Duty to warn refers to the responsibility of a counselor or therapist to inform third parties or authorities if a client poses a threat to themselves or another identifiable individual. It is one of just a few instances where a therapist can breach client confidentiality. Normally, ethical guidelines require that therapists keep information revealed during therapy strictly private.
What Is Duty to Warn?
The American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct" specify how and when confidential information can be disclosed. These ethical guidelines suggest that private information can only be disclosed with the permission of the individual or as permitted by the law.
Legal instances where such information can be revealed include when it is necessary to provide professional services, when obtaining consultations from other professionals, to obtain payment for services, and to protect the client and other parties from potential harm.
The specifics of a legal duty to warn vary by state. In most cases:
- A therapist is required to breach confidentiality if clients pose an imminent threat to either themselves, the therapist, or a third party.
- The necessary information must be divulged to someone who is capable of taking action to reduce the threat.
- In most cases, the person who is in danger and law enforcement would be notified.
History of Legal Duty to Warn
Two landmark legal cases established therapists' legal obligations to breach confidentiality if they believe a client poses a risk to himself or others.
Tarasoff v. Regents of the University of California (1976)
Legal duty to warn was first established in the case of Tarasoff v. Regents of the University of California (1976) where a therapist failed to inform a young woman and her parents of specific death threats made by a client.
Tatiana Tarasoff and Prosenjit Poddar met in 1968 as students at the University of California, Berkeley. Poddar came to believe that the two were in a serious relationship, a view that was not shared by Tarasoff. When she expressed that she was not interested in a romantic relationship, Poddar began to stalk her and experienced a serious emotional breakdown.
In 1969, Poddar became a patient of a psychologist named Dr. Lawrence Moore at UC Berkeley's Cowell Memorial Hospital. After expressing his intentions to kill Tarasoff to his therapist, Moore alerted campus police and gave his opinion that Poddar required hospitalization and that he posed a danger to himself and others.
Poddar was detained briefly but appeared rational and stable, leading police to release him with a promise that he would stay away from Tarasoff. Soon afterward, the director of the psychiatry department at Cowell Memorial Hospital ordered the written letter and therapy notes destroyed.
Neither the police nor Poddar's therapists warned Tatiana Tarasoff or her family of the threats. Poddar continued to stalk the young woman and on October 27, 1969, he murdered her. Poddar went to the Tarasoff home armed with a kitchen knife and a pellet gun. After a confrontation, Tarasoff screamed for help, at which point Poddar shot her with the pellet gun.
She fled into the yard, but Poddar caught her and proceeded to stab her to death with the kitchen knife. He then entered the Tarasoff home and alerted the police. After his arrest, Poddar was diagnosed with paranoid schizophrenia, the same diagnosis Moore had initially made.
Her parents filed a lawsuit against the therapists and the University of California, Berkeley. They contended that their daughter should have been warned of the danger, while the defendants held that their responsibility was to maintain the confidentiality of their client. The lower courts agreed with the defendants and the case was initially dismissed. The Tarasoff’s appealed the case to the California Supreme Court.
While the case was eventually settled out of court for a significant sum, the higher court's 1976 ruling specified that confidentiality was secondary to the public's safety.
Jablonski by Pahls v. United States (1983)
The case of Jablonski by Pahls v. the United States further extended the responsibilities of duty to warn by including the review of previous records that might include a history of violent behavior.
The ruling originated from a case in which a doctor conducted a risk assessment of a client, Mr. Jablonski, but did not review Jablonski's history of violence. As a result, the client's girlfriend, Ms. Kimball, was not warned about Jablonski's history of violent behavior. WhenJablonski was released, he then killed Kimball.
Duty to warn gives counselors and therapists the right and obligation to breach confidentiality if they believe a client poses a risk to another person. It also protects clinicians from prosecution for breach of confidentiality if they have reasonable suspicion that the client might be a danger to himself or others.
Duty to Warn Examples
It is important to note that duty to warn only obligates therapists to inform individuals and authorities of any specific threats. They should not discuss the details of their patient's care or treatment. Any information that is not relevant to the immediate threat should remain confidential.
There continues to be a debate about what exactly constitutes a credible threat. Direct, specific plots to harm to kill another individual would clearly trigger a duty to warn, but in other cases, a therapist must use their best judgment to determine if a less-clear threat presents a serious danger.
A few examples of times when a therapist would need to consider their ethical and legal obligations include:
- A client states that they want to kill a colleague, but do not name a specific individual
- A patient says that they fantasize about killing a specific person, but then state that they would never actually do it
- A client has the means to commit harm, such as owning firearms, and expresses extreme anger toward a specific individual but never makes a specific threat
An assessment of a potential threat is often considered in the same way that a therapist would assess suicide risk. The therapist might consider the seriousness and specificity of the threat itself, the client's past history of violent or aggressive behavior, and recent symptom progression.
While it has been decades since the legal duty to warn was first established, it remains a topic of debate. In 2013, the then-president of the APA Donald N. Bersoff suggested that the Tarasoff ruling was a poor decision. Client confidentiality, he proposed, was paramount and breaching it undercuts the trust that clients place in their mental health providers.
Breaking this confidentiality should only happen as a last resort, Bersoff believes.
Some suggest that had Moore not reported the threats, Poddar may have remained in treatment. Had he continued to receive treatment, perhaps he might have recovered from his obsession andTarasoff might not have been killed. However, there is simply no way to know if the situation may have played out in this way.
A Word From Verywell
Psychologists often face ethical dilemmas and are required to use their best judgment to determine the right course of action. Duty to warn presents a challenge in many instances, but it is one that therapists are legally obligated to surmount.
