Scales

  
Select A Topic . . .
Access to Records - "Noncustodial Parent"

Advertising

Advertising - "Expertise"

Advertising - Sliding Fee Scale

Attending the Patient's Wedding (or Other Significant Event)

Authorization Forms

Avoid These Common Errors

Bequest from Patient

Business License

Child Abuse

Child Abuse - Emancipation of Minor

Child Abuse Report Required or Permitted?

Child Abuse Reporting

Child Abuse Reporting - Duty to Investigate?

Child Abuse Reporting - Neglect

Confidentiality - "No Secrets" Policy (Couple Being Treated)

Confidentiality - AIDS/HIV

Confidentiality - Child Abuse Investigations

Confidentiality - Conflicting Requests

Confidentiality - Couple Being Treated

Confidentiality - Dangerous Patient?

Confidentiality - Death of the Patient

Confidentiality - Exception

Confidentiality - Fact of the Relationship

Confidentiality - Group Therapy

Confidentiality - Pregnancy of a Minor

Confidentiality - The Search Warrant

Confidentiality - The Unexpected Caller

Confidentiality and Authorization Forms

Confidentiality and HIPAA

Confidentiality and the Dangerous Patient

Consent to Treat Minor (Sole and Joint Legal Custody)

Consent vs. Authorization

Custody and Visitation Disputes - The Big Mistake

Dangerous Patient - Immunity From Liability

Dangerous Patients and the “Tarasoff Duty"

Dangerous Patients and the Therapist's Duty

Disciplinary Actions

Dual or Multiple Relationships - An Overview

Elder Abuse

Elder Abuse/Dependent Adult Abuse Reporting

Ethical Standards - Conflict with the Law

Ethics

Family Law - "Joint Custody"

Fees

Fees - Barter

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Fees - Sue the Patient?

Fees - The Sliding Fee Scale

Gifts - To and From Patients

HIPAA

HIPAA - Enforcement

HIPAA - Patient Access to "Psychotherapy Notes"

HIPAA - Psychotherapy Notes/Records

HIPAA - Right to Amend Records

HIPAA - Subpoena for Records and Notes

Hypnosis/Hypnotherapy

Immunity From Liability

Informed Consent

Informed Consent - Videotaping/Risks

Informed Consent: Hugs and Other Touching

Laws, Regulations, and the Attorney Generals' Opinions

Liability for the Acts of Others

Licensing and Certification

Mandatory Continuing Education - Does it work?

Negligence vs. Gross Negligence

Online Therapy

Online Therapy - Disclosure

Online Therapy - HIPAA

Online Therapy - Insurance Coverage

Parental Access to Records of Minor

Partnerships - Be Careful

Privilege - A Common Waiver

Privilege - Group Therapy

Privilege - Waiver

Privilege and Confidentiality

Privileged Communications

Professional Corporations

Records - Destruction at the Request of the Patient?

Records - Removal of Information From File

Records - Stolen, Lost or Destroyed

Referrals

Scope of Competence

Scope of License

Self Disclosure

Something Lighter - Cancel the Appointment

Something Lighter - Law and Sausage!

Something Lighter - Self Defense

Something Lighter: A Definition of "Psychotherapy"

Telemedicine - Hours of Experience Toward Licensure?

Telemedicine: Telephone Counseling/Therapy?

Termination - Who is the Patient

Termination of Employment: Who "Owns" the Patient?

Termination of Treatment

Testifying in Court

Think About This - Child Abuse?

Treating Children

Treating Multiple Members of a Family - Conflicts

Treatment Records

Treatment Records - Ownership

Using Patient Information in Public Presentations

Verbal Abuse - Free Speech

 

Bulletin Archives

 

Bulletin Archive

 
by Richard S. Leslie, J.D. Click here for profile.
Attorney at Law - "At the Intersection of Law and Psychotherapy"


Dangerous Patients and the “Tarasoff Duty"

(April 2005
, Volume 2)

… Wow - what a problem exists in California! Therapists are in somewhat of a precarious situation for a number of reasons related to a) the famed “Tarasoff” decision and subsequent court decisions interpreting the duty, and b) the statute that sought to give immunity to therapists under specified circumstances related to threatened harm by the patient against reasonably identifiable victims.

It seems as though some are now questioning whether or not a therapist may safely comply with his or her duty when the patient threatens imminent harm against another by taking reasonable steps to protect the intended victim, such as hospitalizing the patient. There are some who maintain that under specified circumstances, the therapist, in essence, does not have the option to hospitalize but must make a reasonable attempt to warn the intended victim and to notify a law enforcement agency. Failure to do both, they maintain, makes the therapist liable, regardless of how reasonable the hospitalization may have been. This, in my view, is quite troublesome.

Such a rigid approach is not in the best interests of the patient (continued treatment, privacy), nor is it consistent with the principles enunciated in the Tarasoff decision, which called for action that preserved confidentiality to the extent consistent with protection of the victim from the threatened harm. Involuntary hospitalization, for example, is usually such an action.

As this confusing situation now gets debated in the California Legislature, it’s anyone’s guess as to how the confusion will be resolved. Opinions will likely differ on how it should be resolved. The Tarasoff decision, and the duty created thereby, is well known and well respected nationwide, even though each state may treat the subject matter a little bit differently. If there is a duty (as opposed to a right), what is the duty in your state and when, precisely, is it triggered? If you cannot readily answer that question, you should be concerned. This can be a tricky area of the law. Best to get the answer now, when things are calm!