Interesting Duty to Warn Situation in the News

[ClinicalABA]

I recently read an article about Deion Sanders (Coach of Colorado Football) tweeting support for a transfering player. The backstory is that Sanders is kind of a jerk, a lot players from last year's team are transferring to different schools, and he publicly calls them things like "losers". Yeah- great guy there. Really looking out for the kids and young adults as I'm sure the mission of CU mandates. The story here was that the one guy he is tweeting support for (Deuce Roberson) was accused of multiple sexual assaults and rapes while in high school. The article referred to a "therapist" in the Colorado town where the accused attended high school who told the publication (Defector- which is a great sports/pop culture/all things interesting web publication by the way) that three of her clients- all high school students at the time- reported to her that they had been sexually assaulted by Roberson.

This presents an interesting ethical dilemma. The therapist is aware of potential serial sexual abuser. Presumably no specific potential victim is identified, so it may fall short of Tarasoff case. What- if anything- is the actual duty here? What would you do?

Personally, my gut instinct is that I would feel a responsibility to somehow make sure a) this didn't happen to anyone else; and b) this got what he deserved (not surprisingly, his ability to score touchdowns for a top-tier state program that sends multiple players to D1 college programs may have contributed to his not even being questioned by the authorities). I don't work with a population where I would encounter this type of thing. I'm hoping that those who do work with sexual assault/rape victims would have specific training as to how to address such situations in a manner that protected the public while still maintaining the confidentiality of the client.

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[Sanman]

As the psychologist was treating the victims and not the criminal, I don't think that Tarasoff really applies. Now, I am not sure if the victims reported the crimes or not. I would assume that the counselor would support the decision of the victim either way.

 

[AcronymAllergy]

Yeah, I would think that if the patients are the victims rather than the attacker, there isn't necessarily a Tarasoff situation. If the victims told the psychologist that the attacker said he planned to assault other people in the future, I still don't know that a therapist can, or has any obligation to, report/warn based on what is essentially hearsay, particularly if there are no specific targets.

But if the patients are high school students, there might be an obligation to report sexual assault of a minor, depending on state law.

 

[WisNeuro]

Aside from the issues with potential abuse/assault of a minor which AA mentioned, I don't think this falls under Tarasoff in adult cases. One of the key tenets to our mandated reporting issues is imminence. If someone is suicidal, we have to judge that their risk is high, and likely imminent. Similar to duty to warn for violence, if we reported everyone who had an increased propensity for violence, we'd be making a lot of calls to the authorities.

 

[PsyDr]

1) I don't think this is a duty to warn. The therapist isn't warning anyone. They are just reporting what an unidentified patient said. I don't really see a breach in confidentiality, unless there is some court documents naming the victims.

2) The courts have expanded the entire idea from a "duty to warn" to a "duty to protect". That's a little terrifying. Of course, it is state by state.

3) Colorado's duty to warn only applies to threats by people under the care of the therapist. The accused doesn't sound like he is a patient of the therapist. No duty to the accused.

4) Naidu v. Laird established a duty to protect unidentified people, from unintentional harm committed by your patient.

5) Lipari v. Sears, Roebuck & Co. established a duty to protect the general public from the actions of an EX patient. Some VA patient stopped psychiatric treatment. A month later he shot some people in a nightclub while drinking. Yep. That means you could be responsible for someone you haven't seen in two months, who injures someone you have never heard of.

6) Peck v. Counseling Service of Addison County established a duty to protect property, not just people. Specifically, the patient burned down someone's barn.

 

[ClinicalABA]

Yeah- since the perp is not the client and there is no specified victim identified, it's not likely covered by the usual case law stuff (e.g., Tarasoff). Still- knowing that there is a potential serial sexual assaulter/rapist victimizing girls in you local high school would be a difficult thing to just sit with. Especially if you knew of this guy after the first client, then another, and another come in to clinic and report that the same guy did it to them. That'd be tough and I'd definitely feel guilty. The mandated reporter stuff is also tricky, as the perp was also technically a child at the time of the alleged crime (though i'm prompted to re-review my own local statutes to see if that matters). Definitely not a statutory crime due to the "Romeo and Juliet" clauses about relatively small age differences.

Reported the guy probably would not have made much of difference either, as this is a small town and he was really good at making touchdowns.

 

[cara susanna]

If the patients and possible future victims were children, yes, it would have applied and the therapist would have had to call CPS. But with adults, it doesn't.

