APPLICATION OF THE TARASOFF RULING AND ITS EFFECT ON THE VICTIM AND THE THERAPEUTIC RELATIONSHIP

Objective: The Tarasoff case and subsequent court decisions and legisl ation in many jurisdictions established a duty to protect the intended victims of patients who pose a serious threat of violence. An approac h that has been legally sanctioned is to warn the intended victim. Thi s study examined the effects of such warnings on the warned persons an d on the therapeutic relationship. Methods: All second-, third-, and f ourth-year psychiatric residents (N=46) in a university-based psychiat ric residency program in San Francisco were interviewed about their ex periences related to issuing Tarasoff warnings. Results: Almost half o f the residents (N=22) reported having issued a Tarasoff warning. Most warnings were issued for patients seen in inpatient units and emergen cy rooms. In almost half of the cases, the resident was unable to cont act the intended victim but did report the threat to a law enforcement agency. Tn almost three-fourths of the cases in which the intended vi ctim was contacted, the individual already knew of the threat. The mos t common reaction among those warned was anxiety mixed with thankfulne ss; most expressed an intent to modify their behavior to increase safe ty. The second most common reaction was denial that the patient would ever hurt them. Clinicians reported that in most cases issuing the war ning had a minimal or a positive effect on the psychotherapeutic relat ionship. Conclusions: Many of the anticipated negative effects of the Tarasoff decision have not materialized.