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.
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.
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.
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.
@@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.
@@AlexCass1515 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.
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?”
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.
@@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.
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.
@@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).
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.
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 ⚖
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’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.
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.
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
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.
Dr. Grand, I've enjoyed your channel for some time but only discovered your clinical video topics. Thank you for your clear explanations of mental health disorders.
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
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 TH-camrs, and to have a Dr. on TH-cam discussing this debilitating disorder, a Dr. I respect... Well, I'm feeling like a kid before Christmas. :)
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
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.
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 .
Thank you , for addressing this going to grad school for MS Clinical Mental Health Counseling -Substance Abuse and Addictions. we've been told so far to report on abuse , abuse of a child , sexual and exploitation .
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.
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?
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.
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-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.
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 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:)
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.
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.
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.
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.
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.
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?
Dr. Grande thank you for sharing your knowledge. I'd like to know about bullies. What is going on w these type of people in their mind? (Are these folks predators, narcs? borderlines? Sociopaths? Anti-socials? what causes it? How to best deal w bullies? What type of person they target? etc.
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!
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.
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.
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.
I really loved this vid, Todd your descriptions are impeccable in every way and you are so funny, your example scenarios make me proper guffaw, keep it coming Dr Grande I learn so much from your knowledge and kindness in sharing your knowledge, cheers big ears.
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!
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 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 going to have a question regarding counceling. I live in a german speaking country. In german you have two forms of „you“ when talking to another person. A „polite/formal-you“, considered the official form of talking to someone, like, let‘s say, your boss, an elderly person, a teacher… Someone who is of higher status than you, or who has to be respected. I am pretty sure people working in business companies still use it too. Beside that there‘s a „daily-you“ which people use in day-to-day life. Especially younger generations skip the formal form. Now. In counceling it‘s recommended to the councelor to use the formal form of „you“. It‘s said to make sure to keep a formal distance to the client. Which should be helpful for the therapist and the client. It should set boundaries and make sure the person seeking counceling doesn‘t mistake their councelor for a friend. In my case, I suffered from abuse from a bunch of people up to that point. Mostly people who needed to be respected. After many sessions I noticed I had problems of opening myself up to her. I didn‘t feel comfortable, felt pressured, felt judged. I noticed that it had to do with the form of „you“ I had to use. I asked her about changing to the informal form of you. Especially when telling stories. She refused. In the end talking to her just started to feel wrong and I quit therapy. It wasn‘t possible for me to build any form of connection to that woman. What would you recommend to therapists in different situations like that? Could the rules be bent? Would it have been useful to bend the rules? I‘m especially interested in the question how a non german speaking therapist would see that topic, especially because you don‘t have this language twist to set boundaries. How does an outsider look into that topic? There have to be more ways of setting boundaries.
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)
Dear Dr G, In Australia as a trial Lawyer our first duty is to the Court. So if the client for example says they did not receive specific correspondence and this is important in their matter. Then for example they show you this correspondence, they either have to give you permission to put that before the court or accept that you resign if there is no consent to such. If it is somehow found out that you did not put a fact that the matter relies on before the court and you had that info you will be struck of. In Australia that means struck of in all states and territories. All the time and money that went into your career is lost.
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.
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.
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.
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. ??
I'm kind of suprised that that sort of thing doesn't come up very often. The violent crime rate was so high when I was young, so I guess there are a lot of people taking secrets to their graves.
My nephews were sexually molested at 11 by a 14 year old. I was told by my sister , their grandmother told me. The family was broken about telling the police. I talked about it to my social worker and she told me she was required to report since they were only 11. So the other boy was in trial, they found him guilty. He was put on a type of parole. He was supposed to be put on Sex Offender list when he turned 18. That didn't happen. After my nephews came forward other young children said he molested too. My nephews had to change schools because they were taunted and bullied so they were sent to school in another town. Same for high school the perpetrator's father was coach of the hockey team, and they were hockey players. It has effected them with the rest of their lives they are now 21. Occasionally they have panic attacks, don't ever feel safe. I was happy my social worker dimed him in. I see my nephews struggle with what happened to them and want to hurt that kid badly have him on the Sex Offender roles and acknowledge his crimes. Very frustrating. Very much anger producing .
3 questions. Can a client ask to be treated anonymously where you, as the DR., doesn’t even know his name? Is it ethical to tell a troubled client we DO NOT discuss murder, rape, child assault etc.? Can you set up boundaries? Could you immediately stop a client if he starts to divulge heinous crimes?
This happened to a psychologist friend of mine but not in a formal counseling situation. The murder was particularly brutal and the individual had murdered before. After discussion it became apparent he was racked with guilt and simply wanted to hand himself in. He felt he would murder again and was danger to society. The hand over to the police was done smoothly. The police said the case would never have been solved without the confession, as by dint of luck it was the perfect crime. The brutality of the murder left seasoned officers shocked and its details were never published. I had passed the individual in the hall way a number times and was always left with a feeling I could not explain.
