Confidentiality with Children

Another set of circumstances has to do with the treatment of minors.  It is always our policy and practice to not work in isolation with children.  We recognize that we can increase our effectiveness when working with children by involving and working closely with other major institutions and significant people in a child’s life.  This includes such people as teachers, family physicians, pediatricians, pastors, and of course, parents.  When working with caregivers who are not parents or guardians or custodians, it is our practice -- as described in the NPP -- to always have parents or guardians or custodians sign an Authorization to speak with those parties. 


We have also come to recognize that in working with minors, children also benefit from a sense of privacy, that they may explore feelings and experiences themselves in a comfortable and safe environment.  Another facet, then, of this Agreement, is that in signing this agreement are indicating that you, as parents, understand and agree that you will not have access tospecific or detailed information about what happens in your child’s sessions.

On the one hand, we do not work with children in isolation.  We assume and expect that if we are working with your child, you will be involved in treatment as well.  We will keep you apprised of general themes, clinical progress, attendance of sessions, and various issues that have to do with your child’s welfare and progress and needs.  Sometimes we will meet with your child alone, sometimes with you alone as parents, and sometimes with you and your child (or children) together for family sessions.  Our hope is to foster a collaborative and trusting relationship with you as parents.  However, on the other hand, it is not our practice to disclose detailed summaries of what transpires in your child’s sessions, such as details or specific questions about things he or she may have said, as it usually is not therapeutically necessary to do so, and it also has great potential to undermine the therapeutic relationship with your child (e.g., they won’t talk to us!). 

Should anything come up in the course of therapy that we think they need to address with you, we will instruct and encourage them to do so.  If they are not willing to do so, we will not force them, and we will not “go behind their backs” and tell you ourselves.  Rather, we will try to work with them to get them to the place where they do feel comfortable telling you.  It has been our experience that that process is more important than the issue they didn’t want to talk about in the first place!  Of course, should we ever come upon anything with your child that had to do with concerns for safety or dangerousness to self or others, we would most certainly let you know.