The Tarasoff raid: a new extension of the duty to protect.
R. L. Goldstein and J. M. Calderone,
Bull. Amer. Acad. Psychiatry & the Law
20(3): 335-42, 1992.
The authors discuss the general outlines of the Tarasoff duty of psychotherapists to protect potential
victims of their violent patients. They describe the flexible range of clinical responses that therapists
have utilized, as well as their professional concerns about preserving patient confidentiality (or at
least strictly circumscribing the scope of disclosure when confidentiality must be breached). A recent
case is reported that illustrates a striking new extension of Tarasoff, involving a police search and
seizure of a psychotherapist's confidential treatment records and tapes, in response to a third-party
complaint that the records contained evidence of his patients' violent acts and propensities. The
implications of this case are that the therapist's discretion in the assessment of his duty to protect,
the selection of a proper course of action, and the implementation of specific responses may be taken
out of his hands, for all intents and purposes, and expropriated by law and order officials. Moreover,
regardless of whatever clinical approach he adopts and whether or not he issues a warning, his
attempts to preserve patient confidentiality are bound to prove unsuccessful in any future legal
proceedings. Patient communications are likely to lose their confidential status on the grounds that
they caused or triggered the Tarasoff warning (or that they should have triggered it). If the patient
directed serious threats against the therapist himself, the court may find that, as a consequence, a
"genuine therapeutic relationship" ceased to exist and thereafter all patient disclosures were no
longer confidential on that basis.(ABSTRACT TRUNCATED AT 250 WORDS)