+1(978)310-4246 credencewriters@gmail.com
  

Chapter 15 Assignment

What are the four roles and responsibilities of the clinician and define.

Define duty to warn.

Why was the Tarasoff case important in psychology?

Discuss the ethics of relationships with clients.

What are four special roles of clinicians?

What is the definition of commitment of clients?

What are some commitment issues?

Define insanity defense.

Discuss competency to stand trial.

What did you like about this course?

Abnormal
Psychology
Clinical Perspectives on Psychological Disorders 5e
Richard P. Halgin
Susan Krauss Whitbourne
University of Massachusetts at Amherst
slides by Travis Langley
Henderson State University
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Chapter 15
Ethical and Legal Issues
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
ROLES AND RESPONSIBILITIES OF
CLINICIANS
Therapist Competence
Informed Consent
Confidentiality
Privileged Communication
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
ROLES AND RESPONSIBILITIES OF
CLINICIANS
•
•
•
•
Therapist competence — Mental health professionals are
guided by professional standards and are expected to have the
intellectual competence to assess, conceptualize, and treat
clients whom they accept into treatment.
Informed consent — Client participates in treatment goals,
understands treatment plan, knows clinician’s credentials, and is
advised of treatment risks.
Confidentiality — The therapist has a duty to safeguard client
disclosures as private.
The content of therapy is legally considered privileged
communication; there is a legal privilege of nondisclosure
unless the client waives it.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
EXCEPTIONS TO PRIVILEGED
COMMUNICATION
Mandated Reporting
Duty to Warn
•
•
Every state requires some form of mandated reporting when
professionals learn first-hand of cases involving child abuse or
neglect.
When the clinician learns a client plans to hurt another person,
the clinician is required to warn the potential victim that the client
plans to harm him or her. Duty to warn laws arose in response to
the “Tarasoff” case of 1969. Complicating this matter is the
imprecise nature of predicting dangerousness.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
â—¼
Prosenjit Poddar was a student from Bengal, India. He entered
the University of California, Berkeley as a graduate student in
September 1967 and resided at International House. In the fall of
1968, he attended folk dancing classes at the International
House, and it was there that he met Tatiana Tarasoff. They
dated, but apparently had different ideas about the relationship.
He assumed their relationship was serious. This view was not
shared by Tarasoff who, upon learning of his feelings, told him
that she was involved with other men and that she was not
interested in entering into an intimate relationship with him. This
gave rise to feelings of resentment in Poddar. He began to stalk
her.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
â—¼
During the summer of 1969, Tarasoff went to South America.
After her departure, Poddar began to improve and at the
suggestion of a friend sought psychological assistance. Prosenjit
Poddar was a patient of Dr. Lawrence Moore, a psychologist at
UC Berkeley’s Cowell Memorial Hospital in 1969. Poddar
confided his intent to kill Tarasoff. Dr. Moore requested that the
campus police detain Poddar, writing that, in his opinion, Poddar
was suffering from paranoid schizophrenia, acute and severe.
The psychologist recommended that the defendant be civilly
committed as a dangerous person. Poddar was detained but
shortly thereafter released, as he appeared rational. Dr. Moore’s
supervisor, Dr. Harvey Powelson, then ordered that Poddar not
be subject to further detention.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
â—¼
â—¼
In October, after Tarasoff had returned, Poddar stopped seeing
his psychologist. Neither Tarasoff nor her parents received any
warning of the threat. Poddar then befriended Tarasoff’s brother,
even moving in with him. Several weeks later, on October 27,
1969, Poddar carried out the plan he had confided to his
psychologist, stabbing and killing Tarasoff. Tarasoff’s parents
then sued Moore and various other employees of the university.
Poddar was subsequently convicted of second-degree murder,
but the conviction was later appealed and overturned on the
grounds that the jury was inadequately instructed. A second trial
was not held, and Poddar was released on the condition that he
would return to India.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
â—¼
After this rebuff, Poddar underwent a severe emotional crisis. He
became depressed and neglected his appearance, his studies,
and his health. He kept to himself, speaking disjointedly and often
weeping. This condition persisted, with steady deterioration,
throughout the spring and into the summer of 1969. Poddar had
occasional meetings with Tarasoff during this period and taperecorded their various conversations to try to find out why she did
not love him.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tarasoff Case
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
The news on July 20, 2012 was dreadful: Wearing a helmet, gas mask,
and ballistic gear, James Holmes—a University of Colorado (Denver)
graduate student—tossed tear
gas into a movie theater in Aurora,
Colorado during the first minutes
of the midnight show of
The Dark Knight Rises. Armed
with a shotgun, a rifle, and a pistol,
Holmes had more than 700 rounds
of ammunition with him. After his
gun jammed, Holmes walked out
of the theater and surrendered.
Twelve victims died, and 70 were
injured during the shooting.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
On July 16, 2015, after an 11-week trial, a jury found Holmes guilty of 24
counts of first-degree murder, two counts for each of the 12 victims. He
