"45% of those who have communicated with potential victims feel that they have had to violate their own clinical judgment in making an extratherapeutic communication, as against between 30% and 32% of those who have made other communications... [T]herapists who warn victims are those most likely to feel that they have at one time acted contrary to their best clinical judgment....

Two facts emerge from the data. First, the likelihood that a therapist will believe that he or she has acted contrary to his or her best clinical judgment increases as the number of different kinds of third-party communications increases. Thus, among those therapists who communicated with third parties other than the victim, only 14% of those who made only one kind of disclosure felt that they had been forced to compromise their clinical judgment, whereas 33% of those who made each kind of communication, other than to a victim, had this feeling. Of those who made every type of communication, including communications to potential victims, nearly one-half felt that their clinical judgment had been compromised.

Second, the Tarasoff communication is the one most closely associated with a therapist's belief that he or she has compromised clinical judgment. Thus, among therapists who did not communicate with potential victims, but felt compromised, the difference between those who made three types of disclosures and those who made four types is only 7%. As soon as the disclosures entail a Tarasoff communication, however, the percentage of those therapists who felt compromised increased substantially. Thus, of those who made four types of disclosures including warning, 48% felt compromised at some time, whereas only 33% of respondents who made four types of disclosures but did not warn felt compromised -- a difference of 15%.

Warning, then, may well cut against the grain of clinical judgment for a number of [the] respondents. This finding is particularly interesting in light of the widespread ethical commitment to the physical well-being of threatened third parties ... This apparent inconsistency may be explained by the suggestion that [the] respondents believe that there are means other than warning the victim for satisfying their ethical obligation to potential victims. Yet [the] respondents misunderstand Tarasoff as requiring them to warn.

The tension between warning and sound clinical judgment may simply be inherent in the Tarasoff requirement that therapists protect victims. The California Supreme Court, after all, never suggested that it was adopting the Tarasoff duty because it made clinical sense. Rather, it adopted the duty out of a view that the increase in public safety compensated for whatever was being taken from professional autonomy. Whatever the public safety gains, our data suggest that therapists feel they pay a higher clinical price by warning than by making other forms of third party disclosures." [Daniel J. Givelbe, William J. Bowers and Carolyn L. Blitch, "Tarasoff, Myth And Reality: an Empirical Study of Private Law in Action," 1984 Wis. L. Rev. 443, 470-472].