I love how measured Dr. Grande is with his wording. "If you're standing next to someone who's wanted for murder, that's not always a safe place to be."
@N Silva *Must* you bring your ridiculous gender politics into a serious discussion like this? As a crisis counsellor, I assure you that I hold all lives as equal, and all murders as equally heinous. You obviously need some therapy yourself to deal with your issues of anger toward women and low self-esteem.
My great uncle was a psychiatrist. He would never tell me any stories but he did say that one time when he was watching the news there was a certain list of the top 10 most wanted criminals in our city and 4 of them were his patients.
You make ethics sound more fluid than I think they are, but maybe personal ethics are different than clinical standards (is that a thing). Oh, professional ethics vs personal. I can’t believe they are not the same. I can’t believe it’s so hard to not know what direction to take depending on the circumstances.
I _want_ to see the logic behind this sort of confidentiality. On the one hand: Deny people closure and justice for the death of a loved one, and thereby put their mental health in grave jeopardy; deny justice to someone who was murdered, raped, _inter alia._ On the other hand: protect the mental health of the perpetrators. Think of it this way: two people need a liver transplant, one is an unrepentant alcoholic junk-food gobbler, the other tries to be reasonably healthy. Who should get the liver? When granting a positive right causes a negative harm, society might be better served if that right is changed to a privilege.
Good one! I think the client can decide when they are ready to disclose, since they are all required to sign the disclosures at the beginning of therapy. In this manner, the client is actually making the decision (in most cases, when they are competent enough....but then, wouldn't they be able to claim insanity, and that they didn't know what they were signing, and that they couldn't be accountable for the action(s)? I know the legal definition of insanity for crimes is very strict, but what about for signing the disclosure in the first place?
The idea is to not make the client afraid of being honest with the therapist. Without confidentiality, nobody would trust their therapist. Obviously if the person is a danger to others, you have to say something. But theoretically there could be plenty of situations in which someone who wouldn't ordinarily kill someone does it once. So they've killed someone but they aren't a danger to anyone else so in that case there would be a duty NOT to report. And you can't make it a privilege instead of a right because if it's a privilege the therapist can set any rules they want based on whether they think the client is a good person or not.
@@lynnes1864 That is absolutely repugnant. That a murderer's feelings has any value whatsoever in the face of the harm they've created is disgusting and truly indefensible. There is no reason why society should be calibrated to the worst among us.
Dr Grande, if this scenario ever happens to you, please, please, take care because your fans care about you so much, please just phone Hercule Poirot and put it in his hands... He'll sort out if, and how, this person (murderous client) needs to be brought to justice ! x
When I was about 13 y.o. I started having problems at school, so the school sent me to talk to a psychologist. She promised me she wouldn't tell anybody whatever I'd tell her. So I told her I was having a hard time figuring things out because I had realized I was gay. A few weeks later I found out she had told the Principal, and the Principal told my parents. The lesson I've learnt was: if you can not keep your very secret, don't expect strangers to keep it.
When I was 12 I became depressed, my parents took me to a psychologist. I knew she would tell my parents any secrets I had. I held on for months of appointments until she gave up.and figured I was just a depressed teen.
I not sure where you live. But here in Australia that shit is not allowed! My son has seen a child psychologist, and anything my son told the psychologist was confidential. The only loophole would be if he told them anything in regards to hurting himself or others, or if someone was hurting my son, that would be only circumstances where confidentiality would be void.
I asked this same question to my shrink and she gave me a funny look and said, "Yes, of course I would have to report it!" (She knew I was asking more due to my fascination with true crime than anything personal, haha.)
When I was a teenager, a psychiatry told me that too. She said "whatever you tell me I'm going to tell your mom" so I said what's the point then, she wrote me prescriptions for three different drugs and sent me out. I was 15yrs old
@@MsSwitchblade13 this makes me glad I wasn’t able to see a psychiatrist until I was 25 (due to not having health insurance). I can’t imagine being that young and dealing with that
@@MsSwitchblade13 it’s shitty but at that age we had no ability to legally consent to any treatment without an adult’s knowledge. The paperwork would’ve looked real different just a few years later, but sometimes people 18+ still get tricked into signing a release so their parent hears everything and I imagine that feeling is the same - “so what’s the point?”
