Drawing of Anger, made possible by Creative Commons, http://goo.gl/pYeceX
A published Minnesota Court of Appeals decision that came down this week starts: “Jerry Expose, Jr., was convicted of the criminal offense of making a terroristic threat during an anger-management counseling session.”
I say, half-joking, “If you can’t make a terroristic threat during an anger-management counseling session, then when can you?”
More seriously, the case of Expose v. Mattson raises a significant issue. The nature of psychotherapy and counseling is, of course, to provide a safe environment for complete, open, candid communication. It is built on a foundation of confidentiality and trust. On the other hand, it is obvious that there must be an exception made when a health-care professional like a psychotherapist is told information about a concrete threat to the health or well-being of another person. A system in which a healthcare professional would be bound to sit by silently while his patient plans and implements an act of violence against himself or someone else is unimaginable and intolerable.
But it is, of course, a delicate balance. In the case of Expose v. Mattson, the trial court felt the balance tipped in favor of the health care providers. On appeal, however, the critical decision in tilting the balance in the opposite direction was that the mental health therapist was an intern. The therapist was not yet a licensed psychotherapist and so the appellate court held that neither she nor the clinic at which she interned could find a shield in the statute devised to protect licensed therapists.
Does the result seem harsh? Maybe the Minnesota Supreme Court will weigh in and reinstate the district court’s decision. But I think there is some merit to the idea underlying the Court of Appeals decision — health-care professionals are in extremely delicate positions and wield dangerous power. Maybe putting interns in that position, junior or student counselors who might not yet have the training and experience to distinguish “venting” from “terroristic threats,” was not what the Minnesota legislature had in mind when it established immunity for licensed providers?