that the therapist’s help is urgently necessary in order to protect the child from a dangerous person or circumstance. In this situation, the child’s parent, or the parent’s attorney, may ask the therapist to write a letter “to the court,” wherein the therapist would recommend some change in the minor’s visitation arrangement.2

It is quite understandable that a therapist may want to provide one of the above-described letters, based upon a genuine desire to help the client, but they must consider the possibility of becoming embroiled in the client’s legal matters.3 The general rule is that a therapist should avoid offering their opinion on a legal issue, such as custodial rights or the child’s visitation schedule. Although some parents may accept a therapist's refusal with little fanfare, others may continue to try and change the therapist’s mind, and may ask the therapist to speak with the parent’s attorney. Ultimately, some therapists eventually tire of such pressure and agree to produce the requested letter.4

There are therapists who do not question a parent regarding the request for a letter or seriously consider whether it is advisable to write one; they simply produce the requested document. Generally speaking, when a therapist writes a letter on a matter that is the subject of contention in a family court matter, there is a significant risk that they will encounter legal and ethical problems, as evidenced in numerous complaints that are filed with licensing boards and ethics committees.

Legal and Ethical Issues
Prior to offering a professional opinion, a therapist needs to determine whether it is appropriate to do so. In making such a determination, the therapist would be expected to consider any relevant legal and ethical standards.5 Generally speaking, the standards that are relevant to this area concern the following:

Scope of Competency
In order for the therapist to provide professional recommendations regarding a particular topic or issue, they must possess a sufficient degree of education, training and experience to competently render such an opinion. Consequently, a therapist who offers an assessment of, or recommendations concerning, an issue while lacking the competency to do so may be accused of engaging in unprofessional conduct.6

Multiple or Dual Relationships/Conflicts of Interest7 8 9
A therapist is expected to avoid performing multiple roles for the same clients or treatment units, particularly when doing so is likely to impair their professional judgment, or where there is a potential conflict of interest. There may be a potential conflict of interest, when a treating therapist provides an evaluation of his or her psychotherapy client for use in a legal proceeding.

Bias/Lack of Objectivity10 11
A therapist is expected to remain impartial in a legal proceeding and to avoid compromising their judgment. When a therapist offers an opinion or recommendation regarding his or her psychotherapy client, for use in a legal matter, the therapist may be subject to an allegation that their opinion was biased, because of their concurrent role as the person’s therapist. Should the opinion concern a legal issue such as custody, an aggrieved party may decide to complain of bias, and point out that opinions regarding custody are supposed to be issued by individuals who have met specific requirements and guidelines.12

Disclosing the Limits of Opinions/Offering Opinions About Persons Not Evaluated13
It is unethical for a therapist to offer an opinion about a person that they have not evaluated. Furthermore, it is expected that a therapist will disclose the limits of the information upon which their opinion is based. Consequently, when a therapist offers an opinion which describes the alleged problems of some person whom they have never met, there is a significant possibility that the individual may accuse the therapist of unethical conduct.

The Benefit of Consultation
It is advisable for a therapist to seek consultation from a colleague or other reliable source at the time the request is made. While it is appropriate to seek consultation about a matter at any time, consultation is likely to be more effective when it is sought prior to offering the requested letter.

Questions to Consider
Before responding to a request for a letter, a therapist may find it helpful to consider the following questions:

  1. What is the specific nature of the request?
  2. What does the requesting person want from you?
  3. Are you reluctant to respond to the request? Why?
  4. What does the request have to do with your role as a therapist?
  5. Are there any reasons that you should not honor the request?
  6. Do you feel pressured or compelled to honor the request? If so, why?
  7. Is it appropriate to provide the information requested?
  8. Are you qualified to address the issue?

Anticipating Problems
It is often possible for a therapist to anticipate that they may be asked to interject their opinion on a legal matter. The common example is when a therapist is asked to provide treatment to a child whose parents are in the middle of a divorce. Or, a therapist may discover that one of their child clients has become the subject of litigation. In either scenario, it is fairly inevitable that one or both parents will ask the therapist to provide information about the child’s treatment, or to express an opinion regarding the child’s relationship to his or her parents. The therapist may even be asked to comment on issues such as custody or visitation.

