Teen reluctant to talk to his counselorFor therapy to be optimally effective, a person must be able to disclose their thoughts, feelings, experiences, and behaviors without fear of judgment. They must also exist confident that their therapist volition not share this information with third parties. The ability to be vulnerable in therapy tin can support a strong therapeutic alliance and tin can assist a person recover more quickly. For minors, yet, the right to privacy in therapy is express.

Legally speaking, people nether the age of xviii practice not typically have a right to confidentiality in therapy. Nevertheless, some therapists ask parents to concur to the therapist's confidentiality rules earlier they will care for the customer. Additionally, though minors practice not have a legal right to privacy from their parents, their right to privacy from third parties (employers, advertisers, etc.) is similar to that of adults.

Why Is Confidentiality Of import for Children?

Therapeutic confidentiality is key to constructive treatment for numerous reasons, including building and preserving a stiff therapeutic alliance. The benefits of confidentiality include:

ane. Increasing cooperation in handling

A child or adolescent has petty reason to disclose information they don't want shared with their parents if there is no guarantee of confidentiality. But often, the information they don't want disclosed is the data that is nigh important for them to discuss in therapy.

2. Ensuring a child gets effective treatment

If a child cannot safely disembalm whatever they want, the therapist may non have enough information to know what kind of help the kid needs.

iii. Protecting the child from hazard of abuse or homelessness

Non all parents have unconditional love for their child. For case, some parents may corruption or disown a child for their sexual orientation or behavior. If this data is disclosed, it could make a client vulnerable to unkind or abusive treatment.

four. Protecting the child from third parties

Confidential data can be used for a broad range of purposes—bullying, marketing, fifty-fifty stealing a person'due south identity. And so even when a small has no right to confidentiality from a parent, they still have a right to privacy from third parties.

five. Improving the parent-child human relationship

Some parents may worry that "secrets" will undermine their relationship with their child. But when a child can openly hash out their feelings in therapy, their relationship with others, including their parents, may improve.

Legal Protections for Minors

A complicated web of federal and state laws, professional ethics, and statutory interpretations by various courts govern minors' correct to confidentiality in treatment. Privacy concerns are complex legal bug that rarely have a elementary respond. Therapists, parents, and others who take specific concerns about confidentiality may wish to talk to an attorney knowledgeable virtually the laws in their country.

In general, the right to privacy in treatment is connected to the right to consent to treatment. Because a child cannot legally consent to handling, the parent often acts every bit a personal representative for the child. Almost children practice not have a legal right to privacy from their parents, as a parent may need certain information in order to consent to treatment.

A parent more often than not has the right to request a child's medical tape. This may include a child'due south diagnosis, symptoms, and treatment programme. However, the parent does not have the right to view handling notes unless a court orders otherwise. Professionals accept psychotherapy notes to analyze the contents of a conversation. The notes are for personal use rather than official documentation.

The Health Insurance Portability and Accountability Human action (HIPAA) is the main federal law governing medical privacy. It protects minors from disclosures to tertiary parties who are not their parents. It requires health care providers, including therapists, to take reasonable steps to protect client privacy.

Some states extend additional privacy protections to minors that go beyond HIPAA. For instance, California gives minors the correct to control their ain health care information when they otherwise have the correct to consent to care. When a state offers a child more privacy rights than the child has under federal law, a therapist must follow state law.

In some cases, a parent may non have the right to information about their child'due south treatment. Those might include:

  • When a parent has signed an agreement to respect the confidentiality between the health intendance provider and the minor.
  • When a parent has lost or given up their parental rights. For example, the biological parent of an adopted child would not typically have a right to handling data.
  • When a court social club specifically prohibits the parent from accessing the kid'southward information.
  • When the kid is emancipated. (Child emancipation is when a minor becomes legally responsible for their own care before the age of eighteen.)

In some contentious custody cases, a court may engage a lawyer for the child—often called a guardian ad litem—to represent the child'southward best interests. Depending on the case, the state, and the courtroom's gild, that lawyer may get to make up one's mind whether and when parents tin can view information about mental health treatment.