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!
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."
Cuestar Exactly you'd have to be nuts to tell a therapist the truth anyway
He's just perfect!
"measured." That is the perfect term.
@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.
Measured is a perfect description! Love Dr Grande's objective approach :)
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 would say that the "psychologist" was a first-class jerk. Not only unprofessional but also by common morals bad.
@Giacomo Rossi: There's a circle in Hell reserved for those kind of people . . .
good lesson
taught you not to trust anyone i bet
Bottom line, patient confidentiality is super easy to break, never tell a psychologist anything you wouldn't be comfortable telling the police.
That’s not true lmfao unless you’re looking to continue your bad behavior and aren’t actually looking for help then sure thing.
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
@@patrickburton1401 So you are actually saying it IS true.
@@DutchmanAmsterdam then why would you be seeking professional help to being with
If you are in the situation in which you have to listen to this bit of advice, you should turn yourself in.
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.
Great job helping 👏 👏 clap
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
@@blahsomethingclever Sluicing risk? What is that?
@@MichelleMyBelle2.0 I think he meant suicidal
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.
I've kinda wanted to google this for a while but google probably already thinks I'm some sort of serial killer based on my search history
right? i just have a curious mind😭
@@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.
@@AlexCass1515 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.
@@AlexCass1515 so, what? Are you saying we're not safe searching about bombs? Because I was just doubling down on your original comment
40% of murders unsolved?! Yikes
In Brazil is 90%
@@KhalerJex I wonder about Mexico.
That’s just the ones that are reported too I assume (as in likely excluding prostitutes, etc.).
Funny, my thought was, hmm, a four in ten chance I wouldn’t get caught? Nope, the odds aren’t in my favour, lol.
@@spiritmatter1553 It's way easier to get away with murder in rural areas compared to cities ;)
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
...so you say!😂🤣👍
@@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?”
“Of course I would have to report it”-she said nervously as she glances to a cabinet containing a gun
you must work hard getting all these videos out! thank you so much for them. they are so educational and interesting. Thank you, Dr. Grande!!
Out of all the people who asked this question, I wonder how many ended it with, “Asking for a friend”?
As someone who wants to be a therapist (mixed specialties), this was very interesting/informative. Thank you!
How many and which specialties were you thinking of achieving pls? Curious... 🏴
Being a butcher nd a psychiatrist
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.
One of the most thorough analyses I’ve heard. Outstanding and extremely nuanced.
As lawyers like to say, "It depends".
I cant imagine the stress of being a lawyer with knowing all the loopholes. The career I'm going for does require me to be in court tho sometimes oof
My engineering professors say the same thing. "It depends" really applies to everything it seems.
@@SeanKula yep. That’s usually the experts view on things!
@@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.
@@AlexCass1515 I agree. I wasn’t being sarcastic or anything
I've wondered about this and how it works. I learn something new with each of your videos! I like your mind Dr. Grande :)
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?
I'm dead lmaooo
Most underrated comment ever. Come on, people now, people now, come on. Shld be at least 1k likes
Lmaoo
Imagine going to therapy for months being absoulutely silent through each session then one day: "i have a confession... I listen to nickleback"
@@grantrogers1858 "I'm sorry but we're going to have to hospitalise you. This is not rational behaviour"
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.
th1smomentisfate sometimes a victim cannot speak up, and someone using their voice for them is far more responsible than staying quiet.
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.
Mariam M what do you think anonymous reports are for
I have always wondered about this. Awesome topic 😊 Amazing discussion as always. Thank you for putting out such interesting topics with education.
Thanks for giving us an inside view of what it's like for the mental health clinician.
"Protective privilege ends where public protection..." Can't remember the rest but that was a real tongue twister x
One person's rights end where another person's begins.
That's basically the stipulation our rights in the US.
Can a counselor be charged if he knows that a person is dangerous, doesn't tell, and the person reoffends?
Duty to warn is law in a lot of states
@@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?
not charged, but one california dr. was sued half a million.
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).
This is so interesting and honestly also terrifying. I couldn’t imagine being a counselor and that coming up with a patient
Whats terrifying in that? The murder is in past and unless patient discloses he plans to kill therapist, no worries.
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.
he broke the formula by saying
"Todays question is"
instead of
"Todays questions asks"
He wanted to see if someone noticed.
I don't know how this guy releases so many decent content in short succession. Keep it up is all I can say.
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 ⚖
There are soldiers who believe the "killing climate" of war allows for other crimes to be excused. Enough said.
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’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.
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.
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.
I think she was a psychopath who saw that Selena could get close to her fans. I also would like to hear his opinion on it.
