Opinion ID: 2168313
Heading Depth: 1
Heading Rank: 3

Heading: Does the Privilege Apply to Brown?

Text: The issue posed here is whether counselor Brown, who works under the supervision of a psychiatrist, is an adjunct to the psychiatrist (placing Brown under the psychiatrist's privilege) or whether counselor Brown is himself the real caregiver (placing him outside the privilege). The nature and degree of control exercised by the psychiatrist is thus central to the analysis. The description of a leading commentator puts the matter well: If, for example, the psychiatrist works closely with a social worker who takes part of a patient's history it should not matter whether the psychotherapist is present since the patient should treat the social worker with the same trust. Similarly, if a paraprofessional is working under close supervision and control of a professional he should be covered. In contrast, paraprofessionals who are left virtually unsupervised ... are probably not considered by the patient as psychotherapists and they should not be included in the privilege. J. Weinstein and M. Berger, Weinstein's Evidence, para. 504[05], at 504-26 (1989). Under this test, the evidence suggests that the true caregiver was counselor Brown. As far as we can determine from Brown's testimony, Brown was the only person at the mental health center who actually consulted with C.P.; C.P. and the psychiatrist never saw each other. Brown's relationship with C.P. was apparently a typical one. After Brown completed an initial consultation with a patient, he would come up with a diagnostic formulation to determine what the patient appeared to be diagnostically and then develop a treatment plan. Record at 83. Brown subsequently presented his diagnosis and plan to the psychiatrist for approval. Such presentation sessions with the psychiatrist typically lasted five to fifteen minutes. The psychiatrist would either approve the plan, add something to it, or direct that Brown prepare a new one. It appears that the psychiatrist did not prepare plans for patients treated by Brown. After a plan was approved, Brown consulted with the psychiatrist about a patient only twice a year, perhaps quarterly. We conclude that the evidence supports the trial court's determination that C.P.'s communications to counselor Brown were not communications to a physician. [4] After all, C.P. never even saw a physician. To paraphrase Weinstein, counselors who operate independently with little intervention by a psychiatrist are probably not regarded by patients as physicians and thus should not be included in the privilege. J. Weinstein & M. Berger, supra. The existence of the relationship is a question of fact to be determined by the trial court on the basis of the evidence. See Chicago & Erie R.R. v. Schenkel (1914), 57 Ind. App. 175, 189, 104 N.E. 50, 55. Because the trial court's determination is supported by substantial evidence, we affirm it. Brown was not covered by the privilege. We affirm the judgment of the trial court. DeBRULER, GIVAN, and PIVARNIK, JJ., concur. DICKSON, J., concurs in result.