Clients Who Threaten Therapists: How to Stay Safe

The overwhelming majority of those with mental illness will never become violent. But it’s also true that therapists can be uniquely vulnerable to stalking, harassment, or even violence from clients. Here are some ways therapists can stay safe.

1. Understand your vulnerability

As therapists, we typically work alone, behind closed doors, with people who are struggling in their lives. Clients may mistakenly believe that our lives are perfect, or hold us responsible when their lives don’t improve in the ways they had hoped for. 

In extreme cases, clients have attacked and even killed their therapists. Just since 2018, there have been at least three well-publicized incidents of current or former clients becoming violent with their therapists—one case ended with the client being killed by police as the attack was in progress.

Most therapists worry about their own safety. And most of us don’t feel well-trained to protect ourselves. Even if you have never experienced threats, intimidation, or violence from a client, you may wonder what you would do if that time comes.

2. Screen for safety

Thankfully, there are a number of proactive steps you can take to protect your safety. This starts, as you might expect, with a strong initial screening of prospective clients. 

While no screening process is perfect, you can ask directly about:

  1. Issues that might suggest future risk of violence, such as history of violence or threats. 
  2. The presence of guns in the home, which is known to increase the risk for both suicide and homicide.

That information can be incredibly helpful in determining whether a client is a good fit for your practice. If a client leaves you feeling uncomfortable about your personal safety, you generally are not required to work with them. At a minimum, you should have conversations early on with colleagues and supervisors who can help ensure your continued safety. Those same people may also be helpful in determining how much risk is too much to take on.

3. Use protective technology

You also can use technology to protect yourself from the worst-case scenario of a client threatening or attacking you. 

By using a video camera in your waiting room, a locked door between the waiting room and the counseling area of your office, and a panic button in your office, you can keep dangerous clients out, while bringing help in. Here’s an example of a programmable panic button that you can wear anywhere, without the need to install anything in your office.

4. Learn how to identify and address your risks

No therapist should have to choose between their personal safety and their professional responsibilities. It is possible to successfully address both. We offer an on-demand, 1 hour video CE course, Clients Who Threaten Therapists: Legal, Ethical, and Safety Issues, where I address these concerns in detail and how you can use the informed consent process to proactively protect yourself. And the course covers one of the most challenging issues for therapists faced with a dangerous or threatening client: How you can share the information you need to share to protect yourself, while also staying firmly within your legal and ethical boundaries.


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