In the category of Professional Orientation and Ethical Practice on the National Counselor Examination (NCE), the Counselor Preparation Comprehensive Examination (CPCE), or another counseling exam, you’ll need to have a good understanding of confidentiality and the limits of it.
Tarasoff Warnings (sometimes called Tarasoff Exceptions, the Tarasoff Rule, Duty to Warn, or Duty to Protect) is about some of the limits of confidentiality. In other words, when confidentiality can be or will be broken or breached to protect the client or someone else.
What is confidentiality? To understand Tarasoff Warnings, it’s best to start by getting an understanding of confidentiality. Clients come to therapy and generally have an understanding that what they talk about there stays there. Therapists hold what clients say and (as a general rule) do not share this with others. For many patients, this strict confidentiality is a significant factor in allowing them to trust their counselor.
What is a Tarasoff Warning? Confidentiality in therapy is not without limits. A Tarasoff Warning is a general term used to describe these limitations—such as if a client is at risk of harm to themselves or someone else, or the counselor learns that another person is at risk of harm. In these cases, the potential victim, authorities, and possibly other pertinent people must be warned. Read the history section below to understand some of the legal cases that have shaped Tarasoff Warnings.
Are there other names for Tarasoff Warnings? Yes, you might hear Tarasoff Warnings go by many other names. You may also hear them called Tarasoff Exceptions, the Tarasoff Rule, Duty to Warn, or Duty to Protect to name some of the most common. You’ll see these names used interchangeably on this page.
Are murder or harm to others covered by Tarasoff Warnings? Yes, the Duty to Protect covers multiple scenarios. In the event that a client tells their therapist they are going to kill someone, the therapist may need to report this. Likewise, if the therapist learns someone is at risk of harm due to their client, the Tarasoff Rule would require them to inform the potential victim and authorities.
Do Tarasoff Warnings include diseases? Often, yes, in the event that a client has a contagious and life-threatening disease—such as HIV or AIDS—and the client is not warning people they may infect, this may fall under the scope of a Tarasoff Warning and need to be reported. Likewise, if the client with the infection is intentionally planning to infect another person, this would most likely need to be reported.
Is suicide a part of Tarasoff Warnings? Yes, when a client is at risk of suicide, therapists may need to go to lengths to maintain the patient’s safety such as alerting a loved one and/or law enforcement, or may place the client on a “hold” where they are hospitalized for their safety. Whenever a client’s confidentiality is breached, the counselor must determine what the risk of harm is. A client simply stating, “if this happens, I’d rather kill myself” may not meet the requirements of a Tarasoff Warning. Counselors should seek consultation, supervision, and familiarize themselves with research and case examples when considering a breach of confidentiality.
Interestingly, there have not always been limitations to confidentiality. These limitations have arisen as a result of various court cases, some of which will be highlighted here. That said, keep in mind that Tarasoff Warnings are generally considered a moral duty, but in some places have been made law.
What is Tarasoff vs Regents? In this case, Tatiana Tarasoff was murdered by a stalker. It so happened this stalker was in therapy, and had told his counselor he was going to kill Tatiana. As a result, Tatiana’s parents sued the therapist. From this case, the California Supreme Court ruled that the therapist was responsible and stated that when “a patient poses a serious danger of violence to others, [the therapist] bears a duty to exercise reasonable care to protect the foreseeable victim of that danger.” (Ewing, 2005)
What are Ewing vs Goldstein and Ewing vs Northridge Hospital Medical Center? The therapist does not always need to learn that someone is in danger from the client directly. As ruled in these cases, Dr. Goldstein was seeing a client who was going through a breakup. The patient had asked his father for a gun, but the father refused. The patient told his father that he was going to kill the person that was now dating his ex. The father warned Dr. Goldstein, who directed the father to bring the patient to the hospital. The hospital kept the patient overnight, then discharged him the next day. After release, he killed Keith Ewing, then himself. Ewing’s family sued Dr. Goldstein and the hospital because they did not warn Ewing or law enforcement. As a result of these cases, the Duty to Warn should be given to the potential victim and/or law enforcement.
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What if your client tells you they’re going to kill someone? Therapy is confidential, right? So do you have to keep this a secret? Well, that’s where Tarasoff warnings come in, which is the topic for our video today. My name is Keegan. I recently graduated with a master’s degree in counseling. I’m making videos like this to help you and others prepare for the NCE, the CPCE, or whatever counseling exam you might be taking. Understanding, confidentiality and the limits of confidentiality, such as Tear us Off warnings an important part of ethical practice,
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which is why they fit into the professional orientation and ethical practice category of the NCE and the CPCE. This means that having a good understanding of Tarasoff warnings is not only important for your exams, but also for good ethical practice. As a therapist. In general, I think that we really like concepts to be simple. Confidentiality is one of those that we really want to be simple and generally is probably for the most part, simple in the sense that what we talk about in sessions doesn’t leave our sessions. Except that’s not perfectly true. If we’re in supervision, we need to talk to our supervisor.
