When it comes to treatment for depression, confidentiality in children is a very important part of the process. In general, it is more straightforward the younger a child is, as younger children naturally have less autonomy from parents and caregivers.
Initially, as a parent or guardian, you will have to consent to treatment for your child. In certain emergency situations, a health provider may have to treat a child without parental consent, if unavailable. However, in the majority of cases, a treatment plan will be discussed in-depth with the family, and consent will be obtained.
Before the onset of treatment, the mental health provider will typically explain the limits and laws of confidentiality, and discuss the boundaries of confidentiality. The boundaries include what information providers and parents agree will be kept private between your child and provider, and which information will be disclosed to you.
Younger children receiving mental health treatment typically receive less traditional "talk therapy" and more play therapies, like role playing, drawing and paying games; or treatment with medication. Given this, privacy concerns for children are less common than for adolescents and teens.
When Your Child Is Resistant to Treatment
It is important to remember that some young children receiving depression treatment may shape their responses to a therapist in order to please a parent, or may be concerned about punishment for what they reveal. This may be easily handled by talking to your child before the onset of treatment and explaining that she will not be punished for what she shares. You may also encourage her to be open and honest in her treatment, and reassure her that she will not be judged.
If despite your efforts to assure and encourage your child to be open and honest, she is still reluctant to productively share, you may want to allow her to keep certain things private between her and her provider. The boundaries of confidentiality can be negotiated in an ongoing way with your child's provider. After all, the most important part of your child's treatment is creating a safe relationship that can help facilitate her recovery from depression.
Potential Ethical Violations. American Psychological Association. Accessed: December 02, 2010. http://www.apa.org/topics/ethics/potential-violations.aspx
Rachel Hodgkins. "Postcards From a New Century: Children and Confidentiality. The British Journal of General Practice. May 2001: 422-424.
Stephen H. Behnke, JD, PHD, Elizabeth Warner, PsyD. Confidentiality in the treatment of adolescents. Monitor on Psychology. March 2002; 33(3): 44.