It’s not “super easy to break”. Remember all those papers you sign at the bottom of? These tell you exactly where confidentiality begins & ends. There is always a list of crimes you can’t admit to without having to be reported that you’ll see... unless you skipped over them like a Terms Of Service while installing new software
I have been in this situation. Even after their confession to the police in my presence (they wanted to meet me at the police station saying that they had something they wanted disclose in an open case) I wasn't sure what to do. People were asking me questions I didn't know if I could or should answer so I didn't. The detectives informed me that in this case, it was not protected information. I even asked them (the client) if they understood their rights and that they can have an attorney present and that they should. They said they understood and continued to disclose information. They were arrested at that time and currently awaiting trial.
@@papawhiskers9994 y’all will be fine I search up murder and murder videos all the time. I even searched up for hat goes into making a bomb just cause I took chemistry in highschool and the chemistry that goes into bombs and nuclear bombs is just cool af. Space is pretty interesting too ahaha.
@@Thedreamer20015 to be fair though. I'm sure alot of writers google crazy things all the time, not to mention research and just plain curiosity. Id wager that 99,9% of searched are just searched by curious people as oppose to 0,1% who actually intent to do something harmful with the importation give
@@randomserbianguy5677 lol intent doesn’t really matter when you are trying to build substances or projects that should be revisited. I’m sure if I hate the tools that I could build a bomb with a fair amount of work but it’s just the possibility. Those substances are highly reactive and arr crazy toxic at certain points. Curiously makes sense and I wish I could learn these things cause bombs arr cool, but at the end of the day. It makes a lot of sense that they keep a pretty tight cap on shit like that.
Thank you for pointing out how important the clinician's safety is. The difficulty is when a client makes ambiguous statements which seem threatening...but not in an explicit manner. This seems a rare event...but...who knows? Thank you for discussing this topic with such clarity.
The true danger is dealing with mental disease. It's why therapists have 10x sluicing risk. Though that's hard to statistically separate from somewhat unusual individuals attracted to study this field in the first place
He meant suicidal but he’s wrong either way. Psychiatric doctors have the highest suicide rate of any mental health professional, and I couldn’t find any statistics related to counseling increasing anyone’s suicidal tendencies.
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@@louissanderson719 well it’s hard to just assign unanimous decision like right or wrong because there are usually hundreds if not thousands of factors that go into it. In general. I don’t think I’d have much problem defending a murderer but I draw the line at people who have done things to kids and that’s about it. But even than say the kid was trying to rob an old man and the old man shot and killed the kid. I’d still defend that old man. But I ain’t defending some child molester or something.
This is exactly why I decided to switch my majors. I'm a DV survivor and changed my major first to radiology after leaving my abuser in 2017, and now thanks to covid which popped up literally right when I was healed enough to go back to finish my degree (covid definitely triggered my hypochondria, OCD, and comorbid ASD) I've once again switched majors, this time away from health care all together. Project management, here I come! 🤣 Good luck to you, LMPHs are the unsung heroes in our world.
Very off topic but can you do a video on selena quintanilla and the person that killed her, it is very interesting how their friendship went from one thing to another.
Reminds me of a case in america with 3 friends ,one of the friends called skylar was stabbed to death by shoaf and Eddie ,very strange case indeed and very sad
Here's something even worse than a client confessing to a murder, what happens when a client confesses to listening to Nickelback? What happens to the client at that point? What about the therapist? Does (s)he have to get decades of therapy at that point?
If someone confessed to me that they got away with murder, rape, or molesting a child I would turn them in because a victim getting justice is more important to me than a career.
I would also not be able to live with myself having that knowledge, but you saying that this person told you that is not enough proof if there isn't any evidence and of course, they'll deny doing it. They might still get away with it. They weren't caught because there wasn't any evidence against them
It’s not just about ending your career. You could also face large fines and even jail time due to HIPAA violation. It’s different if they tell you they have harmed a child/ elderly person or plan to harm someone. Duty to warn or duty to protect may apply. As Dr Grande stated many times, it is important to seek supervision. These situations are not black and white. There are so many variables that may impact the way you act. As clinicians we have a duty to treat our clients. If for whatever reason we feel we cannot then we must refer them to the most appropriate service/clinician.
