Last year, just before the Presidential election, 20 year-old Mitchell Kusick had an important conversation with his therapist. He was having homicidal thoughts, and he told his therapist about them so that he could get the help he needed. He did exactly what he was supposed to do.
His therapist, Dr. Corey Candelaria, did what he was supposed to do, as well. He worked with Mr. Kusick. He placed him on a 72-hour mental health hold to get him into a hospital and to increase the likelihood that Mr. Kusick would not act on his thoughts. As part of his duty, Dr. Candelaria also notified the authorities of his client's homicidal thoughts.
The problem in this case was in the nature of Mr. Kusick's homicidal thinking. In addition to wanting to kill students at a high school and one of his friends, Mr. Kusick mentioned that he wanted to assassinate President Obama, who had been traveling to Colorado frequently just before the election.
It is a federal crime to threaten the President's life, and Mr. Kusick was interviewed by the Secret Service while he was still in the hospital. He was then sent to a federal correctional facility and charged with a crime.
Mr. Kusick accepted a plea deal yesterday, which includes time served and probation. He has also agreed to continue in therapy. It could have been worse for him--he was facing up to five years in federal prison. He will still have a felony on his record, however.
When a therapist breaks a client's confidentiality, it almost never ends in an arrest. It sometimes ends with the client getting angry with the therapist for violating his/her trust. It often ends with the client in a hospital against his/her will for a few days. But, it rarely ends in a felony conviction.
Psychologists take confidentiality very seriously. It is the foundation of the therapeutic relationship, and it is one of the main reasons why therapy works. Clients need to be able to trust that they can say anything to their therapists without having it revealed to anyone else. In the instances when a therapist is required to break confidentiality (danger to self, danger to others, grave disability, child abuse, and sometimes elder abuse/at-risk adult abuse), there is always the chance that the therapeutic relationship will be destroyed. It is still important to break confidentiality in these instances, but it is not always in the best interest of the client--the typical rule of thumb is that the need to protect a client ends as soon as there is some sort of serious public danger.
9 News Political Reporter Brandon Rittiman covered Mr. Kusick's story yesterday, and he interviewed me about confidentiality. Here is the video:
If you are attempting to watch this video on a non-Flash enabled device, click here to view it.
Thanks for reading-- Max Wachtel, Ph.D.