There are various interpretations of the Duty to Protect Doctrine across the country.  Unfortunately, the language can be nuanced and sometimes vague altogether.  There is no uniform language of instructions in many circumstances.  Be that as it may, therapists providing psychological or clinical sessions with patients have an important role in guarding the latter’s privacy.

First, the therapist should exhibit professionalism in attitude and behavior.  Second, the therapist should provide the best treatment for the patient’s condition that their expertise allows.  Third, the sessions should be held in the most secure office location imaginable.  Fourth, conversations between the therapist and the patient in those sessions are confidential.  Fifth, those conversations, when necessary and appropriate, can include the therapist’s supervisor for guidance.  Again, these particular conversations are held privately.  Sixth, the electronic filing system of patients’ medical records needs to have the utmost security system installed before a therapist even thinks about having their first patient.  Finally, prescriptions made by the clinician for the patient can be considered correspondence, but that correspondence is solely between the therapist and the patient. 

As an aside, when a patient threatens someone’s life, the therapist can throw out patient confidentiality altogether.  Is the threat legitimate?  They will have to use discernment to figure that out.  The therapist will have entered the Duty To Warn Doctrine arena when they deem the threat valid!  They will need to understand what their statute indicates before contacting the intended target, the intended target’s family, and finally, the police.  In that order, to prevent another Tarasoff case!

Vikki