___________________________________ Code of Ethics for Counselors and Marriage and Family Therapists
ETHICAL DECISIONS: KEY POINTS FROM THE TARASOFF CASE
• The therapist had an obligation to use reasonable care, based on what he knew, to protect the intended victim from danger. • Depending on the specifics of the case, the therapist may have had to make numerous contacts to notify and warn the potential victim(s), notify law enforcement, contact medical or psychiatric facilities, or persist in taking all steps necessary to warn and protect.
The following precedents were set, following this case, that altered legal statutes and professional standards for ethical practice. • Therapists have specialized knowledge due to the therapeutic relationship of the therapist and client that should inform the duty to protect in this case. • The Tarasoff case, and cases that followed, support the therapist’s duty to warn/protect intended victim(s), not the community at large. • Counselors must be competent to identify and evaluate clients’ potential for violent behavior and assess their potential to commit dangerous acts. • If a patient poses a significant risk of violence to another party, the therapist “bears a duty to exercise reasonable care to protect the foreseeable victim of danger.” • One standard by which the breach of confidentiality and the duty to warn will be judged is the standard of what a reasonable professional in the community under the circumstances would do. This is supported by laws and professional standards. • Counselors must be competent to work with clients with those diagnoses that may include violent behavior or refer those clients to other professionals. Counselors and therapists work only within their area of expertise. • Client records are critical to document that the therapist understood the nature of the situation in relation to the client’s diagnosis. • Counselors must take reasonable steps based on their knowledge of the facts. • Counselors should consult with colleagues if they are unsure of how to proceed according to their code of ethics and the law of their state. • A therapist is liable for a negative outcome if their actions fall below the expected level of care. Only supporting professional standards from the ethics codes are listed subsequently, so the identifying numbers will not be consecutive: ACA Standards • B.2.a. Serious and Foreseeable Harm and Legal Requirements. The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed.
ETHICAL QUESTIONS: TARASOFF CASE ON DUTY TO WARN
Since the Tarasoff case, many laws and association standards and codes of ethics have changed to mandate the duty to warn. There are still a number of issues to consider related to ethics today: 1. Was the counselor competent to deal with the cultural aspects and the mental health diagnoses? 2. What information concerning cultural contexts existed? 3. Was the counselor competent to deal with dangerous or violent clients? 4. Can the counselor violate this ethical standard of confi- dentiality if they are no longer seeing the client? 5. What should be done if clients pose a significant danger to others and need therapy but do not return to therapy, placing the client and society at increased risk? 6. What if clients avoid therapy because the therapist may disclose their shared information to law enforcement? 7. What if clients are not forthcoming with their true feelings and intentions because they believe the counselor will dis- close them to law enforcement or mental health facilities? 8. What is the responsibility of the therapist or counselor, who believes the client poses a danger, to follow up after a client is released from a facility? For how long? Hint: To answer these questions, remember what exceptions to confi- dentiality rules are allowed in HIPAA and association standards in cases of foreseeable harm to self or others. Resulting court opinions form the basis for a general accep- tance of the notion that treating professionals have a duty to protect if they know there are intended victims. This is important and relates to the general principles of beneficence, meaning “striving to benefit,” and nonmalfeasance, meaning to do no harm. In Tarasoff v. Regents of the University of California , it was ruled that if the patient poses a significant risk of violence to another party, the therapist “bears a duty to exercise reasonable care to protect the foreseeable victim of the danger.” States differ in their requirements for identifying foreseeable danger or intended victims, as well as the scope or the degree of possible danger. These are important factors to be considered and acted on to protect both individuals and society.
42
EliteLearning.com/Counselor
Powered by FlippingBook