Confusion still exists among members of the psychological community regarding the Duty to Protect and Duty to Warn doctrines. They are mutually exclusive principles. Professionals will first need to learn from respective state law whether both principles apply, if only one of them is allowed, and if the language is nuanced before entering their occupation. Let’s examine these principles to gain a better understanding what they concern.
The Duty to Protect doctrine indicates that members of the psychological community have a legal and ethical obligation to protect the patient. One of the important aspects is the therapist engaging in the most professional behavior. They must offer the highest, ethical treatment to their patients. Also, even though it can be difficult to predict, the therapist has the duty to protect the patient from harming themselves. Another factor is confidentiality regarding statements from the patient made in therapy, and a solid infrastructure to keep medical records from public consumption.
The Duty to Warn* doctrine indicates that when a therapist has a reasonable belief that a patient will harm a member of the public, the therapist has a number of options available: Contact the intended victim (without revealing the patient’s name), relatives and friends of the intended victim, law enforcement giving the patient’s name and the intended victim’s, implement an aggressive out-patient therapy for the patient, or have the patient hospitalized on an emergency basis. This doctrine gives the therapist permission to set aside patient confidentiality in order to protect the community.
Examples of Varied State Laws Concerning the Doctrines are Michigan, Ohio, and Vermont allow for both doctrines, while The Duty to Protect doctrine is applicable for Texas, but not the Duty to Warn doctrine. Also, The Duty to Protect doctrine is allowed in Utah, including Common Law Duty of Care (in place of the Duty to Warn doctrine).
The clinical practitioner will have to remain apprised of state laws where they decide to practice, or experience disciplinary action from their Board of Psychology and malpractice from patients.
*There are regions where therapists can warn intended victims, but aren’t obligated to do so.