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
M Gray definitely not a psychopath. she had too many strong emotions towards Selena to be one. I would more so say she could be a sociopath
Yes!
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.
Watching this a year after Dr. Grande posted it, I can see how far he has come in his speaking. Always interesting, but he’s come a long way!
Dr. Grand, I've enjoyed your channel for some time but only discovered your clinical video topics. Thank you for your clear explanations of mental health disorders.
I love when you open your brain and let us in.
Wandering Free this!
Dr Grande’s mind seems to be a compassionate, orderly place. 👌
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.
This is the dumbest thing I heard in a long time
@@ShotaroAsakura be specific.
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
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 TH-camrs, and to have a Dr. on TH-cam discussing this debilitating disorder, a Dr. I respect... Well, I'm feeling like a kid before Christmas. :)
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
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.
Great assessment. Your clients are in good hands. 👍🏻
Thank you, Dr Grande. 🌹👍 I hope to never walk any of those high wires.
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 .
Are you still here? Im curious about ur case as it happened as an 8 year old. Did he breached confidentiality?
What a great question! As always, a well-thought out response! Gosh how I love this channel! 💜💚
I know this is a year old video, but it somehow escaped me! Thank you!
Thank you , for addressing this going to grad school for MS Clinical Mental Health Counseling -Substance Abuse and Addictions. we've been told so far to report on abuse , abuse of a child , sexual and exploitation .
When I start watching your videos Dr. Grande, I find that I cannot stop, very fascinating.
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.
When you start getting into the territory of personal/public peril, confidentiality enables more problems than it solves.
Thank you for doing these videos. I appreciate your time and expertise in preparing for production.
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?
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.
@@Stranger_In_The_Alps I don’t know if you’re trying to be funny or not, but it sounded a little funny in my head 😂😂
But it also makes sense 😂
@@Kalliopa0122 it’s a far better use of your money. And a prostitute won’t gaslight you like a therapist does. They just listen.
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.)
"If ,
the person standing next to you
is a murder,
you may not be safe."
On this we agree Dr.
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.
Its my understanding that people of Latin American descent are the same way. Very passionate in their love and hate
Barb, what a great question. I've always believed Italians are passionate in all emotions.
As an Argentinian with Italian ancestry, I can confirm, we ARE like that, to some degree at least.
Check the dominant religion of the area. Not all practice but all feel the pressures to fall in line. Could be related.
I would suggest any therapist in this type of bind should get an expert attorney from their licensing board. Obviously outside of active threats
Because I think that most people who are on the run with a huge reward on their head wouldn't go in to see a counselor
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.
@@PutinsMommyNeverHuggedHim That's
what I said "Set a trap for the
murderer, trick him into
confessing . A murderer
would never expect that."
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:)
I’m a psychotherapist and I have a supervision group that I attend monthly and also have my own therapist I speak to monthly.
Thank you, Dr. Grande. I've often wondered what a mental health professional is supposed to do in a situation like that.
If i was a murderer i wouldnt tell my lawyer lmao.
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.
@@Hannah-zw9ow think legal eagle addressed this, and to my memory his advice was the opposite of yours.
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.
You are providing such a wonderful service with your content! Thank you!!
Timely. I was just asked about this question in my ethics class. Thanks!
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.
I also think it would be wise to have sign on clinician door, dont tell me anything u dont want a court of law to know!
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.
@@yesterdayitrained that's not accurate- mandated reporting includes vulnerable adults
@@nikkih6907 I stand corrected.
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.
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.
Incredibly interesting video, as per usual! Love your dedication to your channel & your wealth of knowledge Dr Grande!!
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?
Very good point
This should be viewed accross the world so people know their limits on what to say and what not to say
Dr. Grande thank you for sharing your knowledge. I'd like to know about bullies. What is going on w these type of people in their mind? (Are these folks predators, narcs? borderlines? Sociopaths? Anti-socials? what causes it? How to best deal w bullies? What type of person they target? etc.
Wow. You answer questions I have not thought to ask yet! I have wondered this about doctors, lawyers and also clergy.
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!
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.
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.
A lot of the times it’s not even true people like to fantasize that there some gangster or a vigilante
yes
XIV Words You'd have to be nuts to tell a therapist the truth anyway
They still have to report it though, because you never know when someones lost it enough to actually do something.
Happy Monday Doc!
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.
Thanks Dr. Grande! Your videos are so interesting and informative! I’m just working on my Masters in Counselling Psychology right now.
I really loved this vid, Todd your descriptions are impeccable in every way and you are so funny, your example scenarios make me proper guffaw, keep it coming Dr Grande I learn so much from your knowledge and kindness in sharing your knowledge, cheers big ears.
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!
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.
Can you do a video on Tony Soprano? I’m so fascinated with his character. Thank you.