Steamy Senpai yeah except “someone using their voice for them” is not going to achieve justice. That isn’t enough evidence to have someone tried or convicted of anything.
Client confidentiality must always be paramount. Counsellers KNOW that being party to distasteful or unpleasant secrets is a part of their job. And with that professional aspect of the job, goes the unspoken implication that in such a situation, they are personally responsible for bending those rules. Rules are there to maintain the profession's integrity, whilst protecting any individual professional who is burdened by this dichotomy of conscience over consequence.. Work it out, people. Rules are there to get people to stop and think. If you think you need to bend or break those rules, do it. Just do it in a way that allows you enough plausible deniability to remain inviolate, but still be able sleep at night.
So, the murderous person can't seek help. Our law enforcement system seems based on situations getting out of hand first before enforcement happens. Is there a way to estimate how many murders could be prevented with professional intervention?
Several months ago I had an incident with my girlfriend which culminated in me trying to put my hands around her neck. She managed to pin me down so I didn't cause any damage, but I was still horrified afterwards when I realised what I had just tried to do. I've never tried to do anything like that in my life otherwise. A couple weeks ago I told my university counselor about this incident in an attempt to figure out ways to deal with my anger. She ended up telling me that if I didn't put some distance between me and my girlfriend for a couple weeks she would have to report me to the university or the police, despite the incident having taken place over half a year ago. For better or worse I had some family matters to attend to anyway, so I had to visit my parents for a week. But the remaining faith I had in counselors (which was already low due to previous bad experiences) was wiped out after that.
Well yeah. You commited an assault and battery and you’re surprised she wasn’t going to say “oh okay totally fine no problem?” If you can’t stop from putting your hands around someone’s neck then you need to be single until you have attained a level of self control that you no longer do so. Period. Full stop. Seeing as how you should have done jail time I’d say you can call yourself pretty dang lucky. If I was your girlfriend you’d have a felony record now.
I have mixed feelings about this because the OP went for help so obviously they were remorseful and wanted to figure things out. The counsellor was obviously concerned and needed to provide some guidance here as well. I agree with Rebecca though that if I was the girlfriend there would be an assault charge but the poster really didn’t explain the incident either so we don’t know who the aggressor is in the situation. I’m not sticking up for abusive people at all but it’s not always obvious what happened from a very short narrative. Hence mixed feelings.
@@rebeccashields9626 assault and battery very rarely lead to actual jail time if there isn't grievous bodily harm present. And if the attack of the original commenter was incompetent enough to not cause harm to his girlfriend it would likely be charged just as an assault.
I think its really sad if someone is actively trying to become a better person by seeing a therapist twice a week but then has to keep things to himself... He can't really be present in the situation and the therapy is really going nowhere. I think you should be able to trust your therapist 100%, otherwise what's the freaking point. And by avoiding therapy the person has no chance of improving and might commit more crimes.
Therapists can’t always treat people who use drugs with psychotherapy until the client makes a commitment to quitting, of course relapse is possible. But the same is for people committing crimes. You can’t do a crime and pardon your burden by unloading on a therapist and expecting to go out and do the same thing… that’s counterproductive
The abduction, rape and murder of Sheree Beasley (6yo girl) was one instance where the only non-circumstantial evidence against the perp was a confession made to his psychotherapist (although he later also confessed to a cellmate). The courts ended up accepting the evidence, which wasn't great jurisprudence, but at least had the benefit of locking up a POS for the rest of his life. I personally thought that an acquittal followed by a lynching would have been a better outcome for all. She was abducted less than a mile from where I now live, and her body was dumped in a spot that I've driven past many many hundreds of times - the area used to be farmland, but it is now quite a trendy winery.
@@pixieonthemoon8633 Yes. It seems like, regardless of the law, if a counselor didn't warn and a person reoffended---Dang! Can you imagine living with that on your conscience?
I'd bet that's mostly complaints addressed at a medical board who can then give the mental health clinician a slap on the wrist or in extreme cases revoke their license. Maybe civil suits could be a possibility too but I doubt state or federal indictments would be made in cases like that unless we're talking extreme negligence (like an active serial killer confessing to his psychiatrist and not be reported to the police).
