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Scenario 2a: a woman contacts her therapist about a friend of her son's "martyrdom mission.".

A woman contacts her psychologist from whom she has been receiving therapy for the past year for bouts with depression. She reports that she has just learned that a friend of her 19-year-old son appears to be recruiting her son for a martyrdom mission. This friend has voiced some fundamental Islamic beliefs that are very anti-American. The woman has overheard worrisome conversations between her son and his friend but had tried to discount their significance until her son revealed today that he was asked to become a Martyr for an unspecified attack against the United States. He is very concerned that his friend is involved in something that may be planned for the near future. They are afraid to report this to the police because her son has a juvenile record and he is somewhat anti-American himself. They are naturalized citizens of the United States after having moved here from Iran many years ago.

Problem: This situation is not covered explicitly by the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct. Pertinent portions of this Code are as follows:
 5.05 Disclosures.

 (a) Psychologists disclose confidential information without the
 consent of the individual only as mandated by law, or where
 permitted by law for a valid purpose, such as (1) to provide needed
 professional services to the patient or the individual or
 organizational client, (2) to obtain appropriate professional
 consultations, (3) to protect the patient or client or others from
 harm, or (4) to obtain payment for services, in which instance
 disclosure is limited to the minimum that is necessary to achieve
 the purpose.

 8.01 Familiarity With Ethics Code.

 Psychologists have an obligation to be familiar with this Ethics
 Code, other applicable ethics codes, and their application to
 psychologists' work. Lack of awareness or misunderstanding of an
 ethical standard is not itself a defense to a charge of unethical

 8.02 Confronting Ethical Issues.

 When a psychologist is uncertain whether a particular situation or
 course of action would violate this Ethics Code, the psychologist
 ordinarily consults with other psychologists knowledgeable about
 ethical issues, with state or national psychology ethics committees,
 or with other appropriate authorities in order to choose a proper

Comments (Robert Kinscherff, Director of forensic training at the Law and Psychiatry Service of the Massachusetts General Hospital; senior forensic psychologist for the Boston Juvenile Court Clinic; member of the faculty of Harvard Medical School, communication to Susan Brandon, May 5, 2002):
 I do not believe that the Ethics Code explicitly mentions mandated
 reporting of child abuse, elder abuse, etc. Rather, the Code handles
 it by obligating psychologists to be aware of and to utilize
 whenever appropriate or mandated the exceptions to confidentiality
 found in the law. This is partly because most of the relevant law
 is state law and these laws governing confidentiality and
 permitted/mandated exceptions to confidentiality differ in their
 specific details. The law that permits or requires a psychologist to
 break confidentiality in order to protect third parties from
 potential violence is the closest body of law to the scenario.
 However, this law contemplates that it is the client/patient who
 poses the serious threat of harm to a third party; it does not
 contemplate violation of the confidentiality of the client/patient
 if the client/patient is not the source of the risk of harm.

 There is no specific mention of national-security related issues in
 the Code, and I am unaware of any APA policy document or guidelines
 document that refers to national security issues as they might arise
 in the practice of psychology.

 The Code as currently worded would actually permit breaking of
 confidentiality despite the patient's/client's wishes in the
 "national security risk from a third party" scenario BUT ONLY IF
 there were applicable state or federal law that MANDATED the
 breaking of confidentiality or PERMITTED the breaking of
 confidentiality in order to protect the client/patient or others
 (see, for example, 5.05(3) which permits disclosure to protect
 others if mandated or permitted by law).

Problem: Where might a psychologist help, such as by providing telephone numbers for tip lines, going to the police with the client, etc.? Are there rules for such actions?
 (Kinscherff:) There are no written rules for these steps. However,
 each of these steps [referred to above] presumes that the
 patient/client will be taking the affirmative actions, not the
 psychologist. The psychologist would only be acting in a supportive
 role by providing information (telephone number) or support (going
 to the police with the client). This situation is not unlike those
 situations in which a client/patient may disclose being victimized
 by domestic violence; the psychologist might help the client/patient
 access further supports by locating shelter services or other
 related services, or might support the client/patient by going with
 them to file a police report regarding the domestic violence. In
 either case, the psychologist is not violating the confidentiality
 of the professional communications without the consent of the

Strategies: Seek guidance from the American Psychological Association and state psychological associations to consider:

* Including statements regarding information related to national security in its code of ethics;

* Broadening training programs to include instruction on how to deal with such situations, and

* Teaching clinicians and clinical students how to become familiar with various law enforcement agencies and rules, and how to deal with third parties such as probation officers.

Problem: What information about the family might be useful to law enforcement agencies?

Strategies: The woman and her son appear amenable to approach by law enforcement for several reasons. First, both are naturalized citizens of the United States and have lived in this country for many years. Second, the mother being in therapy suggests a significant degree of acculturation of the family. Third, the fact that the son approached his mother with his fears about his friend indicates that the son regards his mother as a confidant and perhaps an authority figure.

Implications for practice, training and research:

This scenario highlights the fact that law enforcement may be in situations that challenge current views of confidentiality. It would be useful to look at the literature regarding precedents with organized crime.

Investigation is needed that compares the development and maintenance of informants in counter-terrorism efforts with the support of informants in other contexts, such as organized crime and narcotics.

One might ask how the appropriate response of the psychologist would be changed by a reduction in the age of the child (e.g., from 19 to 15), or by the assumption that the community in which the family lives is rural or middle America, where Christian fundamentalist groups are known to be more likely to have strong support.

There is a need for the American Psychological Association and state psychological associations to develop an ethical code for practitioners for instances where a client may have information relevant to terrorism (similar to other mandates that already exist, such as those for instances of abuse of children and the elderly and a client's intention to harm himself or another person). Such instances are peculiar because they involve third-party harm. Psychologists need to be trained for what behaviors to look for, and how to report information to law enforcement while protecting the client and their family and community. This may include some kinds of cross-cultural training. The APA may have to work with legislatures and licensing boards regarding some of these issues. Similar training and issues of confidentiality need to be considered for the training of clergy, teachers, and physicians.
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Publication:Countering Terrorism: Integration of Practice and Theory
Geographic Code:1USA
Date:Feb 28, 2002
Previous Article:Scenario 1: a trustworthy local businessman reports suspicious activity by an apparently Middle Eastern neighbor.
Next Article:Scenario 2b: a Palestinian reports to the FBI that a recent suicide bombing in Israel was committed by his brother.

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