Settlement Reached With ‘Prozac Doctor’

A psychologist known as the “Pied Piper of Prozac” has reached a settlement with a Washington state board, ending nearly three years of litigation over his methods of diagnosing and treating patients.

James Goodwin may continue his practice but must consult with an advisor for as long as three years. But, according to the agreement, the state board also says it recognizes Goodwin’s preferred method of therapy as effective in treating some forms of depression.

“I’ve got to say that after all these years, it’s a victory. It’s a victory because I’m accepted finally for what I do,” Goodwin said.

Goodwin found himself the focus of a nationwide stir a few years ago when he claimed that everyone in society suffers from at least some level of depression and would benefit from a combination of cognitive therapy and antidepressant drugs such as Prozac, the most widely prescribed medicine for depression.

In cognitive therapy, psychological disorders are treated by attempting to alter a patient’s patterns of negative thinking and behavior.

Prozac works by selectively enhancing the function of the brain chemical serotonin, which has been linked to clinical depression and other disorders. Since its introduction in 1988, it has become one of the best-selling drugs in the world; more than 12 million people take it.

The state waived any monetary fine against Goodwin in recognition of his lost practice time and the cost of the advisor, whom he will pay. Goodwin estimated that costs of his legal bills and lost time have totaled $300,000.

The agreement with the state Health Department’s Examining Board of Psychology says there is evidence indicating that Goodwin negligently violated the state code by failing to obtain written consent when he asked patients to discuss their treatment regimens with potential patients.

But it also says the two sides “agree to disagree whether there is evidence of actual harm of a client.”

In December 1993, the state board accused Goodwin of breaching patient confidentiality, diagnosing patients without adequate evaluation, pressuring patients into taking Prozac and retaliating against a psychologist who protested his treatment methods.

In 1995, the board lodged administrative charges of mental impairment against Goodwin, alleging that he had a psychological disorder that should bar him from practicing.

Last February, after seven days of hearings, the board dismissed the charge that Goodwin was mentally impaired. That still left allegations of negligence, incompetence and practicing in an area of psychology for which he was not trained.

A hearing on those allegations was to have started Oct. 21, but was canceled when the two sides reached the settlement.

The agreement says the state Health Department “is aware of no psychological or psychiatric infirmities, neither in the past nor at this time, which render Dr. Goodwin unable to practice psychology with reasonable skill and safety.”

Further, it says the department recognizes that cognitive therapy plus certain medications such as Prozac “can be an effective means of treating some depressions. Without necessarily agreeing with Dr. Goodwin’s position, the department recognizes that Dr. Goodwin sincerely believes that it is the best means of treatment of depression at this time.”

Under the agreement, Goodwin will revise the disclosure statement he gives his clients to emphasize that his preferred method of treatment includes cognitive therapy and medication. Clients must sign the agreement before psychological services begin.

If a client decides to discontinue treatment, Goodwin agrees that he will contact that person only to offer aid in finding other professional help.

And if he asks existing clients to tell prospective clients about their treatment, Goodwin will get written permission from both.

The week before the agreement was reached, Goodwin acknowledged that he had made a mistake in only obtaining oral, not written, permission in such instances.

“It might have caused harm,” he said. “I let a person be open to risk. I admit that.”

In return, Goodwin said, he asked the state to acknowledge that there is nothing wrong with him or his treatment methods.

“I wanted my licensing board to basically admit: ‘We don’t necessarily agree, but it’s valid what you do. You keep on doing it,’ ” he said.

An advisor acceptable to both Goodwin and the state will be named to consult with Goodwin on patient diagnoses. The advisor will be appointed for three years, although that period can be shortened if the advisor and state agree.