Reference · Values and Ethics

Duty to warn and duty to protect

The short answer

When a client makes a serious threat of violence toward someone, confidentiality can give way.[1] Federal law and the NASW Code permit disclosure to prevent serious, imminent harm, but they do not require it.[2] Whether you must act, and how, is set by state law.[3] Tarasoff created a duty to protect, which can be met by warning the person, calling police, or other reasonable steps.[4]

The key ideas

  • Tarasoff: duty to protect

    In Tarasoff v. Regents (Cal. 1976, Tarasoff II), the California Supreme Court held that when a therapist determines, or by professional standards should determine, that a patient presents a serious danger of violence to another, the therapist must use reasonable care to protect the intended victim. The duty is to protect, which may be met by warning, notifying police or other reasonable steps. It is state case law, not a national rule.[4]

  • Tarasoff: confidentiality yields to public peril

    The court reasoned that the public policy favoring confidentiality in therapy must yield when disclosure is essential to avert danger to others. Danger must be serious and the disclosure tailored, consistent with NASW 1.07(c) and HIPAA 164.512(j).[4]

  • HIPAA serious threat to health or safety

    HIPAA permits (does not require) a provider, in good faith and consistent with applicable law and ethical standards, to disclose PHI believed necessary to prevent a serious and imminent threat, to people able to prevent or lessen it including the target. It also covers aiding law enforcement. Good faith is presumed when based on actual knowledge or credible representation.[2]

It varies by state

The exam is national, so it tests the shared principle. Your state's law decides the details below.

mandatory
27
mandatory
permissive
16
permissive
mixed
3
mixed
no duty
3
no duty

  • Duty to warn vs duty to protect, and state statutes

    After Tarasoff, most states enacted laws that require or permit mental health professionals to disclose information about dangerous patients, usually with immunity. Statutes differ on mandatory vs permissive, on the trigger (identifiable victim, serious threat), and on discharge by warning victim and police.[3][4]

  • State variation: duty to warn or protect

    National principle: confidentiality can yield to a serious threat of violence, and HIPAA 164.512(j) and NASW 1.07(c) permit disclosure. What varies: whether a duty is mandatory, permissive or absent, who it covers, the trigger, and how it is discharged. NCSL's chart (updated March 2022) codes 27 states mandatory, 16 permissive, 3 mixed (AZ, DE, IL), 3 no duty (ME, NC, ND), Georgia case law only. Check the law where you practice.[3]

Mixed (statute lists both)

No duty to warn or protect

Case law only

Find your state's licensing guide, then read your state's statute before you rely on any summary.

How the ASWB exam tests it

  • Threat-of-violence questions test the national principle: confidentiality yields to serious, foreseeable, and imminent harm. An answer that treats one state's rule as universal is wrong.[3][1]
  • HIPAA permits a warning; it does not require one. "HIPAA requires you to warn" is a wrong-answer lure.[2]
  • Tarasoff is a duty to protect, met through reasonable steps. Warning the person is one option, not the only one.[4]
  • When a disclosure is needed, the best first step is often to tell the client, when that is feasible, and to share only what is necessary.[1]

The common trap

Choosing "warn the intended victim" as if a mandatory duty to warn were national law. The safe national answer: assess the risk, consult, protect through the reasonable steps your jurisdiction allows, and document.[3][4]

Covered on other pages

  • NASW 1.07(a)-(c) Privacy and confidentiality: core and limit

    Respect privacy and do not solicit private information without compelling professional reason. Confidentiality is the default; it does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or others, and then only the least information needed.

  • NASW 1.07(b),(d),(e) Consent to disclose and discussing limits

    Disclose with valid consent from the client or a legally authorized person. Planned disclosures should be preceded, when feasible, by telling the client about it and consequences, whether legally required or consented. Discuss confidentiality limits early and as needed.

  • State variation: who is a mandated child abuse reporter

    National principle: every state requires certain people to report suspected child abuse (CAPTA framework) and social workers are among the most commonly listed professionals. What varies: lists of professions and whether everyone must report. CWIG (May 2023): about 17 states plus Puerto Rico make any person a reporter, four states only that, and 41 states list social workers.

Related explainers

Sources

  1. 1.NASW Code of Ethics (public page). www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English/Social-Workers-Ethical-Responsibilities-to-Clients
  2. 2.eCFR 45 CFR 164.512. www.ecfr.gov/current/title-45/part-164/section-164.512
  3. 3.NCSL. www.ncsl.org/health/mental-health-professionals-duty-to-warn
  4. 4.Harvard Caselaw Access Project (Tarasoff v. Regents, 17 Cal.3d 425). static.case.law/cal-3d/17/html/0425-01.html
  5. 5.Child Welfare Information Gateway (State Statutes, current through May 2023). artifacts.childwelfare.gov/public/documents/mandatory-reporting-abuse-neglect.pdf

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