Duty to Warn

To avoid the quandary that arises when the therapeutic relationship is damaged by mandated reporting the practitioner is advised to communicate to clients the limits of confidentiality at the onset of treatment (Krase, 2013). In doing so clients will use caution when deciding what to disclose during sessions. Social workers continue to support the client even after breaking confidentiality by advocating for the client during the investigation and consequential course of action. In the case of Ms. Robinson, the social worker should advocate for a holistic approach to sentencing that would take into

The article “Duty to Warn and Protect: Not in Texas” cites the 1999 Texas Supreme court decision in the case Thapar v. Zezulka; which stated that counselors do not have a duty to warn and protect because it breaks client/counselor confidentiality (Barbee, Combs, Ekleberry, & Villalobos, 2007). As a result of the 1999 ruling the

Therapists get legally allowed to warn others of potential dangers. This article should expound on how this can be done, and when the need should be identified by clinician. An ethical decision has to be made by an individual when they decide to exercise their duty to warn. Duty to warn allows the counselors, and psychological therapists to breach confidentiality when a person endangers life of another. The clinical therapists cannot be prosecuted for warning a third party of imminent danger or if they unreasonably suspect the patient might harm themselves. Initially, the therapist had no right to disclose the content of their discussions to another party until Tarasoff got killed.

Even though sometimes unintended, violations can occur in real-life therapeutic practices (Warren and McGee, 2013). The example given is of a woman who is struggling with binge-purge episodes goes to seek counseling. After the meeting, it was suggested her peers come to a session with her. The counselor thought it would be a good idea. She contacted three of the client’s peers without getting written consent. In turn, this caused the client not to return for the following session (Warren and McGee, 2013). When building a therapeutic relationship with any client, there is a level of trust that must be established with reliable confidentiality that is meaningful and inclusive of the effective informed consent process (Warren and McGee, 2013). By doing this, clients can be more at ease with sharing information with the counselor knowing they are in a safe

Tatiana Tarasoff was murdered by Prosenjit Poddar a patient of psychotherapist employed by the University of California Hospital. Tarasoff parents brought an action against the university regents, doctors and campus police. The Tarasoffs complained that the doctors and police failed to warn them that their daughter was in danger from Poddar. Justice Tobriner argues that a doctor or psychotherapist treating a mentally ill patient has a duty to warn third parties of threatened dangers arising out of the patient’s violent intentions. Tobriner argues that the public interest in safety from violent assault must be weighed against the patient’s right to privacy. Justice Clark dissenting from Justice Tobriner’s majority opinion argues that confidentiality in the psychiatrist patient relationship must be assured for three reasons.

Great post for this week you did a really good job of defining “duty to warn” and “duty to protect” in your own words, which made it a lot easier to understand. The Duty to warn give individuals such as therapist the responsibility to warn or inform the third party or authorities if a client poses a threat to himself or another individual. The “duty to warn” is one of the few instances where client confidentiality can be breached.

In 1995, when the ACA was in the process of revising its code of ethics, I proposed a model rule based on the Hatherleigh article. The ACA adopted the proposed rule with minor changes. This rule, which set precedent for state laws (such as the Florida statute mentioned above) and other professional codes of ethics in counseling and psychology (such as the American Mental Health Counselors Association code), permitted disclosure under certain conditions. This rule, which I named the “Contagious, Fatal Diseases” rule, states,

The rise of ethical practice and accounting for the individuality of clients has led to a wide-range of ethical considerations and guidelines to help demonstrate appropriate actions. Firstly, under principle-based ethics there are four general principles of ethics (Kerridge, et al., 2005) which create a mindset of important considerations a psychologist must keep in mind in all actions. Beauchamp and Childress listed these as autonomy; the right to self-determination, beneficence; acting with compassion for others, non-maleficence; avoiding harm and justice; acting fairly and objectively(Kerridge, et al., 2005) .They also named two derived principles- veracity and confidentiality. These general principles are crucial for psychologists as they are flexible enough to allow the psychologist to adapt to best handle to the complexity of the situation.