In these instances, it is important for the therapist to learn what the child’s parent(s) expect of them and it is necessary for the therapist to clarify the nature and limits of their role as the child’s therapist. When only one of the parents initiates contact, the therapist must ensure that they obtained the appropriate consent to provide services prior to beginning therapy with the minor It is advisable for the therapist to carefully assess all the facts and circumstances carefully, and to be cautious about engaging in treatment of the minor without the involvement of both parents.14 The parent who initiated treatment often assumes that the therapist will be willing to advocate for them regarding visitation or custody issues. In such instances, it’s also likely that, at some point, the therapist will be asked to write a letter. Considering the prevalence of such requests, especially in cases where there is family court involvement, the question isn’t whether the therapist will receive a request for a letter. It’s when.

Michael Griffin, JD, LCSW, is a Staff Attorney at CAMFT. Michael is available to answer member calls regarding legal, ethical, and licensure issues.


1. The amount of time spent in such deliberation depends on the nature of the request and the particular facts and circumstances.
2. These circumstances have the potential to lead an unwary therapist into trouble and it is strongly recommended that a therapist seek appropriate consultation when needed.
3. There are exceptions to almost any rule. The discussion concerns many or most circumstances. In select circumstances, subject to direction of the court, it may be possible for a therapist to provide information related to visitation, or other issues.
4. If the therapist declines to write a letter, it is generally advisable to document their decision, including any applicable reasons
5. The legal and ethical standards that are discussed in this article are not intended to be an exhaustive list of every legal or ethical standards relevant to the subject matter. The ethical standards cited can be found in Part I of the CAMFT Code of Ethics, which is available at: The legal and ethical standards that apply will vary, depending on the facts and circumstances of a given situation. Those who are members of other professional associations should consult the ethical standards provided by each organization.
6. §4982(s), Business & Professions Code, Performing or holding oneself out as being able to perform professional services beyond the scope of one’s competence, as established by one’s education, training or experience is unprofessional conduct.
7. §4.1 CAMFT Code of Ethics: Dual /multiple relationships occur when a therapist and his/her client/patient concurrently engage in one or more separate and distinct relationships. Not all dual/multiple relationships are unethical, and some need not be avoided, including those that are due to geographic proximity, diverse communities, recognized marriage and family therapy treatment models, and community activities, or that fall within the context of culturally congruent relationships. Marriage and family therapists are aware of their influential position with respect to clients/patients, and avoid relationships that are reasonably likely to exploit the trust and/or dependence of clients/patients, or which may impair the therapist’s professional judgment.
8. §10.3 CAMFT Code of Ethics: Whenever possible, marriage and family therapists avoid performing conflicting roles in legal proceedings and disclose any potential conflicts to prospective clients/patients, to the courts, or to others as appropriate. At the outset of the service to be provided and as changes occur, marriage and family therapists clarify role expectations, limitations, conflicts, and the extent of confidentiality to pre-existing or prospective clients, to the courts, or to others as appropriate. 

9. §10.4 CAMFT Code of Ethics: Marriage and family therapists avoid providing both court evaluations and treatment concurrently or sequentially for the same clients/patients or treatment units in legal proceedings such as child custody, visitation, dependency, or guardianship proceedings, unless otherwise required by law or initially appointed pursuant to court order. When pre-existing clients/patients become involved in a legal proceeding and the marriage and family therapist continues to provide treatment, they should discuss the potential effects of legal involvement with their clients/patients, including clarifying the potential role conflicts, clients’/patients’ expectations, and possible requests to release treatmen tinformation.
10. §10.5 CAMFT Code of Ethics: Marriage and family therapists, regardless of their role in a legal proceeding, remain impartial and do not compromise their professional judgment or integrity. Marriage and family therapists understand that their testimony and opinions are impactful on legal outcomes. Marriage and family therapists use particular caution when drawing conclusions or forming or expressing opinions from limited observations or sources of information.
11. §10.8 CAMFT Code of Ethics: Marriage and family therapists who are custody evaluators (private or court-based) or special masters provide such services only if they meet the requirements established by relevant ethical standards, guidelines, laws, regulations, and rules of court.
12. See, Kashing, Sara, JD, “Private Child Custody Evaluator Requirements,” The Therapist, Nov./Dec., 2012
13. §5.14 CAMFT Code of Ethics: Marriage and family therapists do not express professional opinions about an individual's psychological condition unless they have treated or conducted an examination and assessment of the individual, or unless they reveal the limits of the information upon which their professional opinions are based, with appropriate cautions as to the effects of such limited information upon their opinions. (See also section 10.7 Professional Opinions in Court-Involved Cases.)
14. Therapists are generally advised to be cautious, but this should not be interpreted to mean that a therapist is automatically precluded from providing treatment to a minor unless both parents are involved. No two situations are identical. The treatment plan that is appropriate in a given circumstance depends on all of the relevant facts and circumstances.