Violent Patients and the Tarasoff Duty in Private Psychiatric Practice

Abstract

The author reports the results of interviews with 34 psychiatrists who practiced privately outside major metropolitan areas. The psychiatrists discussed experience with violent patients, and their knowledge of, attitudes toward, and experience with the Tarasoff duty. Most psychiatrists were aware of the duty and accepted it as an ethical responsibility. In their response to Tarasoff, this sample was not substantially different from a national sample of psychiatrists practicing in metropolitan areas. Violence toward psychiatrists was more common in office practice than elsewhere. Tarasoff cases in office practice more often ended in violence or in a ruptured therapeutic relationship than Tarasoff cases in other settings. The author concludes that the threat of violence is a greater problem for the office practice of psychiatry than has previously been described.