VIOLENCE, VICTIMS, AND A THERAPIST'S DUTY TO PROTECT (CALIFORNIA).

Persistent Link:
http://hdl.handle.net/10150/187729
Title:
VIOLENCE, VICTIMS, AND A THERAPIST'S DUTY TO PROTECT (CALIFORNIA).
Author:
MCKILLOP, DENNIS JOHN.
Issue Date:
1984
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Issues regarding confidentiality and potential dangerousness, when an individual is seen in outpatient psychotherapy, are addressed in this study which was derived from a controversial California Supreme Court decision. The Tarasoff holding imposed a duty to protect upon psychotherapists where the therapist knew, or should have known, that there was a treat of violence to a third party. This case appeared to pit society's interest in the prevention of violence against its interest in effective psychotherapy (through a postulated cost to the psychotherapy relationship of a duty to warn involving a breaching of confidentiality). A two-pronged research procedure consisting of a survey of 278 psychotherapists and a structured interview with 61 psychiatric outpatients was utilized to collect data regarding the decision-making process that a therapist employs when confronted with a potentially aggressive patient. It was found that, in general, dangerous outpatients both entered psychotherapy voluntarily and were potentially violent before entering treatment. Such individuals did not frequently meet the legal criteria for commitment and were reported to be more dangerous toward intimates than strangers. The formation of a therapeutic alliance did not appear to be a necessary condition for the patient to reveal dangerousness. Findings from therapist responses revealed that they infrequently responded to potential violence by committing the patient to a hospital or by notifying the police. Their most common responses were more frequent psycotherapy and voluntary hospitalization. Warnings were reported as an intermediate level response. Outpatient respondents indicated that their they considered it appropriate for a therapist to use information from therapy sessions to warn others in the case of serious threats. Confidentiality did not appear to be a premier concern, with few outpatients reporting that they would abandon treatment if confidentiality were broken during a homicidal emergency. Finally, warnings may not significantly impair a therapy alliance nor create an appreciable level of psychotherapy attrition. This finding is suggestive that, from a social policy perspective, a warning may be an efficacious procedure and may not generate the commonly predicted thwarting of effective treatment and ultimate reduction in public safety.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Violence -- Research.; Aggressiveness.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Psychology; Graduate College
Degree Grantor:
University of Arizona
Committee Chair:
McWilliams, Spencer

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleVIOLENCE, VICTIMS, AND A THERAPIST'S DUTY TO PROTECT (CALIFORNIA).en_US
dc.creatorMCKILLOP, DENNIS JOHN.en_US
dc.contributor.authorMCKILLOP, DENNIS JOHN.en_US
dc.date.issued1984en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractIssues regarding confidentiality and potential dangerousness, when an individual is seen in outpatient psychotherapy, are addressed in this study which was derived from a controversial California Supreme Court decision. The Tarasoff holding imposed a duty to protect upon psychotherapists where the therapist knew, or should have known, that there was a treat of violence to a third party. This case appeared to pit society's interest in the prevention of violence against its interest in effective psychotherapy (through a postulated cost to the psychotherapy relationship of a duty to warn involving a breaching of confidentiality). A two-pronged research procedure consisting of a survey of 278 psychotherapists and a structured interview with 61 psychiatric outpatients was utilized to collect data regarding the decision-making process that a therapist employs when confronted with a potentially aggressive patient. It was found that, in general, dangerous outpatients both entered psychotherapy voluntarily and were potentially violent before entering treatment. Such individuals did not frequently meet the legal criteria for commitment and were reported to be more dangerous toward intimates than strangers. The formation of a therapeutic alliance did not appear to be a necessary condition for the patient to reveal dangerousness. Findings from therapist responses revealed that they infrequently responded to potential violence by committing the patient to a hospital or by notifying the police. Their most common responses were more frequent psycotherapy and voluntary hospitalization. Warnings were reported as an intermediate level response. Outpatient respondents indicated that their they considered it appropriate for a therapist to use information from therapy sessions to warn others in the case of serious threats. Confidentiality did not appear to be a premier concern, with few outpatients reporting that they would abandon treatment if confidentiality were broken during a homicidal emergency. Finally, warnings may not significantly impair a therapy alliance nor create an appreciable level of psychotherapy attrition. This finding is suggestive that, from a social policy perspective, a warning may be an efficacious procedure and may not generate the commonly predicted thwarting of effective treatment and ultimate reduction in public safety.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectViolence -- Research.en_US
dc.subjectAggressiveness.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.chairMcWilliams, Spenceren_US
dc.identifier.proquest8421976en_US
dc.identifier.oclc691293940en_US
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