was also found guilty of 140 counts of attempted murder for the 70
people wounded and guilty of one count of possession or control of an
explosive or incendiary device. In August 2015, Holmes received one life
term for each person he killed, plus 3,318 years for the attempted
murders of those he wounded and for rigging his apartment with
explosives.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
Alongside the criminal court proceedings, a number of victims
and survivors of the shootings have filed lawsuits against the
movie theater, the psychiatrist who treated Holmes, and the
University of Colorado. One of those lawsuits alleges that the
University of Colorado psychiatrist should have placed Holmes on
a psychiatric hold prior to the attack. The psychiatrist testified
during the trial that Holmes confessed thoughts of homicide to
her, but he never discussed specific plans. She ultimately
decided that he did not meet the criteria for a 72-hour hold. The
psychiatrist reportedly warned colleagues on a University of
Colorado safety committee before the Aurora shooting that her
patient might be a threat to others.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
â—¼
Shades of Tarasoff
The circumstances surrounding the Holmes case must sound eerily familiar to
social workers who learned about the California Supreme Court case Tarasoff vs.
Regents of the University of California during their professional education. In this
well-known case, Prosenjit Poddar, an Indian graduate student at the University of
California, Berkeley, began dating a fellow student named Tatiana Tarasoff. He
kissed her a few times and felt he had a special relationship with her. Poddar was
unfamiliar with American dating norms and felt betrayed by Tarasoff, who did not
share Poddar’s feelings. Because of his depression, Poddar sought counseling at
the university health service. During a counseling session with Lawrence Moore,
PhD, Poddar revealed his intention to get a gun and shoot Tarasoff. Moore sent a
letter to the campus police requesting them to take Poddar to a psychiatric
hospital. The campus police interviewed Poddar, but he convinced them that he
was not dangerous. They released him on the promise that he would stay away
from Tarasoff. When the health service psychiatrist in charge returned from
vacation, he directed that the letter to the police be destroyed, to protect Poddar’s
privacy, and that no further action be taken.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
â—¼
Poddar moved in with Tatiana’s brother over the summer while Tatiana was visiting her aunt in
Brazil. When Tatiana returned, Poddar stalked her and stabbed her to death.
Tatiana’s parents sued the campus police, health service employees, and regents of the
University of California for failing to warn them that their daughter was in danger. The trial
court dismissed the case because it concluded there was no cause of action. The appeals
court supported the dismissal. An appeal was filed with the California Supreme Court.
In 1974, the California Supreme Court reversed the appellate court’s decision; they held that a
therapist bears a duty to use reasonable care to prevent foreseeable danger arising from a
patient’s or client’s condition: “When a therapist determines, or pursuant to the standards of
his profession should determine, that his patient presents a serious danger of violence to
another, he incurs an obligation to use reasonable care to protect the intended victim against
such danger. The discharge of this duty may require the therapist to take one or more of
various steps. Thus, it may call for him to warn the intended victim, to notify the police, or to
take whatever steps are reasonably necessary under the circumstances.”
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
â—¼
Duty or Privilege to Warn and Protect?
The Tarasoff decision, which has been cited in the James Holmes case and many
other cases, is often misinterpreted. I have encountered many social workers
who, having learned about the Tarasoff case, assume they have a so-called duty
to warn. In fact, some do and some do not, depending on their state’s law. Since
the Tarasoff ruling, many states have adopted laws that address the limits of
clients’ confidentiality rights when social workers and other mental health
professionals believe that disclosure without client consent is necessary to
prevent serious, imminent, and foreseeable harm to a third party. However, only
some states’ laws mandate a true duty to warn. Other states permit but do not
require social workers to warn. And, many states require or permit social workers
to take “reasonable steps” to protect third parties from harm, which may or may
not include warning a potential victim. As per the Tarasoff decision, reasonable
steps may include warning the intended victim, notifying the police, or taking
whatever steps are “reasonably necessary” under the circumstances.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Holmes Case
â—¼
â—¼
â—¼
Thus, the concept of duty to warn is often interpreted too narrowly and
oversimplifies current law in the United States. It is more accurate to say that
some states have established a duty to warn, some states have established a
privilege to warn, some states have established a broader duty to protect, and,
finally, some states have established a privilege to protect.
The practical implications are significant. In states that establish a duty to warn or
protect, the bar is set high; social workers who fail to discharge their duty expose
themselves to considerable risk. In states that establish a privilege to warn or
protect, social workers are permitted, but not required, to disclose confidential
information without a client’s consent. That said, even in the latter states, social
workers must meet the standard of care with regard to whether they should have