Personally I'd work with the client to try to motivate them to report themselves. If that didn't work, well it's definitely a muddy situation. I would probably staff it with other professionals as well as contact my licensing board for guidance. Lets say it is something serious (murder?) I'd want to make sure I followed the appropriate protocol and leave my personal feelings out of it. That's where having good solid professional support really comes in handy.
I told a counselor of sexual abuse by a bunch of ppl when I was growing up and how i myself as a kid took advantage of other kids my age. I didn't know better and was just doing what I was taught. The counselor disappeared and i havent heard from him again. Not sure if a 8 year old is breaking the law with another 8 year old but ..he wasnt comfortable obviously.Someone deleted everything said in the on line session where you can go back and review the conversations and it wasnt me who deleted it .
Such an interesting video Dr. Grande. The conflict between the duty of confidentiality and the duty to protect the public is an interesting one. Thank you for explaining the Tarasoff case, definitely one of the California Supreme Court's most important and well-written decisions ⚖
Dr. Grande-I'm curious about different behavior traits/norms of people from varying parts of the world. For example: I've had a man in my life for a number of years. His family is Italian, though he was born in the U.S. He can be extremely charming, loving, and charismatic. However, he can also be quite volatile, angry, demonstrative, and loud. I've heard it said-jokingly- if you tie the hands of an Italian man behind his back, he'll be unable to speak :) As I've talked with other people of Italian descent, they have confirmed that most Italians do everything "large." They love and laugh large, and their negative emotions are equally large. Is there any evidence to support that certain ethnic groups are more prone to any given set, or types, of behaviors? My ancestry is largely English, Swedish, and German. My relatives seem to have a much calmer overall demeanor, though pretty stubborn and driven! Is it nature over nurture, nurture over nature.....or a combination of both?? I'd appreciate any insights you have into this topic. Thanks for all you do. I appreciate your work so very much! Kind Regards~
Barb, I too am German, British Isles and Swedish + Finnish. My family can be very negative. But then, my mom is a covert narcissist so that's probably a big part of it. Anyway, we'll criticize each other to death but not usually in a loud way. More of a matter of fact way. It's annoying as hell. It would be interesting to hear about how ancestry might affect behavior. However, I think that this is a politically incorrect mine field. Stereotyping people from different countries/ancestry is likely taboo in psychiatry.
I have always been curious about this topic. Thank you, Dr.! I found your channel today, love the videos I've seen and subscribed. I haven't seen them all yet lol so forgive me if you've done this topic: How do counselors avoid burnouts and depression? Who's there for you? I can imagine sessions become heavy and then you also have a personal life. I've always wondered this...
Normally they have supervision, you know when and if their own personal issues are brought into play or they sense manipulation going on - they always have trusted and respected psychiatrists/counsellor to talk to:)
This unfortunately didn't really answer my question. My friend is apprehensive about going to counseling because he doesn't want a paper trail. He's worried, what if something happens in the future and a counselor testifies? What if they have notes about his anger problems and narcissism? He saw a counselor last week who said "you don't want to be diagnosed a narcissist, you don't want that on your record." Now he won't go to counseling...
If there is any doubt whatsoever, it’s best not to tell a counselor. If he just wants to get some things off his chest, I’ve found the best person to tell is a prostitute.
Thank you Dr. Grande. 🌷 ☯️ Always informative. Confidentiality should not apply to murderer, or abuser- truly - the doctors have ethical obligations to absolutely report those people ... I wish the issues would be just black and white.
That’s actually a really bad idea. Your lawyer can’t help you unless they know everything. If you don’t tell them exactly what happened, they won’t know how to defend you, and you could be completely blindsided in court. If you’re concerned about that you’re better off representing yourself.
@@Hannah-zw9ow it depends on the circumstances. If they don't got anything on me and its circumstantial then I aint telling him shit and he just does his thing. If they got alot of evidence on me then I guess it doesn't really matter
I don't know anything about this myself, but saw someone mentioning underneath another video that your lawyer apparently can't put you on the stand if they know you're guilty? So it may be better to not tell your lawyer.
foxylee I’m an Australian and we’ve only had one case like this ever happen and it was a huge scandal with a royal Commission to follow. The case of “lawyer X”. There’s strict laws and regulations prohibiting legal council from sharing information with the defence that could convict a client. They wouldn’t be able to practice law again and they could be fined or jailed. There’s literally no reason not to tell your lawyer everything.