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we might need to consult colleagues. We need to keep notes, and our notes need to possibly go to the insurance company. If our client runs into legal trouble, we may be called into court. There’s so many parts of confidentiality that may end up being a an exception or a limit of confidentiality. Tarasoff warnings are one of those things because sometimes things will come up in sessions that we can’t keep confidential. as a quick note, you’ll sometimes hear Tarasoff warnings called Tarasoff Exceptions, Tarasoff Rules or the Tarasoff Rule, Duty to Warn, or Duty to Protect. So when we talk about Tarasoff warnings, those are some of the other names that you might hear me use throughout this video and you may hear throughout practice also, or when you’re talking to colleagues or in the literature. Overall, Tarasoff warnings are when some things in sessions can’t be kept confidential anymore. And we have to break confidentiality to warn somebody else or someone like law enforcement about what our client told us.
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So let’s talk about the history of Tarasoff warnings and where they came from, because this might help you understand more of what a Tarasoff warning is or what it covers. The Duty to Warn came about when Tatiana Tarasoff was murdered by someone who had been stalking her. It turned out that this stalker was in therapy. And this stalker had actually told the therapist that he was going to murder Tatiana. However, the stalkers counselor did not tell anyone about this. As a result, then Tatiana’s parents sued the therapist from this case. The California Supreme Court ruled that the therapist was responsible, and they said
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when a patient poses a serious danger of violence to others, the therapist bears a duty to exercise reasonable care to protect the foreseeable victim of that danger. There are other legal cases, though, that also shape what a terrorist warning is and when it needs to occur. Example, therapist doesn’t necessarily need to learn that someone is in danger from their own client for them to have to report it as ruled in Ewing versus Goldstein and Ewing versus Northridge Hospital Medical Center. Dr. Goldstein was seeing a client who’s going through a breakup.
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The patient had asked his father for a gun, but the father refused. The patient told his father that he was going to murder or kill the person that was now dating his ex. The father relayed this information to Dr. Goldstein and Dr. Goldstein told the father to bring the patient to the nearest hospital. The father did bring the patient in and the hospital ended up keeping the patient overnight on a voluntary basis. The next day, the hospital discharge the patient and from there, the patient went on to kill Keith Ewing, and then himself.
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Ewing’s family then went on to sue Dr. Goldstein and the hospital because neither of them notified law enforcement of the danger to Ewing. So from these cases, what we take away is that terrace off warnings might need to include warning the potential victim and or law enforcement. Keep in mind, though, too, that terrace off warnings don’t only have to revolve around murder, they can include other things too.For example, if the therapist learns of someone saying that they’re going to beat another person or seriously harm them, this is something that may fall into the terror of soft warning. Also, even though they’re not saying they’re going to kill the person.
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And in some cases, mental health professionals may learn that their client or their patient has a contagious life threatening disease. This could include something like HIV or AIDS. If the person with this disease does not plan on informing someone that they’re coming into contact with or is intentionally planning to infect someone. These are situations where Duty to Warn may come into place. That said
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if a clinician is in the situation where they’re having to do a Duty to Warn or having to warn someone of a potential harm or threat that’s against them or that they could be at risk of this should not be considered lightly breaching a client’s confidentiality is a serious matter. In fact, some in the field oppose tear off warnings because they think confidentiality is so important. There should be no situation where it’s broken. The other piece of this is that therapists should always consider carefully what their clients mean. For example, some clients will say something like, they make me so mad, I just want to kill them.
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Of course, some clients might be serious. However, in the majority of cases with a phrase like that, they’re probably just using that to try to express how angry or how irritated they are by the situation. Before we get into how suicidality fits into terrorism warnings, if you’re enjoying this video and learning something from it, please help me out by giving it a like and subscribing to the channel. Although not often discussed as part of a terror safe warning, sometimes clients are going to be at risk of harm to themselves. In fact, this is most likely the situation you’re going to see most often.
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And in situations where clients are a harm to themselves, this is another time where we may have to break confidentiality. Again, we should consider how they’re saying it and what they’re saying carefully, because some clients might say something like, If that happens, I’m going to kill myself. They may again just be using that to express their frustration or their discomfort with the situation. However, they may also be serious with this, and if a client is intending on ending their life, we do have to take those situations and report them to the appropriate people.
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In some of those situations, because suicidality is quite common in the mental health space, this is something that can actually be helpful for us when we’re thinking about terror. Soft warnings. You’ll likely be trained and learn and how to question someone’s suicidality and check for how suicidal they are. And if they’re able to leave that session that day or if they’re needing to stay in the hospital or in an inpatient situation until they’re able to maintain their own safety, as we know with suicidality.
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we’ll ask about things such as their plan, their intent and so on. And these can also be helpful for us when we’re questioning someone’s homicide ality or if they’re planning on harming or hurting someone in some way. Following that same line of questioning or thinking will be helpful for us. In summary of all of this terror self warnings can go by many names It can be called the terrorist exception, the Tarasoff Rule, Duty to Warn, Duty to Protect—these terms all relate to breaking or breaching a client’s confidentiality to let the appropriate people know that the client is at risk of hurting themselves
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or killing themselves or hurting or killing another person, or possibly infecting someone with a contagious and life threatening disease, or perhaps all of these. In these cases, we need to notify the authorities, the intended victim and or possibly the parents, guardians or family. I hope that you found this video helpful in learning more about terrorist warnings or the Duty to Warn. I have plenty of other videos on this channel, so make sure that you check them out and subscribe so you don’t miss any future videos. Thanks so much for watching.
