By David Joel Miller.
How much confidentiality should children get?
This can be a very touchy issue. Nothing more infuriates a parent than the sense of loss of control over their child’s care. Parents routinely want to know all about what their child is talking about in therapy. Children often ask “Do you have to tell my parents,” before they will disclose something. There are no simple answers.
Two primary questions here.
1. How much should the parents be told?
2. How much are they legally entitled to know?
There are good reasons why parents need to know what is going on with their child. There are also some equally good reasons why they should not be told. Let me try to explain both.
Consider this a general answer and deliberately vague, lots of factors play into this situation and these vary widely from location to location. So the legal practice in one state may not apply in another. From the therapist point of view, there are something’s the parents need to know and other things that will interfere with the process if the therapist tells them.
The exact legal requirements are another issue which varies with the jurisdiction.
Parent, therapist, and the child may also discuss ahead of time just what things will be told to the parent and what should be kept confidential.
Some parents want to know everything the child says. They want the counselor to pry those secrets out of their child. They ask us things like “Is he doing drugs?” “Is she having sex?” The great illusion of some parents is that if they knew all their children’s secrets they could better control the child’s behavior and “Keep them from making mistakes or doing something wrong.”
Let me give you a real-life example of a parent’s effort to control their child’s behavior and how it backfired. This particular example is based on a news story, not my clinical practice so parents, if I have seen your child, relax this is not your kid. I have imagined a few things that were likely to happen after the news account left off.
Dad was worried about his daughter staying out late and was suspicious she was having sex with one of the boys from her school. Dad wants to put a stop to this behavior. He gets an adult this girl trust to talk with her. Have that sex talk. She reveals that yes after going to a local hangout she and this boy did go off and have sex. The girl is 17 the boy is 18. So this sex, in my state, would have been illegal as statutory rape but not reportable by the counselor as child sexual abuse.
Dad is told. He becomes enraged. Dad pressures the police and the local D. A. to arrest this older boyfriend for statutory rape. Dad also files a lawsuit against the hangout where the two of them met for endangering the morals of children. Let’s not worry about the merits of a suit like this just now. The boy is in jail, the hangout is fighting to stay in business and now checks all the kid’s ID’s and no longer allows anyone under 18 to enter. Everyone in this small town knows who had the sex that caused the problems for all of the other teens.
This Girl, now furious with her father, sneaks out her window, goes to another spot and hooks up with a couple of older guys. She is going to get even with dad. She is now having sex with lots of older guys, not just the one cute potential boyfriend who is away in jail.
A better approach would have been to talk with the girl about love, relationships and the dangers of unprotected sex.
Parents make the mistake of thinking that they need to control children’s behavior to keep them safe. So very often that “protected” child turns 18 and now all bets are off.
Parents, at some point in your child’s life, probably in the teen years, your role should move from protecting your child to teaching them how to make good choices. That learning to make choices part scares most parents. What if they make a mistake?
Parents fear this because frequently those parents have made all those mistakes themselves.
We all need to live our lives, learn to make choices, for better or worse and sometimes in the process we fall down and get hurt. A good parent can loosen their grip enough to let the child make some decisions and learn from them before they reach the point of having to face those huge, life-altering, decisions all alone.
Lots of teens ask me to not tell their parents things because they know they have messed up. Often the parents are very understanding and can help the teen solve the problem. Embarrassment and the keeping of secrets are not helpful to the teen.
Some reasons parents should not be told what their child says.
If there is a danger the parent will over react, or harm the child then the counselor may be ethically bound to keep things from the parent.
More than one parent was concerned about what the child was saying because the parent was engaged in illegal activity, used drugs or had some other secret they wanted to hide.
If you are the parent whose child is in therapy, trust the therapist to tell you what needs to be told, to report what legally has to be reported and to try to help your child through the process of learning to make their own decisions.
If you are that teen in therapy, have this conversation with your counselor. Ask them what sorts of things they will be telling to your parents and what is confidential. Unless there is a safety issue involved it is generally best to let your parents know what problems you are dealing with and the counselor can help you with the process of telling them. Don’t let embarrassment keep you from getting help. We all make mistakes in life. The smart people know they need to fix those mistakes and sometimes that means asking for help.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books
- Can you force a teenager to go for therapy? (counselorssoapbox.com)