Can a psychiatrist blame a parent if they haven't spoken with them yet?

BLAME?: Interesting question, I do not know about blame but there certainly can be questions about family etc. A thorough history will include family history. Blaming would not be very productive but sometimes patients can misinterpret the doctor's response and say that they were blaming someone or another.

Loaded question: First of all, blame for what? If the patient claims a parent did something to the patient, we will certainly question the plausibility of the situation and the consistency of the patient's report. It would be unlikely that a parent would admit to something like incest, although I have seen it happen. We are not the police, but we do have certain reporting obligation. The answer is that we are our patients doctors. Our job is not playing lawyer or judge rather, our job is to help our patients understand and cope with the reality of the world around them. Whether or not we contact the parents depends upon the needs of the patient and many other factors that are too numerous to go into in this format. It must be left up to our discretion and the patient's desire. We cannot contact the parent regarding issues out of our own curiosity. Our patients have to permit us to talk to the parents. Some patients have motivation to lie about their parents. We are not mind readers however. Likewise, some parents have motivation to lie about what they have done to their children. It is a very difficult position for the psychiatrist to be and we must use our utmost discretion in making decisions about these issues. If things are extremely complicated and we are unsure of what to do, we seek consultation with a colleague.