School threat case highlights limits of privacy in counseling
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."
Foglesong said he had homicidal and suicidal thoughts and was afraid he could carry out his idea of wearing a mask to a Sissonville High School football game where he could shoot into the crowd, targeting some he believed were sexual predators or other "bad people," and that would incite police to fire at him.
Although Kershner did not comment on the specific case, he said situations are more serious if specifics are explained: if the person has a particular place, person and way of doing something in mind and has the means to act.
"It depends on the counselor and what their limits are, but the community need for safety trumps the client's need for privacy. That's the way the profession looks at it," he said.
"Most counselors would err on the side of protecting the community. In the past decade, there have been instances where folks did these things and were in counseling at the time."
Clayman said the call has become more difficult more recently with an increase in violence.
"I don't understand the sudden urge of people shooting people," Clayman said. "A lot of these people have depressive issues . . . wanting to go out in a blaze of glory . . . it's a distorted thought.
"And it's often difficult to determine what to do. We all live in dread that we'll make the wrong clinical decision."
Kershner said the situation is further complicated when a patient is seeking help for these thoughts. That indicates the client may be ambivalent or struggling with the situation. He said that takes extra thought and perhaps additional opinions from a colleague.
"That's a difficult judgment call. It gets into a pretty complicated area, and that line is different for everybody. Each counselor has their own comfort levels in how they make the assessment," he said.
"There are guidelines to try to standardize these things, but it gets very subjective. This is a difficult position for any counselor to be in."
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