Psych CASC / OSCE · Forensic psychiatry — duty to warn and third-party risk
Explain confidentiality limits and protective steps after a threat — CASC communication station
MRCPsych/FRANZCP-style CASC: explain limits of confidentiality, duty to protect principles, minimum disclosure, containment plan, and alliance repair after a third-party threat.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar. The examiner plays the patient who made a threat. [1]
Candidate instructions. Explain that confidentiality has limits when there is serious risk to others. Cover why you may need to warn the named person and/or involve police or hospital care; what minimum information will be shared; that care continues; and next steps for safety and treatment. Be empathic, non-punitive, clear. Do not invent specific Act section numbers. Check understanding. [3][4][5]
References5ShowHide
- [1]Appelbaum PS Tarasoff and the clinician: problems in fulfilling the duty to protect Am J Psychiatry, 1985.PMID 3976915
- [2]Binder RL, McNiel DE Application of the Tarasoff ruling and its effect on the victim and the therapeutic relationship Psychiatr Serv, 1996.PMID 8916238
- [3]Appel JM Trends in Confidentiality and Disclosure Focus (Am Psychiatr Publ), 2019.PMID 32047382
- [4]Knoll JL The psychiatrist's duty to protect CNS Spectr, 2015.PMID 25712614
- [5]Bersoff DN Protecting victims of violent patients while protecting confidentiality Am Psychol, 2014.PMID 25046702