● Counselors believe the client needs hospitalization to prevent harm to self or others. ● information is required as an issue in a court action. ● clients request that their records be released to themselves or to a third party (HIPAA, 1996). ● The ability to predict danger is unreliable. ● Violating the client’s confidentiality would have interfered with effective treatment. ● Instituting the Tarasoff principle might deter therapists from treating potentially violent patients. ● A ruling on the Tarasoff principle could lead to unwarranted commitments to institutions. Analysis The court rejected all these arguments and declined to dismiss this case. The court instead ruled that the duty to warn is valid under New Jersey law. The court decision stated that even though therapists could not be expected to accurately predict danger or harm in 100 percent of the situations, they have the ability to make a professional judgment in the relationships of the client with others. This therapist observed several warning signs, and the client’s own statements and actions of a violent nature should have provided the therapist with enough evidence to decide that a warning concerning the potential of danger was in order. The court made an analogy and compared the situation with the responsibility to warn communities and individuals about carriers of a contagious disease. The court stated that the client/therapist confidentiality must be secondary to the greater welfare of the community. In cases of imminent or potential danger, the therapist has the duty to warn. The therapist faced the jury and was not held liable for damages, but the Tarasoff principle of duty to warn and protect was adopted in New Jersey. son of the risk from the client. A judge dismissed the case against the therapist, who asserted that his client did not disclose a threat to the new boyfriend directly to him. Ultimately, the California Court of Appeals reinstated the case, explaining, “When the communication of a serious threat of physical harm is received by a therapist from the patient’s immediate family and is shared for the purpose of facilitating and furthering the patient’s treatment, the fact that the family member is not technically the patient is not must be aware of the context of a client’s history and their personal relationships. The court advised that communications from clients’ family members in the context comprised a “patient communication.” Mental health professionals, however, must use caution when accepting the warnings of third parties, such as parents or spouses, who are emotionally involved as they may have ulterior motives. This ruling required that if the therapist determines that individuals have credible information, then that constitutes patient communication and necessitates the duty to warn. crucial.” Analysis The court expressed that psychotherapy does not occur in a vacuum and that for therapy to be effective, therapists
Other circumstances dictate that the counselor must legally report information in the following cases as outlined by law: ● Counselors believe a client younger than 16 years of age is a victim of incest, rape, or some other crime. Case Study: Duty to Warn M. K. was a 15-year-old client of a New Jersey psychiatrist for two years. The client was open with the therapist about his use of illegal drugs and his violent thoughts about a fantasy to threaten people with a knife to control and rob them. He also told the therapist about his sexual relationship with a 20-year-old neighbor. It was clear that he had a strong emotional attachment to the young woman; however, M. K. often expressed his anger and jealousy that the woman was dating other men. The therapist observed that M. K. showed symptoms of severe anxiety when he spoke of the woman. In a subsequent session, M. K. told the therapist that he once fired a BB gun at her car as she drove by his house. M. K. stole a prescription pad from the therapist and attempted to forge his signature in an attempt to purchase 30 Xanax pills. The pharmacist noticed that M. K. was acting suspiciously and, because of his age, called the therapist. The therapist told the pharmacist to disregard the prescription, and M. K. went home. He later stole a gun and shot the young woman to death. The therapist had attempted to reach M. K. by phone to discuss the stolen prescription forms but did not reach him before the woman was shot. The woman’s father had heard of the Tarasoff case, and the family hired an attorney to bring a civil suit against the therapist. The suit charged him with the wrongful death of their daughter and his failure to warn and protect her. The therapist hired an attorney who argued to dismiss the suit claiming that the Tarasoff principle should not apply in New Jersey based on the following: Case Study: Duty to Warn (continued) A Ph.D. and marriage and family therapist (MFT) had treated a client, a former policeman, for three years. The therapy centered on work-related injuries and the breakup of a 17-year relationship with a woman who began to date someone else. The client allegedly told the therapist that he was having suicidal thoughts in early June. The therapist recommended hospitalization and asked for permission to speak with the client’s father. The father told the therapist that his son was deeply depressed, had lost his desire to live, and had mentioned harming the man his former girlfriend was currently dating. The client checked himself into the hospital as a voluntary patient on June 17. The therapist received a phone call from the client’s father the next morning stating that the hospital would soon release his son. The therapist then called the admitting physician and urged him to maintain the client’s hospitalization for further observation through the weekend. The psychiatrist disagreed and released the client. The client did not contact his therapist after he was released from the hospital. No one from the hospital contacted the therapist after releasing the client. On June 23, the client shot the boyfriend of his ex-partner and then killed himself with the same handgun. The parents of the new boyfriend filed a wrongful death lawsuit and named the therapist as one of the defendants. The lawsuit claimed the therapist had a duty to warn their
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Book Code: PCUS1525
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