disclosed confidential information to protect a third party from harm.
These conceptual distinctions are both complex and compelling. They provide yet
another example of the importance of sound ethical decision-making.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
RELATIONSHIPS WITH CLIENTS
The therapist must keep therapeutic
boundaries. Most ethical codes forbid
romantic and sexual involvement.
In addition to sexual or romantic
involvements, it would be inappropriate
for clinicians to become involved in
business relationships with clients.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
THE BUSINESS OF PSYCHOTHERAPY
Payment Issues
â—¼ Paid by client or, more often, third party.
â—¼ Health maintenance organizations and
managed care health systems arose to
keep insurance affordable.
â—¼ Conflicts arise between managed care
and client treatment needs.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
SPECIAL ROLES FOR CLINICIANS
â—¼ EXPERT WITNESS
â—¼ EVALUATION IN CHILD PROTECTION
CASES
â—¼ GUARDIAN AD LITEM
â—¼ EVALUATIONS OF PEOPLE WITH
COGNITIVE DISORDERS
ALL HAVE INHERENT ETHICAL DILEMMAS: SOMEONE
OTHER THAN THE ONE THEY ARE EVALUATING IS
PAYING FOR THEIR SERVICES.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
SPECIAL ROLES FOR CLINICIANS
•
•
•
The role of expert witness has many challenges, in
that the clinician is called on to provide specialized
information in court.
In cases with evidence or charges involving child
abuse, a mental health professional may be asked to
make recommendations about the child’s care.
In some cases, the clinician is appointed as a
guardian ad litem, a person appointed by the court to
represent or make decisions for a person legally
incapable of doing so in a civil legal proceeding.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
COMMITMENT OF CLIENTS
COMMITMENT:
An emergency procedure for the
involuntary hospitalization of a
person who is deemed likely to
create harm for self or other
people as a result of mental
illness.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
COMMITMENT ISSUES
â—¼
BALANCE CLIENT’S RIGHTS WITH CLIENT’S BEST
INTERESTS
â—¼
RIGHT TO LEAST RESTRICTIVE TREATMENT
â—¼
RIGHT TO REFUSE MEDICATION
Commitment stems from the legal principle that the state has the
authority (referred to a parens patriae) to protect those who
are unable to protect themselves. This responsibility is vested
in various professionals such as psychologists, physicians,
and nurse specialists.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Forensic
Issues
Copyright ©
© The
Companies, Inc.
Inc. Permission
Permissionrequired
requiredfor
for reproduction
reproduction or
or display.
display.
Copyright
The McGraw-Hill
McGraw-Hill Companies,
INSANITY DEFENSE
The argument, presented by a lawyer
acting on behalf of the client, that,
because of the existence of a mental
disorder, the client should not be held
legally responsible for criminal actions.
Contrary to popular belief, this is a
legal term, not a psychological term.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
INSANITY DEFENSE
In question is the individual’s state of
mind at the time of the criminal action.
â–ª Unable to appreciate wrongfulness of their
conduct and to control their actions due to
a severe mental disturbance.
â–ª Generally require DSM-V diagnosis of
psychotic disorder, severe mood disorder,
dissociative disorder.
â–ª Personality disorder will not be sufficient.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
INSANITY DEFENSE:
HISTORY
• M’Naghten Rule
• Durham Rule
• American Law Institute
• Insanity Defense Reform
Act
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
INSANITY DEFENSE:
HISTORY
•
•
•
•
M’Naghten Rule (the “right-wrong test”): Under the delusional belief
he was commanded by God, Scottish woodcutter Daniel M’Naghten
killed an English government official. He was deemed not responsible
because his mental state prevented him from knowing the difference
between right and wrong.
The Durham Rule emerged from a 1954 court decision asserting an
individual is not criminally responsible if the “unlawful act was the product
of mental disease or defect.” This allowed for the insanity defense but
was too broad.
In 1962, the American Law Institute published guidelines saying
people are not responsible if mental disorder prevents their
“appreciating” wrongfulness of their actions or from controlling their
actions.
After John Hinckley was found not guilty by reason of insanity after
shooting President Reagan, Congress passed the Insanity Defense
Reform Act of 1984 trying to clear up the ambiguity inherent in ALI
standards. The defense now had to prove insanity rather than rely on a
“reasonable doubt” regarding the client’s sanity.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
COMPETENCY TO STAND
TRIAL
Whether a defendant is aware of and able to participate in criminal
proceedings against him or her.
•
•
The determination of competency to stand trial is a prediction
by a mental health expert of the defendant’s cognitive and
emotional stability during the period of the trial.
To increase precision of competency assessments, forensic
experts developed standardized instruments to be used in such
evaluations.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Mental health professionals play an
increasingly important role in the legal
system and find they must familiarize
themselves with a whole array of
forensic issues.
The intersection between psychology
and law will continue to grow as
society looks for interventions that are
humane, ethical, and effective.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
For more information on material covered
in this chapter, visit our Web site:
http:/www.mhhe.com/halgin6e
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Purchase answer to see full
attachment

  
error: Content is protected !!