Psychology Standard of Care Expert Witness
A psychology standard of care expert witness states what a reasonably careful psychologist would have done, sources that standard, and shows where the record departs from it. Dr. Mendonsa is an Expert Reviewer for the California Board of Psychology Enforcement Unit, opining on standards of care, ethics, and alleged misconduct.
The standard of care for a psychologist is the skill, knowledge, and care a reasonably careful psychologist would use in the same or similar circumstances. It is assembled from the APA Ethics Code, forensic specialty guidelines, state statutes and board regulations, and community practice, and it must be proved by expert testimony — in a California license matter, to clear and convincing proof.
No single document states the standard of care for a psychologist; it is assembled. The APA Ethical Principles of Psychologists and Code of Conduct supplies enforceable standards on competence, informed consent, confidentiality, multiple relationships, assessment, and records. The Specialty Guidelines for Forensic Psychology, adopted by APA in 2011, govern the work once the retention is legal rather than clinical. State law supplies the rest: California enumerates the grounds for discipline at Bus. & Prof. Code § 2960 — gross negligence, repeated negligent acts, unauthorized disclosure of confidential information, sexual misconduct, functioning outside established areas of competence. Over all of it sits the negligence formulation: what other reasonably careful practitioners would have done.
How a California board matter proceeds
A complaint reaches the Board from a client, a colleague, an employer, or a court. Staff investigate, and where the allegation turns on clinical judgment the file goes to an expert reviewer for a written standard-of-care opinion. If the Board proceeds, the Attorney General files an accusation under the Administrative Procedure Act (Gov. Code § 11500 et seq.), heard by an administrative law judge at the Office of Administrative Hearings. Under Gov. Code § 11517 the Board may adopt the ALJ’s proposed decision, mitigate the penalty, or reject it and decide the case on the record; it is deemed adopted if the Board does not act within 100 days. Penalty is measured against the Board’s Disciplinary Guidelines, incorporated at Cal. Code Regs. tit. 16, § 1395.2. Accusations are generally barred three years after discovery or seven years after the act, whichever is first, with a ten-year limit for sexual misconduct (Bus. & Prof. Code § 2960.05).
The burden is the point most often misstated. California does not decide license discipline on a preponderance: suspension or revocation requires clear and convincing proof to a reasonable certainty (Ettinger v. Board of Medical Quality Assurance (1982) 135 Cal.App.3d 853). An opinion written to a “more likely than not” threshold answers a question the tribunal is not asking.
What these cases are about
- Boundary violations and multiple relationships, including contact after termination
- Informed consent, and who the client is on a third-party or forensic referral
- Confidentiality and mandated reporting: Pen. Code § 11166, Welf. & Inst. Code § 15630, and the duty to protect under Civ. Code § 43.92
- Documentation, including the seven-year retention floor at Bus. & Prof. Code § 2919
- Competence, scope of practice, and supervision failures
- Telehealth and multi-state practice, where Bus. & Prof. Code § 2290.5 applies the same standard-of-practice rules to remote care
- Impairment, under the uniform standards required at Bus. & Prof. Code § 315
Three findings, routinely conflated
An ethics violation is a breach of a professional code. A standard-of-care breach is a departure from what a reasonably careful practitioner would have done. Negligence causing harm adds causation and injury. A psychologist can violate an ethical standard without breaching the standard of care, and breach it without causing compensable harm. A board can act on the first two; a civil jury needs the third.
In civil court the elements are duty, breach, causation, and damages, and the standard of care can be proved only by expert testimony unless the conduct is within a layperson’s common knowledge (Flowers v. Torrance Memorial Hospital Medical Center (1994) 8 Cal.4th 992). A claim against a psychologist is professional negligence under Code Civ. Proc. § 340.5. Child custody and parenting-plan evaluations are outside Dr. Mendonsa’s scope.
Where a standard-of-care opinion comes from.
Each opinion is built from material that existed before the complaint was filed, not from the complaint.
The Ethics Code
Enforceable standards on competence, informed consent, confidentiality, multiple relationships, assessment, and record-keeping — read as the profession reads them, not as a litigant would prefer.
APA Ethical Principles & Code of ConductForensic specialty guidelines
Where the retention is legal rather than clinical, the forensic guidelines frame role clarity, notification, methods, and the limits of the available data.
APA SGFP · adopted 2011Statute and board regulation
Grounds for discipline at Bus. & Prof. Code § 2960, records at § 2919, telehealth at § 2290.5, and the Board’s regulations and Disciplinary Guidelines.
B&P § 2960 · 16 CCR § 1395.2The clinical record
Intake, consents, progress notes, risk assessment, consultation, supervision, billing, and termination — including what is missing, and the date the writing stopped.
