Challenges related to confidentiality when the psychotherapy client is a child or adolescent

Full Answer Section

     

• Legal Mandates: In some jurisdictions, there may be legal requirements for reporting certain types of information, such as suspected abuse or neglect.

Suggestions for Resolving Challenges:

• Clear Communication: Establish clear expectations about confidentiality at the beginning of therapy, including any limitations due to legal requirements.
• Involve Parents: Encourage parents to participate in therapy sessions whenever possible, but also respect the child's right to privacy.
• Obtain Informed Consent: Obtain informed consent from both the child or adolescent and their parents, ensuring they understand the limits of confidentiality.
• Document Decision-Making: Maintain detailed records of discussions regarding confidentiality, including any decisions made about disclosure.
• Seek Consultation: If faced with a complex ethical dilemma, consult with colleagues or supervisors for guidance.

2. Changes in the DSM

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has undergone significant changes since its original edition, reflecting advances in our understanding of mental health conditions. Some key changes include:

• Increased specificity: The DSM has become more specific in its diagnostic criteria, leading to a more refined classification of mental disorders.
• Removal of disorders: Some disorders have been removed from the DSM, reflecting changes in our understanding of mental health.
• Introduction of new disorders: New disorders have been added to the DSM to reflect emerging research and clinical observations.
• Shift towards dimensional approach: The DSM-5 introduced a dimensional approach for some disorders, recognizing that mental health conditions exist on a spectrum rather than as distinct categories.

3. APA Code of Ethics: General Principles vs. Ethical Standards

The APA Code of Ethics outlines the ethical principles that psychologists must follow in their practice. The General Principles provide a broad framework, while the Ethical Standards offer more specific guidelines. General Principles:

• Beneficence and Nonmaleficence: Psychologists strive to benefit their clients and avoid doing harm.
• Fidelity and Responsibility: Psychologists establish trust with their clients and fulfill their professional responsibilities.
• Integrity: Psychologists are honest and truthful in their professional relationships.
• Justice: Psychologists treat all individuals with fairness and respect.
• Respect for People's Rights and Dignity: Psychologists respect the rights and dignity of all individuals.

Ethical Standards:

• Competence: Psychologists practice within the limits of their training and expertise.
• Informed Consent: Psychologists obtain informed consent from clients before providing services.
• Confidentiality: Psychologists protect the confidentiality of client information.
• Fees and Billing: Psychologists are transparent about their fees and billing practices.
• Advertising and Public Statements: Psychologists are responsible for their public statements and advertising.

4. Testing for Learning Disorders

Clinical psychologists use a variety of assessments to test for specific learning disorders, including:

• Intelligence tests: To assess a child's overall cognitive abilities.
• Achievement tests: To measure a child's academic skills in areas such as reading, writing, and math.
• Neuropsychological assessments: To evaluate specific cognitive functions, such as memory, attention, and processing speed.
• Observation: Observing a child's behavior in the classroom and during standardized assessments can provide valuable insights.
• Interviews: Interviewing the child, parents, and teachers can help to identify difficulties and strengths.

5. Clinical Psychologists vs. Counseling Psychologists

While both clinical psychologists and counseling psychologists are mental health professionals, there are some key differences between their roles and training:

• Education: Clinical psychologists typically have a Ph.D. in clinical psychology, while counseling psychologists may have a Ph.D. or Psy.D. in counseling psychology.
• Focus: Clinical psychologists often focus on the diagnosis and treatment of mental health disorders, while counseling psychologists may focus on a wider range of issues, such as career counseling or relationship counseling.
• Licensure: The specific licensing requirements for clinical psychologists and counseling psychologists may vary by jurisdiction.

It's important to note that the distinction between clinical psychologists and counseling psychologists can be blurred in some areas, and both professions can provide valuable mental health services.  

Sample Answer

     

1. Confidentiality Challenges with Child and Adolescent Clients

Challenges:

• Parental Consent: Obtaining informed consent from both the child or adolescent and their parents can be complex, especially when there is conflict or disagreement between them.
• Minors' Rights: Balancing the minor's right to confidentiality with the parents' right to know about their child's mental health is a delicate issue.
• Risk of Harm: In cases where there is a risk of harm to the child or others, the therapist may have a duty to breach confidentiality.