Confidentiality has long been a cornerstone of the practice of medicine and psychiatry. In the past 20 years there has been a dramatic increase in the number and type of exceptions to confidentiality. Confidentiality Versus the Duty to Protect: Foreseeable Harm in the Practice of Psychiatry is designed to help psychiatrists and other psychotherapists deal with the problems created by exceptions to confidentiality. The mental health professionals must now have some knowledge of relevant law. Without such knowledge, the clinician carries the double burden of ignorance and anxiety. The wish to lighten that burden is the motive for this book. Written by clinicians, for clinicians, Confidentiality Versus the Duty to Protect: Foreseeable Harm in the Practice of Psychiatry presents a discussion of law as it relates to the clinical issues of confidentiality versus the duty to protect.

This book is divided broadly 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. This section addresses legal issues surrounding clinical practice in the office, in the emergency room, and in the hospital. In the second section, the chapter authors examine specific clinical situations in which confidentiality and duty to protect issues arise. Chapters focus on issues relating to children and families, sexual misconduct between patients and therapists, HIV-positive patients, patients with a dual diagnosis of mental illness and substance abuse, and two other problematic diagnoses: posttraumatic stress disorder and antisocial personality disorder. The book concludes with the presentation of a clinical case in which the patient poses a threat to the potential victim.