Can you comment on Leaving Neverland? We know so much more about the psychology of abuse than we did in the 90s. I wonder how this would be handled in 2019.
Another amazing video, Dr. Grande. 😊 On a side-note: I heard you mention you've got an upcoming video on C-PTSD coming out... I'm so excited about that, and I was just curious if you've got any idea on when it'll be coming. (No rush. You put so much into your content, so I know these things take time. I just don't hear C-PTSD talked about by a lot of RU-vidrs, and to have a Dr. on RU-vid discussing this debilitating disorder, a Dr. I respect... Well, I'm feeling like a kid before Christmas. :)
I've always wondered how this scenario plays out with a priest in a confessional booth. Don't they have a similar rule of confidentiality? Perhaps less strict and official?
Probably less strict because it would be like if you told your friend, they’re not obligated to tell. A priest isn’t like a legally titled therapist, they don’t have the same obligations. Also I think that in their opinion confessing to them is like going straight to god, so I’m their opinion the highest authority (God) knows now. Plus they’re supposed to forgive you of the sins, Gods courtroom is different than the legal justice system. God forgave murderers. I’m not implying you have to believe in the religion, just explaining how they believe (I was raised religious)
I have been close friends with a priest for many years. I asked him several years ago this same question pertaining to someone going to confession in a Catholic church and confessing to a murder. Strict confidentiality is the rule for a priest hearing confession. This priest told me (this occurred in Oregon several years ago) that the only crimes a priest must report is those involving child abuse or elder abuse. In standard confession the priest doesn't actually see the confessor because of the screen in place and I've never heard of a priest jumping up and throwing open the door to the confessional room so I'm not sure how this would work. ??
Thank you for doing this video. Seems like a lot of people on here have different ideas. As an intern I heard from a supervisor who had a client confessed to murder. They did not ask any questions about it. I thought that clinicians would know not to report.
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You keep it a secret and let the story roll on. It could be super juicy and go on and on. Maybe even push them to do it again... after all, once you have a taste of being god you are going to want more! You could be entertained for years. It would be like being in a dramatic thriller movie.
I met a person who was a clinician at a residential, and this 15/16 year old said that he was planning to run away (from the residential), the clinician then said she had to report that and then apparently he grabbed a pair of scissors and tried to stab her with it. He was charged with Attempted Murder but was charged as a juvenile not an adult
It depends on the crime. Robbery, theft, assault, and drug use would be things the client probably needs to "confess" to you to help them get over it mentally. Ultimately, your goal is to improve the mental well being of your client. Murder and rape are two red flags, though I would first give my client the chance to turn themselves in first.
He's...not. psychopaths don't have morality, only ego. Hannibal Lecter still felt bad about letting his client go. Even though he was a killer, he still had morals. They might not be the norm, but they are still morals imho
@@brad885 what about the video explaining the difference between primary and secondary psychopathy? He sounds like the secondary. Because that one mentioned having their own kind of morals and normal empathy abilities. With secondary psychopathy emotional instability can be the cause of most of their issues despite having morals and empathy.
@@bananabreadloaf But he seemed stable. He enjoyed eating people. Serial killers don't have to be psychopaths. I'd make the same argument about the iceman. Triple digit mob killer with a normal life otherwise
I think the the counsellor should never tell the secret. First, the clients’ mental illness may had led to a murder. So if the person responsible for treating the clients mental illness, itself betrays the client,thePOOR person has nowhere to go.
I'm sorry but I do disagree with SOME of what you said, I mean if someone has MURDERED another person then I would argue they are pretty much a danger to ALL people of society and it should be reported and this goes with pretty much any major crime rape, murder, robbery, kidnapping ect. How someone could know that the person in front of them KILLED another human being and has thus far gotten away with it amd NOT report said person and kinda insane to me imo
I've always kept in mind the "mandated reporter" status of professionals and always assumed that ALSO meant if someone confesses a crime to a therapist, that therapist would HAVE to report that.
Mandated reporters are required to report abuse or suspected abuse related to children. That’s it. It doesn’t cover anything else. You probably should form your understanding based on facts, not just a one-sided decision that makes sense to you.
