When your adolescent or teen seeks treatment for depression, privacy and confidentiality issues are at the forefront of everyone's mind. Bound by legal and ethical issues, mental health providers, parents, and teens face a unique challenge of dealing with privacy and confidentiality issues during mental health treatment.
Parents and Caregivers
As a parent of an adolescent or teen, you are faced with a dilemma of wanting to be an active part of her life and recovery, but also fostering her growing autonomy and need for privacy.
Like many parents of depressed teens, you may feel confused and frustrated by her withdrawn attitude and lack of communication. Sometimes, your teen's provider may seem like the only person who is able to communicate with her, so that is who you look to for information.
In most cases, as a parent of a depressed teen, you must consent for her to receive mental health treatment. Additionally, you will have the right to access the content of your teen's treatment. Typically, boundaries of confidentiality are discussed with your child's provider before treatment has started, as there may be certain topics that you want to be made aware of, or that you feel are better kept private between your child and her provider.
Mental Health Providers
Mental health providers who treat adolescents and teens are often faced with the challenge of creating a trusting and therapeutic alliance with their teen clients, while reassuring her loved ones at the same time. Creating a therapeutic alliance with a client is largely based on trust, which can be especially difficult when a teen suspects that everything she says is getting reported back to her parents.
Providers look to find a balance to make both their clients feel secure and respected, and families aware of important issues. As such, your child's provider may make recommendations for the boundaries of privacy and confidentiality based on your family's dynamics.
Your Teen
As your child grows and matures, so does her need for privacy. It is no wonder that many teens are resistant to therapy or medical treatment, knowing very well that their privacy and confidentiality is limited. Teens may be hesitant to share important issues about relationships, sexuality, substance use, or other possibly illegal or dangerous behaviors in treatment, understanding that they may get back to a parent.
Additionally, your teen's natural need for privacy may be compounded by her depression symptoms, making her feel misunderstood and judged -- and overall less likely to share her thoughts and feelings.
Making It Work
It is important that families and providers work together to find an acceptable confidentiality agreement that adheres to laws and ethical standards.
- Allow your teen to be an active participant in negotiating the boundaries of confidentiality. As part of her growing autonomy, allow her to have a voice and negotiate appropriate boundaries for privacy in treatment when possible.
- Consult your teen's provider. Presumably, you have selected a provider who you trust and respect, so ask for their suggestions and recommendations. Providers who work frequently with teens have experience with issues of family privacy and confidentiality.
- Consider family counseling. In addition to your child's prescribed depression treatment program, you might consider family counseling as a way to facilitate communication as a family unit.
There is no perfect way to handle confidentiality and privacy issues with teens. The most important part of your teen's depression treatment is her recovery. Working together as a family and with your teen's provider will assure that everyone receives the respect that they deserve.
Sources:
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.
Robert J. Gregory. Psychological Testing: History, Principles, and Applications, 4th Edition. Boston, MA: Pearson Education Group, Inc.; 2004: 583.
Stephen H. Behnke, JD, PHD, Elizabeth Warner, PsyD. Confidentiality in the treatment of adolescents." Monitor on Psychology. March 2002; 33(3): 44.