 

[Bemosaidit]

I recently read an article about Deion Sanders (Coach of Colorado Football) tweeting support for a transfering player. The backstory is that Sanders is kind of a jerk, a lot players from last year's team are transferring to different schools, and he publicly calls them things like "losers". Yeah- great guy there. Really looking out for the kids and young adults as I'm sure the mission of CU mandates. The story here was that the one guy he is tweeting support for (Deuce Roberson) was accused of multiple sexual assaults and rapes while in high school. The article referred to a "therapist" in the Colorado town where the accused attended high school who told the publication (Defector- which is a great sports/pop culture/all things interesting web publication by the way) that three of her clients- all high school students at the time- reported to her that they had been sexually assaulted by Roberson.

This presents an interesting ethical dilemma. The therapist is aware of potential serial sexual abuser. Presumably no specific potential victim is identified, so it may fall short of Tarasoff case. What- if anything- is the actual duty here? What would you do?

Personally, my gut instinct is that I would feel a responsibility to somehow make sure a) this didn't happen to anyone else; and b) this got what he deserved (not surprisingly, his ability to score touchdowns for a top-tier state program that sends multiple players to D1 college programs may have contributed to his not even being questioned by the authorities). I don't work with a population where I would encounter this type of thing. For beginners or students, this can be a challenging task. One student I know said that https://essays.edubirdie.com/psychology-assignment-help found to solve confusing cases. This is how he receives psychology assignment help and improves his own skill. I'm hoping that those who do work with sexual assault/rape victims would have specific training as to how to address such situations in a manner that protected the public while still maintaining the confidentiality of the client.

It looks like, in this case, the criminal was charged without the psychologist’s involvement. I think she got consent for the disclosure

 

[smalltownpsych]

I do work with a lot of victims of sexual abuse and I leave the actions up to them. We discuss options for how I handle perpetrators who are getting away with it all the time. Some have been involved in sting operations with law enforcement. My stance is always about giving them authority over what they want to to do which is something that was taken away by the perpetrator so there is a little bit of karmic balancing when they make their choices. Conversely, I never want to pressure a sexual assault victim to do something they don’t want to do. Surprisingly most therapists out there don’t seem to get why that is a problem.

Just to clarify, if it is a minor then I will report it as mandated, but I still work with them to get assesnt and also give them authority and agency in how we go about it.

 

[msc545]

As the psychologist was treating the victims and not the criminal, I don't think that Tarasoff really applies. Now, I am not sure if the victims reported the crimes or not. I would assume that the counselor would support the decision of the victim either way.

I think this is very different from the usual Tarasoff situation in that there is really no duty to warn anyone in particular, and the Psychologist's patients are the victims and there is nobody being threatened. If the Psychologist reports anything except some vague unsubstantiated allegations from unnamed victims, nobody is going to be interested. If he did name victims that would be a very serious breach of confidentiality. If anyone is going to complain about the supposed perpetrator, the victims(s) should be the ones.

The Psychologist needs to stay the hell out of this altogether except for treating his patients.

 

[cara susanna]

Here's something I just thought of: university counseling centers/psych clinics are beholden to FERPA, not HIPAA, right (our dept clinic always stressed that)? Would that change anything?

 

[WisNeuro]

Here's something I just thought of: university counseling centers/psych clinics are beholden to FERPA, not HIPAA, right (our dept clinic always stressed that)? Would that change anything?

Both HIPAA and FERPA have duty/release to warn to protect the welfare of others/other students.

 

[smalltownpsych]

Here's something I just thought of: university counseling centers/psych clinics are beholden to FERPA, not HIPAA, right (our dept clinic always stressed that)? Would that change anything?

My off the cuff reaction is that doesn’t seem correct. My understanding is that you would need to be compliant with both federal laws. Not sure what the areas of difference would be so it could be moot. My policy has ways been to go with the law that is directed toward healthcare providers since that is what I am licensed as and looked at from a legal standpoint.

 

[WisNeuro]

My off the cuff reaction is that doesn’t seem correct. My understanding is that you would need to be compliant with both federal laws. Not sure what the areas of difference would be so it could be moot. My policy has ways been to go with the law that is directed toward healthcare providers since that is what I am licensed as and looked at from a legal standpoint.

https://www.acha.org/documents/Programs_Services/ConEd/FERPA_HIPAA_ACHA20181217_Slides.pdf

 

[cara susanna]

Ohh, right, our dept clinic didn't have HIPAA because we didn't use EMR (at least, not back in my day)

 

[smalltownpsych]

https://www.acha.org/documents/Programs_Services/ConEd/FERPA_HIPAA_ACHA20181217_Slides.pdf

I stand corrected. Good example of why one of the first slide states when in doubt to consult an attorney. Also, a good reason to participate in an online community with other psychologists and continue learning. I should get CEUs for this. 😁

 

[WisNeuro]

Ohh, right, our dept clinic didn't have HIPAA because we didn't use EMR (at least, not back in my day)

Did they take and bill insurance?

 

[cara susanna]

Did they take and bill insurance?

Nope, sliding fee scale only