Which factor is necessary for a therapist to disclose privileged communication regarding an identified victim?

The necessity for a therapist to disclose privileged communication regarding an identified victim hinges on the concept of duty to protect. In many states, including Massachusetts, mental health professionals are mandated reporters, especially in situations where there is a credible threat of harm to an identifiable victim.

For disclosure to be warranted, there must be a clear and immediate threat to the victim's safety, which is often assessed based on whether the patient possesses the ability to carry out that explicit threat. If a therapist has legitimate reasons to believe that the patient has communicated intentions or plans that pose a danger to an identifiable individual, this establishes a legal and ethical obligation to intervene to prevent harm—thus leading to the disclosure of such privileged information.

Other responses, such as the need for the patient's consent, do play a role in confidentiality and privilege; however, in the face of a credible threat to someone's life, the therapist's duty to protect the victim supersedes the need for consent. Likewise, previous therapy outcomes and knowledge of the victim’s whereabouts, while potentially relevant in context, do not satisfy the immediate requirement for action to prevent harm. The critical factor is the explicit threat and the patient’s capability to carry it out, which creates an urgent need for the therapist to act to protect the