In recent years, duty to warn has been receiving increased attention following public tragedies and mass shootings such as Aurora, Colorado. We know that when a clinician is vigilant in recognizing and managing clients with violent behaviors, it can contribute to the appropriate handling of dangerous situations and minimize risk to themselves, patients, their families, coworkers, and the community as a whole.
As a frontline clinician who specializes in the treatment of personality disorders, managing clients with violent tendencies is a central concern. Some personality disorders are at a higher likelihood to harm others and put their mental health provider at risk, but not all personality disorders or those with mental illness are going to be violent and raise the "duty to warn" question.
Because the issue of duty to warn is complex, it's important to review and understand the specific requirements for the state you practice in. And while duty to warn requirements may vary, the steps to take to protect yourself to manage and avoid in-session violence and threats are universal.
It does not matter if you are a novel or seasoned therapist, threat identifiers are not always searchlights, but often times tiny flashlights.
Daniel J. Fox, Ph.D., has been treating and specializing in the treatment and assessment of individuals with personality disorders for the last 14 years in the state and federal prison system, universities, and in private practice. He is a licensed psychologist in the state of Texas and has published several articles on personality, ethics, and neurofeedback. He is the author of The Clinician’s Guide to Diagnosis and Treatment of Personality Disorders. His specialty areas include personality disorders, ethics, and neurofeedback.