There are certain things that I will never understand or accept. In some cases the psychiatrist make a report saying that the offender is pretending is a crazy one to avoid the real jail, but the judge toss all the psychiatrist work and send the fake crazy to those mental instituition, or can be vice versa. The doctor can say the person is crazy, and the judge does not accept it and make different trial decision. My faith on human and on the system is almost zero. I don't know if the system is incompetent or cruel or both together.
I really appreciate these videos. Suppose, hypothetically, he came into your apartment armed with a knife and you had to use the crowbar and whack him 67 times before burying his body in the Santa Cruz mountains near Bonny Doon. It would be self-defense, right? Thank you!
This happened at a local AA meeting. I didn't happen to be there that night, but a guy told about how he had left a body in the trunk of a car at the local junkyard. Needless to say, he didn't sleep at home that night.
Yikes, that's more interesting than my meetings. Something important to remember about 12 step recovery meetings is that the confidentiality you expect there is informal, and there are no legal protections for disclosures made in such a setting. Best to think of it as discussing your problems with a group of friends.
@@uptown3636 Yes! Remember that teenager that had her boyfriend kill the girl he slept with as a fling, and then they were both accepted into the military; it was like at least a year later, and she confessed to some friends in military school, and that's the only reason the pair were caught. They probably would have gotten away with it forever if she didn't crack. Makes you wonder how many people out there keep secrets like this forever. It would probably get easier as time went by, IDK. She must have known they would tell on her!
Dr. Grande is up on current events and made references to the Jussie Smollett and OJ Simpson scenarios my observation which is entertainingly delicious. Dr. Grande your praiseworthy to say the least. Kudos!
You got to love how arbitrary laws just ruin a good thing. Basic logic would tell you that if a therapist will report a crime, the client won't open up about it. Because it is in the best interest of the public for people to talk through anything with their therapist you would assume we would want confidentiality to be absolute.
Superb, as always. I was put in an uncomfortable position of this nature as a clinical intern and subpoenaed to court. Fortunately I had another superb supervisor who counseled me. It helped me in my work those 35 years ago and modeled for me when I reached the supervisory level myself.
Well then the patient is no longer only patient, he is a murder and should release the information to pay his crime. The patient is getting away with murder behind the doctor's curtain. There is a story where a doctor psychiatrists refused to release information to the judge that ordered, the doctor attitude was harming the patient and other people. Actually was the patient complaining that the doctor was not releasing her documents. The doctor made such a mess and caused huge money loss to other people. The harmed patient kept telling everybody, don't sign consent documents.
Here in the UK the part of the Counselling contract is to make the client aware of the rules of breaking confidentiality.Harming themselves, others or the Government/ country. However this does affect how honest a client can be in the therapeutic relationship but it must be stated in the beginning so the client is fully aware of the consequences of what they tell the Counsellor.
Here in Canada, we’ll at least the province of Ontario, consent is supposed to be an ongoing discussion, for example in a later session a client sounds like they’re about to divulge a questionable secret we are supposed to remind them of the confidentiality limits again before they say it. And then document our behinds off.
Here in the UK best practice involves having a discussion with the client (as part of the initial contract), that there are limits to confidentiality. Simple.
The worst would be if an innocent person was convicted of their crime and was rotting away in jail while the real perp (your client) went free. I feel like I would have to say something.
So it all boils down to whether the client is still an active threat to either himself or those around him? It's a tricky situation to be in when someone is having homicidal urges. Many probably don't even know if they should bring it up. It's not like you can just tell the psychiatrist that: "Hey, so it's been really tempting to just go out and murder some random people lately" I'm sure that would raise all kinds of alarms.