Records · Consents · BillingThe community standard
What practitioners in the same setting, specialty, and period actually did — not what an ideal practitioner would do with hindsight and an open calendar.
Setting · Specialty · PeriodThe opposing report
Rebuttal and critique: whether the other expert stated a standard, sourced it, applied it to these facts, and kept ethics, breach, and causation separate.
Rebuttal · Expert CritiqueHow a board or malpractice review is run.
The sequence is fixed, because the order in which an opinion is formed is the first thing cross-examination tests.
Conflicts and role
Before any record moves: the retaining party, the tribunal, the question posed, and whether the assignment is a standard-of-care review, a treating opinion, or a rebuttal. Roles are not combined.
Written scope
A short letter stating the question, the materials to be relied on, and the standard to be applied. If the question is whether this psychologist breached the standard of care, the letter says so in those words.
Chronology before opinion
The entire file in date order — clinical record, board investigative file, correspondence, prior evaluations, billing — reduced to a source-cited chronology before any conclusion is formed.
State the standard, then apply it
The standard is stated and sourced in the abstract first, and only then applied to these facts. An opinion that begins at the outcome and reasons backward does not survive a competent cross.
Written opinion
Findings separated into ethics, standard of care, and causation, each with its basis identified and each expressed to the burden of proof the tribunal will actually apply.
Testimony
Declaration, deposition, hearing at OAH, or trial in superior court — the same opinion, on the same basis, as the written report.
The background this opinion rests on.
Regulatory review, clinical practice, and the classroom where the ethics code is taught.
Standard of care, board discipline, and malpractice.
What is the standard of care for a psychologist, and where does it come from?
It is what a reasonably careful psychologist would do in the same or similar circumstances. No statute recites it. It is established by expert testimony drawing on four sources: the APA Ethical Principles of Psychologists and Code of Conduct; the Specialty Guidelines for Forensic Psychology where the work is forensic; state statutes and board regulations, which in California include Bus. & Prof. Code § 2960 and the Board’s regulations; and the practices of the relevant professional community at the time.
The last source is the one experts most often skip. A standard stated from a code alone, with no evidence of what practitioners in that setting actually did, is a preference dressed as a standard.
What does the Board have to prove to discipline a California psychology license?
Unprofessional conduct within one of the grounds at Bus. & Prof. Code § 2960, proved by clear and convincing proof to a reasonable certainty — not a preponderance (Ettinger v. Board of Medical Quality Assurance (1982) 135 Cal.App.3d 853). The matter is tried before an administrative law judge at OAH under the Administrative Procedure Act, Gov. Code § 11500 et seq.
Penalty is measured against the Board’s Disciplinary Guidelines at Cal. Code Regs. tit. 16, § 1395.2, which the Board may depart from where the facts warrant. An expert opinion that does not address aggravation, mitigation, rehabilitation, and the adequacy of probation terms leaves half the case unanswered.
Is an ethics violation the same thing as a breach of the standard of care?
No, and treating them as one is the most common defect in these reports. An ethics violation is a breach of a professional code. A standard-of-care breach is a departure from what a reasonably careful practitioner would have done. Negligence causing harm adds causation and injury.
A late progress note may violate a documentation standard without falling below the standard of care. A clinician may fall below the standard of care and harm no one. Each finding is stated separately, with its own basis, or the report cannot be used cleanly by either side.
Do you take respondent-side work, or only board-side?
Both, and also plaintiff- and defense-side work in civil psychotherapist malpractice. Current caseload is roughly 60% defense and 40% plaintiff or applicant.
Serving as an Expert Reviewer for the California Board of Psychology Enforcement Unit is disclosed in every engagement, and any file with an actual conflict is declined at intake rather than returned later.
Do I need an expert to prove psychotherapist malpractice in civil court?
In almost every case, yes. The standard of care in a professional negligence action can be proved only by expert testimony unless the conduct is within the common knowledge of a layperson (Flowers v. Torrance Memorial Hospital Medical Center (1994) 8 Cal.4th 992). Claims against a psychologist are professional negligence claims governed by Code Civ. Proc. § 340.5.
The common-knowledge exception is narrow and rarely reaches psychotherapy, where the alleged breach is usually a judgment about risk, frame, or scope rather than an obvious error.
Can you review a case against a psychologist licensed in another state?
Yes. The standard of care for a psychologist is substantially national, anchored in the same ethics code and the same training accreditation, with state statutes and board regulations layered on top. Those state-specific rules are read and cited from the forum’s own code, not assumed from California’s.
Licensure is a separate question from admissibility. Where an engagement requires licensure in the forum state — because it involves examining a person rather than reviewing records — standing there is confirmed before the case is accepted.
Get the standard stated before the answer is due.
A standard-of-care review is most useful before the accusation is answered, the expert designation is served, or the deposition is set.