CHARLESTON, W.Va. - Confidentiality is paramount to counseling.
Without the expectation of privacy, counseling wouldn't work, said Sky Kershner, a counselor with Kanawha Pastoral Counseling Center.
"We don't let that go lightly," Kershner said. "There are not many limits to what could break that privacy."
According to the American Mental Health Counselors Association, a handful of factors trump that right to confidentiality: suicidality, homicidality, child abuse, incompetent person abuse and elder abuse.
"The protection of life, as in the case of suicidal or homicidal clients, exceeds the requirements of confidentiality," according to the association's code of ethics.
This issue was in the public arena last week when a Kanawha Circuit Court jury found a Sissonville man not guilty of making terrorist threats. He had revealed homicidal and suicidal thoughts to a counselor and was subsequently arrested and jailed.
Shawn Foglesong, 40, told a counselor at Highland Hospital he had thoughts of shooting people at a high school football game last fall in hopes of then having police fire at him.
The hospital notified police of what he said to a counselor while undergoing treatment there. After he was released from the hospital in September, he was arrested and put in jail on a charge of making terrorist threats.
Any situation that involves homicidal or suicidal thoughts is not an easy one, said David Clayman, a clinical psychologist with Clayman & Associates. Clayman said many factors determine where that line between patient confidentiality and protecting the greater good lies.
"It's a judgment call - people will come in and make threats, and we're required on a daily basis to almost be detectives," Clayman said. "In this situation, I would start risk assessment from the beginning. And we have to follow up to see if it's just idle thoughts."
Kershner looks for similar factors.
"The kinds of things we generally look for is, how specific are they in terms of whatever their plan is? Are they able to do it? Do they have the means to do it?" Kershner said.
"If somebody says I'm going to kill myself by shooting myself into space and opening my space suit, that's a low probability. But if they say I'm going to drive my car into a tree that I drive past every day, that's a more serious kind of thing."