Ethical and Legal Considerations When Counselling Children and Families

Authors

• Catherine Ford Sori, Governors State University
• Lorna L. Hecker, Purdue University Calumet

Key Points

• Privacy, Confidentiality, and Legal Privilege: Challenges due to competing interests of parents and children.
• Subpoenas: Legal threats to confidentiality; appropriate responses needed.
• Parent Information Sharing: Considerations impacting therapy.
• Informed Consent: Understanding laws and ethical codes for treating minors.
• Special Ethical Issues: Divorce, competency, multicultural considerations, touch.

Intertwining of Ethical and Legal Issues

• Limited guidance in mental health literature for counselling minors outside schools.
• Common concerns: child's right to confidentiality, informed consent, divorce issues, touch, counselor competency, multicultural issues.

Privacy and Confidentiality

• Privacy: Right of clients to control access to their information.
  • Legal control often held by parents for minors.
• Confidentiality: Essential for counselling; requires written release for information sharing.
  • Exceptions include legal requirements, emergencies, or abuse reporting.
• Privilege: Client's legal right to confidentiality in judicial contexts.
  • Established by state statute; varies across states.

Confidentiality with Minors

• Challenges in deciding information sharing with parents.
• School settings have specific confidentiality rules under federal law.
• Mature minors may access treatment independently in some states.

Breaching Confidentiality

• Required when there is harm to self or others, or in cases of abuse/neglect.
• Harm to Self: Includes assessing suicidal thoughts and informing parents.
• Harm to Others: Duty to warn in cases of potential harm (e.g., Tarasoff case).
• Abuse: Mandated reporting of suspected child abuse or neglect.

Subpoenas

• Confidential information should not be released without a court order.
• Involve clients and legal counsel in responding to subpoenas.

HIPAA and Minors

• Parents access children’s health information except psychotherapy notes.
• State laws may provide greater privacy protections.

Sharing Information with Parents

• Various approaches to confidentiality: complete, limited, informed forced consent, no guarantee.
• Agreements on confidentiality should be documented.

Group Confidentiality

• Challenges in children's group counselling; importance of understanding confidentiality limits.

Informed Consent to Treat Minors

• Consent required from parents or legal guardians.
• Emancipated and mature minors may provide consent independently.
• State differences in consent laws.

Special Ethical Issues

• Divorce: Clear role definition needed; avoid taking sides.
• Competency: Only practice within areas of training and competence.
• Use of Touch: Guidelines for appropriate nonerotic touch.
• Multicultural Considerations: Sensitivity to cultural differences in family values.

Conclusion

• Importance of ongoing education and understanding of ethical/legal standards.
• Balance client welfare with risk management; support diverse family structures.

Note: This summary is based on the chapter originally published by Sori & Hecker (2006). The considerations remain pertinent despite evolving societal contexts.