Friday, With a Rifle, From a Hotel in Denver
Marcus, 41, is a long-haul truck driver with PTSD and alcohol use disorder, nine sessions in. He describes a supervisor who 'humiliated' him in front of dispatchers. In this session he is agitated, has been drinking, and says: 'Friday I'm going to be waiting in the lot with my rifle when he comes out. He'll never know what hit him.' He names the supervisor and the terminal location. He also mentions that Thursday he is driving a load to Denver and wants to keep his appointment by video from a hotel there. The psychologist is licensed in Kansas and holds the PSYPACT E.Passport; Colorado is not a PSYPACT state. The psychologist has never met the supervisor and has no release for any collateral contact.
1. What does Kansas law require or permit here, and what protective steps should the psychologist take?
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Kansas has no statute imposing a Tarasoff-style duty to warn or protect, and Kansas courts have generally declined to create a broad affirmative duty to third parties absent a special relationship; disclosure is permitted rather than statutorily compelled. That legal answer does not end the analysis. The clinical and ethical standard is that a serious, imminent threat to an identifiable victim permits - and in practice requires - protective action. APA 4.05 allows disclosure to protect the client or others, and HIPAA 45 C.F.R. 164.512(j) permits disclosure to prevent or lessen a serious and imminent threat to a person or the public. The threat is specific (named supervisor), imminent (Friday), and lethal (rifle, ambush at the lot). Do a structured risk assessment now, arrange emergency evaluation through Kansas crisis services or law enforcement, warn the identified victim and the terminal's security, notify law enforcement where the lot is, and document each action with times. Verify current Kansas authority and Board guidance as part of your documentation.
2. Can the psychologist conduct Thursday's session by video from Denver? Explain.
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Not simply. Licensure generally follows the client's physical location at the time of service, and Colorado is not a PSYPACT state, so even a psychologist holding the E.Passport has no compact authority to treat a client sitting in a Denver hotel room. Options include: see him in Kansas before he leaves; determine whether Colorado's temporary-practice rules permit anything here, which for ongoing treatment they generally do not; coordinate with a Colorado-licensed clinician and Colorado crisis services for the days he is out of state, with written releases and a safety plan; and do not rely on the Kansas license to cover an out-of-state session. Location matters for the protective steps too: warning a Kansas workplace and calling Kansas law enforcement is incomplete if he is calling from Denver. The plan must cover where he actually is on the day of the threat.
3. What should be documented, and what should the psychologist decide about continuing treatment?
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Document contemporaneously and in detail: the verbatim threat, the risk assessment and its results, each protective step with times, who was contacted (victim, terminal security, law enforcement, crisis services), Marcus's response, any consultation obtained, and the reasoning behind each decision - including why warning rather than hospitalization was chosen. Note the alcohol use and the commercial driver's license, but do not report him to his employer; the safety exception covers threats, not general fitness, and an unnecessary report would breach confidentiality. Then decide whether you can continue. An evaluation that ends with a warning often damages the alliance, and Marcus may need a higher level of care; document your recommendation and referral options and keep your malpractice carrier informed. Reassess risk at every contact. The duty to act is triggered by the threat, not by a diagnosis, and it does not expire on Friday.