Functioning Well in a Dysfunctional System: Recommendations for Clinical Psychologists in Workers’ Compensation Settings

Clinical psychologists working in workers’ compensation (WC) settings face unique and complex professional and ethical challenges. The present paper provides recommendations to clinical psychologists for avoiding the largely unintentional harm to clients and unethical practices that can occur within the realm of WC. Although the psychologists working in WC settings more often than not act in ethical ways grounded in years of academic and professional training, the unique tasks required of psychologists in WC settings (e.g., rating injuries; determinations of causality) and the pressures inherent in the system can potentially lead even the most well-intentioned mental health professionals into unsavory ethical and professional scenarios. The authors examine the (un)witting contributions of psychologists to the current dysfunction in the WC system and provide recommendations for traversing the oft-serpentine terrain of mental health evaluations and treatment in WC settings. Specifically, the authors discuss, among the many possible potential pitfalls, (1) bringing personal bias into the evaluative setting, (2) engaging in unsavory advertising practices, (3) cherry-picking and other missteps in record review, (4) engaging in cursory consenting, (5) failure to engage in evidence-based assessment and report writing, and (6) role challenges.     

The Effects of Dextromethorphan on Driving Performance and the Standardized Field Sobriety Test

Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one‐time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects’ ability to drive was assessed by their performance in a driving simulator (STISIM^® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1‐h postdrug administration. The one‐time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM^® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior.