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Designed to help psychiatrists and other psychotherapists deal with problems created by exceptions to confidentiality, this book presents a discussion of the law as it relates to clinical issues of confidentiality versus the duty to protect. The book is divided into two sections. The first section includes a chapter on basic issues, an overview of the law, and chapters on applications of the law in specific clinical settings. The other chapters address clinical practice in the office, the emergency room and the hospital. In the second section, the chapters examine specific clinical situations in which the duty to protect arises. Other chapters focus on issues relating to children and families, on sexual misconduct of therapists, on HIV positive patients, on patients with dual diagnosis of mental disorder and substance abuse and anti-social personality and post-traumatic stress disorder. The book concludes with the presentation of a clinical case in which the patient poses a threat to the potential victim.
The basic issues. Current Status of the duty to protect. The duty to protect in private practice. The duty to protect in emergency psychiatry. The duty to protect in inpatient psychiatry. Managing risk and confidentiality in clinical encounters with children and families. Therapist sexual misconduct and the duty to protect. The HIV antibody-positive patient. Tarasoff and the dual-diagnosis patient. Posttraumatic stress disorder and the duty to protect. The antisocial patient. Driving, mental illness, and the duty to protect. The case of Ms. Troubled.

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