Psychologists and other mental health professionals rightfully experience significant anxiety regarding their duty to protect when working with potentially dangerous individuals who are at risk of harming others or themselves. In fact, a recent study suggests that 75% are misinformed about their legal duties to such clients. The Duty to Protect dispels myths and provides clinicians, supervisors, and trainers with a comprehensive resource addressing the situations where a duty to protect may apply. The duty itself is defined and described, as are risk assessment steps and interventions to reduce risk.

The chapters are written by leading scientist–practitioners to promote best practices in some of the most ethically and legally challenging areas encountered by practitioners. They discuss the legal and ethical foundations of the duty to protect and the duty to warn; professional ethics codes in the U.S. and internationally; risk assessment to others in cases involving threats of homicide, intimate partner violence, stalking, the transfer of communicable diseases, and impairment while operating heavy machinery or motor vehicles. Threats of harm to the self are also discussed in chapters that address suicide, self-injury, and end-of-life issues.

This book is a comprehensive resource that will assist readers in understanding their options and obligations and therefore improve the care they provide in some of the most stressful and potentially dangerous situations faced by mental health providers.

Table of Contents



I. Foundational Issues

  1. Introduction to the Duty to Protect
    Elizabeth Reynolds Welfel, James L. Werth, Jr., and G. Andrew H. Benjamin
  2. A Review of Duty-to-Protect Statutes, Cases, and Procedures for Positive Practice
    G. Andrew H. Benjamin, Le'a Kent, and Skultip Sirikantraporn
  3. The Duty to Protect and the Ethical Standards of Professional Organizations
    Rita Sommers-Flanagan, John Sommers-Flanagan, and Elizabeth Reynolds Welfel
  4. International Ethics Codes and the Duty to Protect
    Mark M. Leach

II. Harm to Others

  1. Protecting Others From Homicide and Serious Harm
    Derek Truscott and Jim Evans
  2. Risk Assessment and the Duty to Protect in Cases Involving Intimate Partner Violence
    Alan Rosenbaum and Lynn S. Dowd
  3. Working With the Stalking Offender: Considerations for Risk Assessment and Intervention
    Barry Rosenfeld, Joanna Fava, and Michele Galietta
  4. Threats Against Public Officials: Considerations for Risk Assessment, Reporting, and Intervention
    Marisa Reddy Randazzo and Michelle Keeney
  5. Driving and Operating Other Equipment: Legal and Ethical Issues
    Samuel Knapp and Leon VandeCreek
  6. The Duty to Protect: Mental Health Practitioners and Communicable Diseases
    Leslie Kooyman and Bob Barret

III. Harm to Self

  1. The Duty to Protect Suicidal Clients: Ethical, Legal, and Professional Considerations
    David A. Jobes and Stephen S. O'Connor
  2. Strategies for Responding to Self-Injury: When Does the Duty to Protect Apply?
    Barent Walsh
  3. End-of-Life Decisions and the Duty to Protect
    James L. Werth, Jr. and Jessica M. Richmond

IV. Additional Considerations

  1. Self Care in the Context of Threats of Violence or Self-Harm From Clients
    —Christiane Brems and Mark E. Johnson
  2. Emerging Issues in the Duty to Protect
    —Elizabeth Reynolds Welfel
  3. Practice and Policy Responses to the Duty to Protect
    —James L. Werth, Jr., Elizabeth Reynolds Welfel, G. Andrew H. Benjamin, and Bruce D. Sales

Author Index

Subject Index

About the Editors

Editor Bios

James L. Werth, Jr., PhD, is professor of psychology and director of the PsyD program in counseling psychology at Radford University and is a licensed psychologist in Virginia, although the first part of this book was completed while he was an associate professor in the Department of Psychology at The University of Akron. In additional to ethical and legal matters, his primary areas of research and practice are HIV disease and end-of-life issues. He has written, edited, or coedited several books and special journal issues on the latter topics. He served on the American Psychological Association's (APA's) Ad Hoc Committee on Legal Issues and Ad Hoc Committee on End-of-Life Issues and currently serves as the federal advocacy coordinator for the Society of Counseling Psychology (Division 17 of the APA). He received his doctorate in counseling psychology from Auburn University in 1995, his master of legal studies from the University of Nebraska–Lincoln in 1999, and served as APA's HIV Policy Congressional Fellow in the office of Senator Ron Wyden (D–OR) from 1999 to 2000.

Elizabeth Reynolds Welfel, PhD, is codirector of training in counseling psychology and professor at Cleveland State University, where she has been teaching graduate students in counseling and counseling psychology for 20 years. Before her appointment at Cleveland State, she was on the counseling psychology faculty at Boston College. She has authored numerous articles on the ethics of professional practice and her book, Ethics in Counseling and Psychotherapy: Standards, Research and Emerging Issues, is in its third edition. Her current research projects focus on ethical issues in the use of technology in professional practice and psychologists' understanding of their legal responsibilities with violent clients. Along with Dr. Elliott Ingersoll, she coedited the Mental Health Desk Reference. Her third book, The Counseling Process, coauthored with Lewis Patterson, is in its sixth edition. Dr. Welfel has conducted numerous continuing education programs on professional ethics across the nation. She received her doctorate in counseling psychology from the University of Minnesota in 1979 and has been a licensed psychologist in Ohio since 1986.

G. Andrew H. Benjamin, JD, PhD, is an affiliate professor of law at the University of Washington and director of the Parenting Evaluation/Training Program. While working with families engaged in high-conflict litigation and lawyers and law students with various mental health and drug abuse problems, he was named "Professional of the Year" by the Washington State Bar Association's Family Law Section. He was elected president of the Washington State Psychological Association, and his colleagues in that association created an award named after him for "outstanding and tireless contributions." Dr. Benjamin was honored by the Puyallup Indian Nation's Health Authority as a "modern day warrior fighting the mental illnesses, drug–alcohol addictions" of the people served by the Nation's program. The American Psychological Association (APA) gave him the Heiser Award in recognition of his record of public service and advocacy. He has published 41 peer-reviewed articles in psychology, law, and psychiatry journals. He also is the author of two other books published by APA: Law and Mental Health Professionals: Washington (1995, 1998) and Family Evaluation in Custody Litigation: Reducing Risks of Ethical Infractions and Malpractice (2003).

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