AIDS and therapists' attitudes about confidentiality and the duty to warn

This study examined how the opinions of various professionals practicing psychotherapy changed regarding the relative importance of confidentiality and the duty to warn third parties when clients in therapy revealed that they were involved in behavior that was potentially harmful. In addition to a survey of demographic and professional characteristics, opinions about therapeutic, ethical, and legal issues, we presented a series of parallel, hypothetical scenarios to 152 psychotherapists (e.g., Clinical Psychologists, Psychiatrists, and Social Workers) in which the clients posed a potential threat to others. The putative risks comprised HIV+ status, infection with some other sexually-transmitted disease, physical abuse, and murder. Results showed that the greater the potential lethality of the outcome, the more likely psychotherapists expressed a willingness to breach confidentiality. Psychotherapists' response pattern in cases of AIDS did not resemble that of either murder or a non-lethal STD when confidentiality and the duty to warn was an issue.