"Because I work with many loftier-disharmonize divorce families, many of the children and teens I see in therapy have their ain minor's counsel. When a modest has their own attorney, this lawyer holds the privilege for the child's therapy, and they often work with me to help proceed emotional safe a priority for the child's counseling. Even when a parent is pressuring me for data, I am able to refer them to the minor's counsel, who will piece of work to protect the child's confidentiality," says Lois Nightingale, PhD, a spousal relationship and family therapist from Yorba Linda, California.

Discussing Confidentiality Concerns with Youth

Ane of a therapist'due south most important ethical duties when treating minors is to talk over confidentiality concerns with the parent(s) and the child. The therapist should be clear well-nigh the police force and their own confidentiality policies. Some important topics to discuss include:

  • The therapist's disclosure policies. Some therapists crave parents to consent to a certain level of confidentiality, even when state or federal law affords the child fewer confidentiality rights.
  • The circumstances nether which a therapist would disclose information the child shared in therapy.
  • The importance of confidentiality in therapy. When parents understand that confidentiality is key to effective treatment, they may be more than willing to respect their child's demand for privacy.
  • The steps the therapist takes to protect the child's privacy. In most cases, a therapist will provide the kid and their parents with a HIPAA disclosure argument that offers details most how and when treatment information may be disclosed to others.
  • The benefits of open communication betwixt a parent and child. Many children practice not discuss challenging topics with their parents because they fright judgment or punishment. When parents empathize the importance of open communication, they may be less likely to overreact. This can encourage better parent-child relationships.

Mandated Reporting

When a therapist believes a child is in danger, they typically have a legal duty to disembalm certain information, even when the child otherwise has a right to confidentiality. For case, mandated reporters must disembalm suspected kid abuse to child protective services. Likewise, a therapist must act to protect the child if they believe the child may appoint in self-damage or hurt others.

Even when a therapist must act to protect a kid, the therapist must utilize a conservative approach, disclosing merely that information which is absolutely necessary and disclosing only to the appropriate person or persons. For example, if a therapist fears a child may be planning a schoolhouse shooting, the therapist may exist required to notify law or schoolhouse authorities. However, the therapist would all the same be required to protect the confidentiality of other handling details, such as the child's sexual orientation or history of abuse.

The duty to warn others when a customer poses an imminent threat can present several ethical dilemmas. Therapists should ensure they understand state laws and their licensing board's ethics rules. Knowledge about 1'south responsibilities tin can brand decisions easier during a crisis.

For more articles and continuing education courses on ethical therapy, bring together GoodTherapy today!

References:

  1. Behnke, S. H., & Warner, E. (2002). Confidentiality in the handling of adolescents. Monitor on Psychology, 33(3), 44. Retrieved from https://www.apa.org/monitor/mar02/confidentiality
  2. Does a parent accept a correct to receive a re-create of psychotherapy notes about a child's mental health treatment? (2017, September 12). Retrieved from https://www.hhs.gov/hipaa/for-professionals/faq/2094/does-parent-have-right-receive-copy-psychotherapy-notes-about-childs-mental-health-handling.html
  3. English, A., & Ford, C. A. (2004). The HIPAA privacy dominion and adolescents: Legal questions and clinical challenges. Perspectives on Sexual and Reproductive Wellness, 36(2), 80-86. Retrieved from https://world wide web.guttmacher.org/journals/psrh/2004/hipaa-privacy-rule-and-adolescents-legal-questions-and-clinical-challenges
  4. Hanson, K. (2018, October 12). Mental health professionals' duty to warn. Retrieved from http://world wide web.ncsl.org/enquiry/health/mental-health-professionals-duty-to-warn.aspx
  5. McNary, A. (2014). Consent to treatment of minors. Innovations in Clinical Neuroscience, 11(3-4), 43-45. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/manufactures/PMC4008301