The Tarasoff v. Regents of the University of California case on confidentiality are legal and ethics-related implications derived from the case where the psychologist failed to inform the victim or the parents of the victim of death threats, thus failing to carry out the duty to protect or warn. Three general categories of states include: those that mandate some duty to warn or protect (and that often specify whether law enforcement, the victim, or a combination should be “warned”); those that allow therapists to warn by protecting them from liability for breach of confidentiality if they do so, but do not require them to issue a warning; and those that offer no statutory or case law guidance (Johnson, Persad & Sisti, 2014).

In addition to duty to reporting, I was quiet surprised at how mandated Laws requiring reporting and the limitations to Confidentiality differ in various states, because coupled to what Joseph and Nellie were discussing in Feldman’s video , New York lawyer are not obligated to carry out reporting (Stein, 2004). In some cases, Professional Counselors/therapists are covered under attorney-Client privilege, if the Counselor/therapist is employed under the attorney, thus making reporting of an abuse void. (Stein, p. 11). Furthermore on the issue of Confidentiality, I found the video’s information and the information I gathered from the State of Maryland, Board of Professional Counselors/therapists and the ACA code of ethics websites, contradictory. According to the discussion, on the Video, a third party can be granted access into a victim’s records, but according to both Maryland and ACA code of ethics websites, Clients recorded are not supposed to be made known to a third party, unless the Client issues an informed consent. So I just think revealing a Client’s information is in violation of the code of conduct and HIPPA act, just like Nurse Brown and the incompetent social worker, they were in violation of the Statue and I could say, COMAR 10.58.04; Professional Competence. Finally, on the ethical issue on the duty to warn, in the case of Tatiana

Another part of the article that seemed pertinent was the section on confidentially and diagnosis. I did not even consider that bringing client records to court would put their diagnosis into public record. If the client were to ever have a job where their records would be searched, they could end up not being hired due to the diagnosis a clinician gave on record in court. This then poses a greater dilemma for the counselor because they are stuck debating whether it is more important to hurt the client or to hurt the general public. If the client is an airplane

Confidentiality is kept into practice for all clients that Dawn Sutton comes into contact with and some of her cases are; 1)If child abuse is suspected, she will report it; 2)IF a client releases information with written authorization; 3)If a court subpoenas your records; 4) If the client is or becomes a ‘vulnerable adult”.(Sunrise, 2002-2008)

Since the patient has demonstrated imminent danger to herself and could possibly be capable of making correct decisions, confidentiality can be breached. Although the patient does not want her mother informed of what is going on, ethical and legal principles supersedes her rights and confidentiality can be breached, since her life is in possible forthcoming danger. The counselor should share information with Marcie’s mom so that she can aid in protection. The counselor is covered by the statement that she included in the intake forms that Marcie was required to sign, prior to consultation which explains to her when

In clinical psychology, several legal issues do exist, and clinical psychologists must adhere to such legal standards. Two common legal issues are maintaining confidentiality and obtaining written informed consent. In regard to the maintenance of confidentiality, the clinical psychologists must never disclose the records of any patient or client unless required by law. This is a significant concern in clinical psychology, which the psychologist is bound by ethical codes and law. These laws necessitate the psychologist to refrain from mentioning of a patient 's treatment or the results of his or her assessment outside the appropriate context. In keeping of clients’ record, psychologists should maintain records securely, efficiently and effectively, such that the results are not predisposed to dissemination by other inappropriate individuals. Though, a psychologist has the responsibility to waive clients’ confidentiality when he suspects harm to self.

Many reasons why psychotherapy can be so helpful are the same reasons that the psychotherapist cannot meet the standards for rendering opinions to the legal system. It’s about conscious and unconscious risks of taking sides, bias, and a loss of objectivity. Psychologists who attempt this dual role (psychotherapist to the client and expert for the legal system) are in inherent role conflict that can violate administrative rules on negligence, competence, welfare of the client, and impaired objectivity and dual relationships (Ohio Board, 2003. p.2) (as cited in Heltzel, 2007, p. 122).