The unintended consequences of Tarasoff

Psychotherapy practitioners and trainees are well aware of the impact of the landmark Tarasoff v. Regents case, which in some states has mandated therapists to report to authorities and potential victims when a client expresses homicidal intentions. As in any case of mandated reporting, the law and its surrounding debate are forced to take positions on the shifting fault line between patient confidentiality and freedom to share openly with their therapist on the one hand, and public safety on the other. A major concern that affects both sides is simply that, with severe mandates in place, therapists will (intentionally or not) steer clients away from expressing thoughts or feelings that legally demand interfering action.

International Psychoanalysis recently linked to a 2010 paper by economics professor Griffin Edwards on the potential unintended consequences of this system. Edwards estimates an 8.9% increase in homicides due to the Tarasoff mandate. This would suggest that in addition to its expected inhibiting effect on patient rights, the law has failed in its express purpose to increase public safety, as well.

Doing their duty: An empirical analysis of the unintended effect of Tarasoff v. Regents on homicidal activity (PDF) [via International Psychoanalysis]

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