quizzes Flashcards
In the middle of an individual session, a client who is separated from his spouse begins making specific threatening statements about the spouse. He says that once the session is over, he plans to go to the spouse’s home and “put an end to all of this.” It is clear to the MFT that the client is intending to commit an act of violence. The MFT should:
Use the remaining session time to attempt to resolve the threat.
One of the key components of Tarasoff is imminent danger. As these statements are occurring in the middle of session, and by all appearances the client remains in the MFT’s office, the danger here is not imminent – and therefore this is not a Tarasoff situation. The MFT cannot break confidentiality. They should use the remaining session time in an effort to resolve the threat. If the client were to leave the MFT’s office, and the MFT believed the client still posed a danger to the spouse, then it would be a situation of imminent danger, and breaking confidentiality to protect the victim would be appropriate. But in the circumstances described in the question, Tarasoff does not apply.
An HIV-positive client is known to share needles with other drug users, and does not inform others of her HIV status. As she is leaving a session, she tells her MFT that she is likely to use tonight, and she doesn’t care if she infects others. “I think I deserved it,” she says, “and I think they do too.” The MFT has been working with the client on issues of self-worth. The MFT knows where the client typically goes to use drugs. The MFT should:
Maintain confidentiality.
Another key component of Tarasoff is that the danger posed by a client is one of serious bodily harm. While HIV infection can have significant consequences, as it has become more treatable over time, the controversy in the therapy world about whether to report clients intentionally or recklessly infecting others has quieted. HIV infection is unlikely to meet the Tarasoff standard of serious bodily harm, and as such, Tarasoff does not apply here.
You could try to make a case that the client poses a general danger to others and therefore should be involuntarily hospitalized, but that section of law requires that the person be a danger to others because of a physical or mental disorder, and that’s not established in the question. (Low self-worth, in and of itself, isn’t a mental disorder.) Based on the information available here, the MFT would simply maintain confidentiality.
A 24-year-old client has signed a Release of Information allowing his MFT to talk to the client’s parents as needed. One afternoon, the client’s mother calls the MFT in great distress. She reports that the client was so angry when she last saw him, that based on his statements and behavior, she believes he is driving right now to seek out a fight at the bar where he typically hangs out. “If one doesn’t come to him,” the mother says, “he’ll start one. And I’m worried he’s going to kill somebody.” The client has a history of being arrested and jailed for assault on several occasions. The mother tells the MFT which bar the client is heading toward. The MFT should:
Contact the bar and law enforcement to inform them of the threat.
The third key component of Tarasoff is that there be one or more reasonably identifiable victims. This doesn’t mean that you need to know their names, but the threat needs to be more specific than a general danger to the public. Here, the potential victims are those who are and will be at a specific bar – that’s a reasonably identifiable group. And court rulings have established that the MFT can treat information about a client, received from a third party, similarly to how they would treat information received directly from the client when it comes to evaluating risk. So as long as the MFT believes the mother’s information to be credible (and there’s nothing here to suggest otherwise), the MFT should treat this as a Tarasoff situation. Contacting law enforcement and the bar are both reasonable steps.
An MFT is working with a client who is involved in the drug trade. The client tells the MFT that his group of drug dealers is planning to “clear some territory” by “taking out” members of a rival network that night. (The client’s group and the rival group have a history of violence in support of their claims of local drug distribution territory.) The MFT understands this to mean that the rival drug dealers will be shot. As the client leaves the office, the client tells the MFT, “I hope I make it through to next week. But if I do, you can raise my fee.” The MFT should:
Contact law enforcement only.
Therapists in Tarasoff situations fundamentally have a duty to protect, and not a duty to warn. While you receive additional legal protections when you attempt to warn intended victims, doing so is not always appropriate. Here is an instance where notifying the rival drug dealers of the threat in advance would heighten the risk for all involved, as the rival dealers are likely to arm themselves in anticipation of a violent confrontation.
Notifying law enforcement, and not the intended victims, is the appropriate action here. This case is an exception, though: Your default position should be to also attempt to notify the intended victims, unless there is reason not to.
Ignorance of the law is an acceptable legal defense for injuring clients.
False
A client is legally entitled to adequate information from the therapist before the
client provides consent to treat.
True
Clients have the right to sue their clinician for abandonment.
True
Clinicians should take additional steps, if necessary, to ensure a client’s
comprehension of the informed consent contract.
True
Couples should be informed that both reconciliation and separation are possible
outcomes of therapy.
True
Terminating services in order to pursue a social, financial, or sexual relationship
with a client is acceptable.
False
If a 13 year old seeks and consents for his own treatment, his parents still have a
legal right to access his records.
false
_____A therapist must obtain signed informed consent prior to treatment.
When treating a couple, the clinician only needs informed consent from one of the
individuals.
False, both
_____Termination rights for both the clinician and the client should be included in the
informed consent.
True
Legally, fees must be disclosed before the onset of therapy.
True
