08/12/2026
The Lindsay Clancy case is, first and foremost, an unimaginable tragedy involving the loss of three children.
It is not our role to retrospectively judge the clinicians involved, determine what they should have known, or suggest that a different clinical decision would necessarily have changed what occurred.
But the conversations emerging from this case have brought an important issue in mental health care into the public eye: scope of practice and clinical competence.
We are in the field of psychotherapy. However, being legally allowed to provide psychotherapy does not mean being qualified to treat every presentation that may enter the therapy room.
Mental health is an enormous field. A clinician can be highly skilled in trauma treatment and have limited specialized training in eating disorders. Someone can have extensive experience treating anxiety and depression without having the expertise required for OCD, psychosis, complex dissociation, severe substance use, or specialized perinatal mental health care.
And sometimes, a client's needs change after therapy has already begun.
Ethical practice requires us to keep asking:
Do I have the training and competence this person needs right now?
If the answer changes, the treatment plan may need to change too. That might mean consultation, collaboration with another provider, specialized assessment, adding another professional to the treatment team, or referring to someone with greater expertise.
At VOX, we don't believe therapists should try to treat everything.
We also don't believe that keeping every client within our organization should be the goal. Private practice necessarily operates within a marketplace, but health care cannot be guided by marketplace values alone. Sometimes the most responsible decision is helping someone find care somewhere else.