I think the psychiatric profession needs to clarify when reporting a crime is appropriate. Mental health professionals only have conversations with one (probably unreliable) person to work from. A Doctor’s perspective on risk of reoffending, random versus premeditated, drug use, etc. shouldn’t be relevant - the judgement of a Doctor can’t be a substitute for the legal system. Put another way, one person, listening to another person without any other evidence to work from is a recipe for injustice
I agree, particularly reporting a potential crime as I think that the fear of prosecution for "failure to warn" makes clinicians really jumpy and therefore leads to clients not truely expressing themselves. Like, for instance, how are clients meant to express anger or suicidal ideation (two of the most common reasons to seek therapy) if those are also two things that would immediately justify breaking confidentiality? There should be a much clearer line drawn such as "the client must be making a direct threat with a method and timeline" not just ideation. So ie. Client says they will kill themselves by hanging next week or client says they want to beat up their ex girlfriend when she gets home tonight but not client has a history of anger and is currently mad at girlfriend or client is considering suicide before a major exam but doesn't know how. All three components: time, course of action, and intent should be stated in the report. (I think this would also help protect clinicians because I doubt failure to warn cases almost ever occur if these three criteria are met. Generally speaking the practicioner could use one of these as a defence.)
Dr grande why do people talk to them self outloud? I do it for a bunch of things. like rehearsing any possible social engagement that could happen in a day. thinking over an important decision I have to make. I feel it helps with anxiety. I usually do it when I'm by myself. But sometimes I do it when I'm walking in public. Thanks -Canadian
Do you speak in full sentences as though you would in a conversation? Are you saying everything out loud or only certain parts of what you're thinking? I used to talk to myself but I'd only say one or two words. I never had privacy growing up so I'd have to play it off.
What about a Sopranos type of situation? Would anyone actually accept treating a person who is obviously a high-level mobster. Whether the therapist finds out through the patient's transparency or through the media? I'm also seeing an issue with ongoing criminality and the duty to protect the public.
I am a masters level social work student and had a previous placement in a high school I was told some concerning things a student had done in their past. It was implied but the person left acts coded or implied. But I stopped them a little bit in to make sure they understood limits of confidentiality, they could continue to talk to me but they need to decide their own words in how and what they describe to me. I felt this person was at risk of retaliation and went immediately to process with my field instructor…who laughed and suggested perhaps the student had a “fictitious disorder”. This person felt scared and caught up in something and I was sought and told by them as much, and the FI says they have to be lying….the student had not opened up to them so there was no way they opened up to me…this was a theme during my time there. My relationships with students were undermined constantly. The FI called the university and said she didn’t want me there anymore. I agreed because the foundation of trust was non existent due to situations like I just mentioned, lack of supervision or taking me to a bar during a pandemic watching her throw back 3 beers by 4pm and telling me to mark it as supervision… I am paying for this “education” and I deserve better. The university wouldn’t listen to my concerns at all, and I feel like I have no advocate or support systems which is another story in itself…I still think of and worry for my students to this day. I seek out input elsewhere, which is why I’m watching this! Thank you.
Interesting. When I was doing my masters placement a couple of my supervisor’s clients told me a bunch of things that they hadn’t told her and my supervisor was surprised. I kind of think it was a personality difference as she was very uptight and proper and I’m more laid back and open. I also wonder if simply the change in counsellor allows them to do that, like it’s easier to confess to a stranger than someone you know?
I’m in Canada but thanks for this discussion it really has me thinking, especially about risk to myself, which hadn’t occurred to me as a psychotherapist. Been enjoying your videos for a while now and especially your sense of humour.
I'm curious. Have there been many medical professionals who lost their license or were sued because they broke a client's confidentiality by turning them in to the police? I know this is a popular foil for TV and movie plots, but how often do people seek the help of a mental health professional, only to confess some heinous crime? If I were a doctor and my patient confessed killing a disabled child, my conscious would send me to the authorities before the client's session was over. "Ummm. excuse me, patient who just confessed killing a disabled child, I need to make a quick phone call... to my 'friend' while you remain here in the office...Thanks!" How often does this really occur?
Hey, Dr. Grande, love the videos and have been through most of them, I think, but you should take out the hyphen between scientifically and informed. Although you would have a hyphen if you said "science-informed podcast," no hyphen is required with an adverb like scientifically. Anyway, other than that, great podcast.
I felt really uncomfortable watching this because it is my firm belief that you have a duty to report a crime if it is confessed. Otherwise you are putting yourself in the position of the arbiter of ethics and that is not your role as a therapist - that is the role of the law.
Slartblartlast Exacty criminals aren't supposed to confess to psychiatrists or priests anyway. They should have a religion where the try to communicate and confess to spirits directly, a criminal that confesses to the living is dumb anyway.
