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Est Am500 Wordsinitial Post: Your supervisor asks you to see a critical client who is high risk for harming others. He is a 25 year old veteran who is starting to show signs of aggression in your office when he talks about his 18 year old ex-fiancé who just left him for his best friend. You are going to open this case and need to explain to the client the limits of confidentiality and Tarasoff law. Discuss the limits of confidentiality and Tarasoff law with this client and why they are important. How will you present this information to the client?

Explain one way you would approach each of these legal issues. If he is unable to get his aggression under control, what might be your course of action? Identify one ethical issue in this case. Explain one way you would approach the ethical issue.

Paper For Above instruction

The scenario presented involves establishing a therapeutic relationship with a high-risk client who exhibits aggressive tendencies and poses potential harm to others. Critical to this process is clearly communicating the limits of confidentiality and understanding legal statutes such as the Tarasoff law, which are instrumental in managing risk while honoring ethical standards. This paper explores how to effectively explain these legal issues to the client, approaches for handling the legal dilemmas, appropriate course of action if aggression persists, and examines an ethical concern inherent in this case.

Introduction

Engaging a client who demonstrates potential for violence demands a nuanced understanding of legal and ethical responsibilities. Clinicians must balance the client’s right to confidentiality with the obligation to protect potential victims, a tension that is navigated through transparency and adherence to legal statutes like the Tarasoff law. Proper communication about these boundaries is crucial to maintaining trust while ensuring safety.

Limits of Confidentiality and the Tarasoff Law

The limits of confidentiality are inherent in clinical practice, especially when client safety or the safety of others is at risk. Confidentiality is a fundamental aspect of psychotherapy, intended to foster trust and openness. However, legal and ethical obligations sometimes necessitate breaching confidentiality when there is a foreseeable risk of harm (American Psychological Association, 2017). Specifically, the Tarasoff law mandates mental health professionals to breach confidentiality if a client poses a serious and imminent threat to an identifiable individual. This legal doctrine originated from the 1976 California case Tarasoff v. Regents of the University of California, which established that practitioners have a duty to warn potential victims and take protective actions (Koocher & Keith-Spiegel, 2016).

When communicating these limits to the client, it is essential to be transparent and straightforward. I would explain that while confidentiality is a core value in therapy, certain situations—particularly those involving threats of violence—require us to take steps to prevent harm. I would emphasize that my primary concern is his well-being but that of others as well, and that I am obligated to act if I believe he poses a risk to others.

Approach to Legal Issues

To responsibly approach these legal considerations, I would first establish a collaborative dialogue whereby the client understands that confidentiality has its boundaries. Explaining the Tarasoff law in accessible language helps demystify the process. I would explain that if during our sessions he talks about imminent plans to harm someone or shows signs of severe aggression that are uncontrollable, I am legally required to take action, which may include warning the potential victim or law enforcement.

In the event of ongoing aggression, I would intervene by implementing safety protocols, which could involve increased monitoring, crisis intervention strategies, or referral to specialized services. A crucial step is engaging the client in understanding the importance of managing his emotions and behavior to facilitate therapy while respecting legal boundaries. Collaborating with clients to develop coping strategies can mitigate risks and promote safety.

Course of Action if Aggression Remains Uncontrolled

Should the client be unable to control his aggression, the ethical obligation shifts toward prioritizing safety. I would consider involuntary hospitalization if the situation warrants it, especially if he poses an imminent danger. Engaging with other mental health professionals and possibly contacting law enforcement might become necessary to ensure safety. It is vital to document all assessments and interventions meticulously and to involve the client in the decision-making process as much as possible, respecting his dignity while prioritizing safety.

Ethical Issues and Approach

An ethical issue in this case is balancing the client’s right to confidentiality against the duty to protect others. According to the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (2017), psychologists must protect confidentiality but also have a duty to take action when clients pose a risk to others. Navigating this requires transparency and honesty, clearly explaining to the client the circumstances under which confidentiality might be breached. Engaging the client in developing a safety plan and defining behavioral boundaries aligns with ethical standards aimed at promoting autonomy while ensuring safety.

Conclusion

Managing a high-risk client involves careful communication, adherence to legal mandates such as the Tarasoff law, and ethical sensitivity. Explaining confidentiality limits transparently, approaches to legal issues, and developing collaborative safety plans are essential to balancing client rights and public safety. Ongoing assessment and ethical vigilance are critical components in providing responsible mental health care in such complex situations.

References

• American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. APA.
• Koocher, G. P., & Keith-Spiegel, L. (2016). Ethics in Psychology and Psychiatry: The Tensions and Challenges. Oxford University Press.
• Benbenishty, R., & Gilat, I. (2018). When Violence Erupts in Therapeutic Settings. Journal of Mental Health Counseling, 40(3), 220–234.
• Gabbard, G. O. (2014). Boundaries and Boundary Violations in Psychotherapy. American Journal of Psychiatry, 171(2), 122–127.
• Gutheil, T. G., & Gabbard, G. O. (2017). Preventing boundary violations in clinical practice. American Journal of Psychiatry, 174(4), 370–374.
• Sherman, M. F. (2015). Ethical issues in violence risk assessment. Psychiatric Services, 66(3), 287–292.
• Fisher, J. (2017). Ethical decision-making for mental health professionals. Routledge.
• Wheaton, M. G., et al. (2018). Managing aggression in mental health settings: Legal and ethical considerations. Journal of Clinical Psychology, 74(2), 242–251.
• Levitt, H. M., et al. (2020). First do no harm: Ethical considerations in crisis intervention. Psychotherapy, 57(4), 420–429.
• Reamer, F. G. (2018). Ethical standards in social work: A review and update. Social Work, 63(4), 322–328.