MMHA 6205 Week 3 Duty to Warn Memo Example

Memorandum

To: Clinic Director, Larkspur Counseling Center

From: Clinical Operations Administrator

Date: Week 3

Re: Whether a client's statement about his former supervisor requires a warning or other protective disclosure

Recommendation

I recommend that the counselor complete a structured violence risk assessment with the client today, increase contact to at least twice weekly, build a written safety plan with him and document each step. A warning to the named person or a call to police is not required on the current facts, but it should be made at once if the assessment finds a plan, access to a weapon or intent to act. This memo assumes our state follows a permissive duty-to-warn statute; counsel should confirm before any disclosure. Larkspur Counseling Center, the counselor and the client are fictional.

What the Client Said

During Tuesday's session, the client, a 31-year-old man fired from a warehouse job two weeks ago, said, in paraphrase, that he was so angry at the supervisor who fired him that he could see himself going to the warehouse on Friday and making the supervisor pay. The counselor asked what he meant. He said he did not know, that he was "just angry," and changed the subject. The counselor reported the statement to her supervisor the same afternoon.

Threat Assessment

The statement must be assessed before any duty can be analyzed, since a duty built on an exaggerated reading of the words will overreach. The facts the scenario provides are these.

Table 1

Risk Factors Present and Absent in the Client's Statement

The table records only what the counselor heard; the risk assessment will fill the gaps.

Three factors raise concern: a named target, a place and a day, and a recent loss. Three lower it: no weapon, no known history of violence and an ambiguous phrase that the client did not explain. The missing information, about weapons at home, substance use and what he meant, is exactly what a same-day assessment would gather.

Legal Analysis

The duty traces to a 1976 California case. The state's highest court ruled that once a therapist concludes, or by professional standards ought to conclude, that a client is likely to seriously harm another person, the therapist must take reasonable steps to protect the intended victim (Tarasoff v. Regents of the University of California, 1976). Protection may take several forms, including warning the victim, notifying police or taking other reasonable steps. Since then, states have taken different paths. Some impose a mandatory duty when specific conditions are met, others permit disclosure without requiring it, and some recognize no duty at all (Johnson et al., 2019). Statutes that do impose a duty usually require an explicit threat of serious physical harm toward a victim who can be identified.

Federal privacy law permits the disclosure if it is needed. Under the federal privacy rule, a provider acting in good faith may share client information when needed to prevent a serious threat that is close at hand, as long as it goes to someone able to lessen the threat, which can include the target (45 C.F.R. § 164.512). The rule does not require disclosure; it removes a privacy barrier where state law or professional judgment calls for one.

On the present facts, the threat is not yet shown to be serious and imminent. The statement is ambiguous and the client has no history or known means. That could change within an hour of assessment.

Ethical Analysis

Confidentiality is the foundation of counseling. Clients tell counselors about anger they would never act on precisely because they expect it to stay in the room, and talking about it is often how they avoid acting on it. A warning that turns out to be unnecessary would likely end this client's treatment and might make him more dangerous, not less. The counselor's professional code allows breaking confidentiality to protect clients or identified others from serious and foreseeable harm, and asks counselors to consult when unsure (American Counseling Association, 2014). The two values are not opposites: assessing and treating the anger protects the supervisor, and only if treatment cannot do so does disclosure become the right tool.

Options

Table 2

Options and Their Clinical Costs

The recommended option is the second; the third and fourth become appropriate if the assessment finds intent, a plan or means.

The counselor should document the statement, the assessment, the consultation with her supervisor and the reasoning for each decision. If disclosure becomes necessary, she should tell the client, where it is safe to do so, what she is disclosing and why.

References

American Counseling Association. (2014). ACA code of ethics.

Johnson, R., Persad, G., & Sisti, D. (2019). The Tarasoff rule: The implications of interstate variation and gaps in professional training. Focus, 17(4), 435-442. https://doi.org/10.1176/appi.focus.17402

Tarasoff v. Regents of the University of California, 17 Cal. 3d 425 (1976).

Uses and disclosures for which an authorization or opportunity to agree or object is not required, 45 C.F.R. § 164.512 (2024).