In California, what constitutes a "significant risk" that may warrant a breach of confidentiality?

• A. Client dissatisfaction with therapy
• B. A client expressing intent to harm themselves or others
• C. Minor issues affecting the therapeutic process
• D. General conversations about self-improvement

Answer: (B)

In California, a "significant risk" that may warrant a breach of confidentiality is defined primarily by the client expressing intent to harm themselves or others. This determination is based on the ethical and legal responsibilities of mental health professionals to ensure the safety and well-being of their clients and the public.

When a client indicates a plan or intention to commit self-harm or harm others, it creates an immediate concern that outweighs the duty to maintain confidentiality. The duty to protect can lead mental health professionals to disclose necessary information to prevent imminent harm. This principle is guided by the ethical standards of care and legal mandates, such as the Tarasoff duty, which requires therapists to take action if a client poses a serious threat of violence.

The other options do not fall under the standard of "significant risk." For instance, client dissatisfaction with therapy, minor issues affecting the therapeutic process, and general conversations about self-improvement do not pose an immediate danger and therefore do not warrant any breach of confidentiality. These situations can typically be addressed within the therapy itself without the need to disclose information to outside parties. Understanding these distinctions is crucial for maintaining ethical standards and adhering to legal obligations in clinical practice.