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 going to have a question regarding counceling. I live in a german speaking country. In german you have two forms of „you“ when talking to another person. A „polite/formal-you“, considered the official form of talking to someone, like, let‘s say, your boss, an elderly person, a teacher… Someone who is of higher status than you, or who has to be respected. I am pretty sure people working in business companies still use it too. Beside that there‘s a „daily-you“ which people use in day-to-day life. Especially younger generations skip the formal form.
Now. In counceling it‘s recommended to the councelor to use the formal form of „you“. It‘s said to make sure to keep a formal distance to the client. Which should be helpful for the therapist and the client. It should set boundaries and make sure the person seeking counceling doesn‘t mistake their councelor for a friend. In my case, I suffered from abuse from a bunch of people up to that point. Mostly people who needed to be respected. After many sessions I noticed I had problems of opening myself up to her. I didn‘t feel comfortable, felt pressured, felt judged. I noticed that it had to do with the form of „you“ I had to use. I asked her about changing to the informal form of you. Especially when telling stories. She refused. In the end talking to her just started to feel wrong and I quit therapy. It wasn‘t possible for me to build any form of connection to that woman. What would you recommend to therapists in different situations like that? Could the rules be bent? Would it have been useful to bend the rules? I‘m especially interested in the question how a non german speaking therapist would see that topic, especially because you don‘t have this language twist to set boundaries. How does an outsider look into that topic? There have to be more ways of setting boundaries.
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)
Priests have greater protection of confidentiality than mental health practicioners because of freedom of religion.
@@bananabreadloaf God forgives murderers? Good news! Where is nearest gun store?
Dear Dr G, In Australia as a trial Lawyer our first duty is to the Court. So if the client for example says they did not receive specific correspondence and this is important in their matter. Then for example they show you this correspondence, they either have to give you permission to put that before the court or accept that you resign if there is no consent to such. If it is somehow found out that you did not put a fact that the matter relies on before the court and you had that info you will be struck of. In Australia that means struck of in all states and territories. All the time and money that went into your career is lost.
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.
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.
This issue is pivotal to my novel (as yet unpublished). Thanks for the infomation.
I
dr grande, can u plz reply here w the words, capitalizing the O, C, E, A, and N? sorry to be a pain
openness to experience, conscienciousness, extroversion, AND neurotocism? doc? lolz
@@gcham1209 last one is Agreeableness.
@@johkonut oh ok. i think i figured it out awhile ago. is that the 1 i missed? if so, thank you
Ultimately, the BEST advice “seek supervision” from someone more experienced in this kind of dilemma than you!
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.
Another nice shirt. Topic was interesting. And glad I don’t have to face that dilemma.
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. ??
I heard that priests hearing confession, should report murder confessed. But that could be different now
I'm kind of suprised
that that sort of thing
doesn't come up very
often. The violent crime
rate was so high when
I was young, so I guess
there are a lot of people
taking secrets to their
graves.
Great topic and show. Thanks!
I learned the hard way they really have no obligation for confidentially, sometimes it's best to keep your problems to yourself
My nephews were sexually molested at 11 by a 14 year old. I was told by my sister , their grandmother told me. The family was broken about telling the police. I talked about it to my social worker and she told me she was required to report since they were only 11. So the other boy was in trial, they found him guilty. He was put on a type of parole. He was supposed to be put on Sex Offender list when he turned 18. That didn't happen. After my nephews came forward other young children said he molested too. My nephews had to change schools because they were taunted and bullied so they were sent to school in another town. Same for high school the perpetrator's father was coach of the hockey team, and they were hockey players. It has effected them with the rest of their lives they are now 21. Occasionally they have panic attacks, don't ever feel safe. I was happy my social worker dimed him in. I see my nephews struggle with what happened to them and want to hurt that kid badly have him on the Sex Offender roles and acknowledge his crimes. Very frustrating. Very much anger producing .
3 questions.
Can a client ask to be treated anonymously where you, as the DR., doesn’t even know his name?
Is it ethical to tell a troubled client we DO NOT discuss murder, rape, child assault etc.? Can you set up boundaries?
Could you immediately stop a client if he starts to divulge heinous crimes?
This happened to a psychologist friend of mine but not in a formal counseling situation. The murder was particularly brutal and the individual had murdered before. After discussion it became apparent he was racked with guilt and simply wanted to hand himself in. He felt he would murder again and was danger to society. The hand over to the police was done smoothly.
The police said the case would never have been solved without the confession, as by dint of luck it was the perfect crime. The brutality of the murder left seasoned officers shocked and its details were never published. I had passed the individual in the hall way a number times and was always left with a feeling I could not explain.
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!
@@PutinsMommyNeverHuggedHim A very special friend.
I find it ironic that the more a client is worried about their therapist reporting them, the more reason the therapist has to actually report.