APA Code of Ethics: Principles, Purpose, and Guidelines
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Felthous AR. Warning a potential victim of a person's dangerousness: clinician's duty or victim's right?.J Am Acad Psychiatry Law. 2006;34(3):338–348.(Video) Explaining the Limits of Confidentiality to a Counseling Client
American Psychological Association. Ethical principles of psychologists and code of conduct.
Adi A, Mathbout M. The duty to protect: Four decades after Tarasoff. Am J Psychiatry Resid J. 2018;13(4):6-8. doi:10.1176/appi.ajp-rj.2018.130402
Bersoff DN. Protecting victims of violent patients while protecting confidentiality.Am Psychol. 2014;69(5):461–467. doi:10.1037/a0037198
American Psychological Association. (2013). 2013 APA presidential address from Donald N. Bersoff, Ph.D., J.D.
Everstine, L, Everstine, D.S., Sullivan, D., Heyman, G.M., True, R.H., Frey, D.H., Johnson, H.G., Seiden, R.H. (2003). Privacy and confidentiality in psychotherapy. In D.N. Bersoff (Ed.), Ethical Conflicts In Psychology (3rd ed.). Washington, D.C.: American Psychological Association.
Vitelli, R. (2014). Revisiting Tarasoff. Psychology Today.
By Kendra Cherry, MSEd
Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."
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In the APA's Ethical Principles of Psychologists and Code of Conduct, section 4.05(b) states, “Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to (1) provide needed professional services; (2) obtain ...When should a practitioner inform a client about the limits of confidentiality? ›
Practitioners often advise patients at the outset of treatment as to situations in which confidentiality might be breached. These may include when patients present a danger to themselves or others as well as child and elder abuse reporting.Under what conditions can a counselor reveal confidential information about a client without their permission? ›
Psychologists may disclose private information without consent in order to protect the patient or the public from serious harm — if, for example, a client discusses plans to attempt suicide or harm another person.What are the limitations to confidentiality in therapy? ›
Any time when the client poses an imminent danger to themselves or others where breaking therapist confidentiality would be necessary to resolve the danger. Any time when the therapist suspects child, elder, or dependent adult abuse.What are three 3 ways to ensure a client's confidentiality is maintained? ›
- Use a secure file-sharing and messaging platform. ...
- Store Physical Documents in an Environment with Controlled Access. ...
- Comply with Industry Regulations (SOC-2, HIPAA, PIPEDA) ...
- Host Routine Security Training for Staff. ...
- Stay Alert of New Security Threats.
Store confidential information in locked file cabinets. Encrypt all confidential electronic information with firewalls and passwords. Employees should keep their desks clear of any confidential information. Employees should keep their computer monitors clear of any confidential information.Under what circumstances can a therapist break confidentiality? ›
When to Break Confidentiality. There are a few situations that may require a therapist to break confidentiality: If the client may be an immediate danger to themself or another. If the client is endangering another who cannot protect themself, as in the case of a child, a person with a disability, or elder abuse.What are the five rules of confidentiality? ›
- Ask for consent to share information.
- Consider safeguarding when sharing information.
- Be aware of the information you have and whether it is confidential.
- Keep records whenever you share confidential information.
- Be up to date on the laws and rules surrounding confidentiality.
1. You are a danger to yourself and threaten to harm yourself (e.g., suicidal). 2. You threaten to harm another specific person (e.g., assault, kill).In which situations may you disclose confidential client information? ›
You generally must protect confidential client information, even if you suspect that illegal business activities have occurred. You should disclose this client information only if a valid subpoena requests it, a regulatory body demands it, or a law compels it.
POSSIBLE EXCEPTIONS TO CONFIDENTIALITY INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING SITUATIONS: CHILD ABUSE; ABUSE OF THE ELDERLY OR DISABLED; SEXUAL EXPLOITATION; COURT ORDERED DISCLOSURE OF INFORMATION; AND/OR IDS/HIV INFECTION AND POSSIBLE TRANSMISSION.What are three examples of when confidential information can be released? ›
- Consulting with other practitioners. ...
- Court or disciplinary actions. ...
- Dangerous clients. ...
- Abused or abusive clients.
Counselling is confidential. This means I will not share information about you with a third party unless you consent to that disclosure. So I will not tell anyone that you attend counselling, or what you say in our sessions, without your permission to do so.What are the types of confidentiality in counseling? ›
In counseling, two types of confidentiality are commonly recognized: content confidentiality and contact confidentiality. Content confidentiality requires that the substance or content of the client's discussion with a counselor not be revealed by the professional.What are the limits of confidentiality and privileged communication? ›
Confidentiality can be defined in terms of a counselor's duty not to disclose information about their client, while privileged communication in a counseling context can be defined in terms of a client's privilege not to have their counselor disclose information about them in a legal setting such as a court of law.When should you inform clients of the exceptions to confidentiality? ›
1.5. 5 Marriage and family therapists are encouraged to inform patients as to certain exceptions to confidentiality such as child abuse reporting, elder and dependent adult abuse reporting and patients dangerous to themselves or others.
Murder, manslaughter, rape, treason, kidnapping, child abuse or other cases where individuals have suffered serious harm may all warrant breaching confidentiality.How do you make the client aware of the limitations of confidentiality and what are these? ›
- discuss confidentiality with your client at the contracting stage.
- be clear about the possible exceptions to confidentiality.
- be explicit about who you may need to share their information with, and who else has access to their records.
- explain that you need to discuss your casework with a supervisor.
If the client may be an immediate danger to themself or another. If the client is endangering another who cannot protect themself, as in the case of a child, a person with a disability, or elder abuse. When required to obtain payment for services. As required by state or federal laws.