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 children. 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’s 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 that varies with the jurisdiction.
The 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 overreact, 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.
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
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How do the parents know what to do for the teenager if the therapist only hears the teenagers side ? We are have fighting problem at home . The teenager walks around like we miss treat her . But it’s the oppersite . She gets everything she wants .
Wow Mike! Sounds like you have a teenager on your hands. Unfortunately, you, your daughter, or the therapist knowing right probably won’t change the situation. If you wanted somebody to decide who is right and who is wrong, you need to see a judge. The teenage years are when many young people begin to assert themselves, decide who they are, and take some risks by trying on new things. The rules of what to do for your child should be pretty much the same regardless of her attitude. 1. Parents should be parents not their child’s best friends. 2. Catch your child doing something right. The things you pay a lot of attention to it will get more. If you really believe your child gets everything she wants, stop giving her so much. Unless you plan to support her till she is 60, she will need to get a job. Her boss won’t always give her everything she wants. Neither will her partner or your grandchildren. Since I’m not there to see the situation I don’t know what you mean by fighting. If you mean arguing, then you probably need to stop arguing. As a parent, you need to set reasonable rules, allow your child to express feelings and you need to administer both praise and negative consequence when she doesn’t follow the rules. Eventually, if you can all get through this, it would be nice to have a good relationship with your daughter. Pick your battles. Parents who try to really clamp down on teenagers can find the child leaves them, possibly for an undesirable partner. In the process of your daughter separating from you, try to avoid damaging the relationship so much that she never talks to you again. You might consider counseling to help you get through this difficult situation. The goal of therapy should be to help people have the best life possible not to decide who is right and wrong
Thanks for contacting me. I’ve had the blog set to auto pilot, publishing prescheduled posts while I’m away, so it’s taken me a while to get back responding to some comments and questions.
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I appreciate this post. I feel strongly about maintaining a child’s confidentiality (and trust) in counseling as far as possible. I remember discussing the issue of children’s privacy at length when I was in graduate school. My professors offered a 3-part answer: 1) since the parents are paying for the sessions the records are theirs and they can ask for them any time, 2) the parents are responsible both legally and morally for their children so they have a right to know what’s talked about, and 3) the counselor, taking points 1 and 2 into account, must always strive to do what is in the best interest of the client. At the time I found that response maddening. It seemed like a dodge, a non-answer. Now I know better. All counselors, especially of children, have to walk tightrope between confidentiality, revelation/reporting, and client’s best interest. No two cases are the same. Part of my intake process for kids is to talk with both parent(s) and kid about confidentiality, therapeutic alliance, trust, and safety before I ever talk with the child alone. Maintaining the Child’s sense of safety and autonomy is very important. But I also reassure the parents that if its important I will help the child tell them. Only in an emergency would I break the child’s confidentiality with a parent without talking with the child first. So far this has worked well.
Thanks for adding those thoughts. I am constantly reminded we have to make the counseling experience safe for clients if we are to help them. Best wishes. David