Adolescent Psychiatrist Questions Child & Adolescent Psychiatry

Patient privacy when it's a child being seen

If my child is being seen my a therapist or psychiatrist will I be told what is going on and what the treatment should be? Or will my child have to tell me? I don't think I will get accurate details from my child.

21 Answers

In my opinion, if it's a young child, it's wrong to exclude the parent. I believe one hour a week is nothing compared to the influence a parent has over a child all week long. I believe it's more important to educate the parent how to respond to the child than to treat the child.
If it's an older child, the law may protect the child's right to privacy.
If your child is under the age of 18, the therapist is ethically obligated to share information about your child's treatment plan, goals, successes. I include all of my parents in every session that I have. First, by asking the parent if there is anything new that we need to work on today and then following up with the parent prior to the child's session. I make sure though to also include the child in this follow up, as I do not want to lose the trusting relationship that I have built with them. My goal is not only to work with the child, but also build communication between the child and parent and not single either of them out.
Yes, it will be explained in detail for your child's treatment because your child is under your protection.
I definitely agree that most children simply do not grasp what their parents are concerned about when asking for an update on their therapeutic progress.

This question is hard to answer as it really depends on
A) state law (for example, CA gives psychologists the authority to determine whether it is in the child's best interest or would not harm the child to disclose confidential information to their parents that was obtained in session and also gives some preteens and teenagers the right to make decisions about their confidential medical or mental health records/information files under certain circumstances.
B) why or under what circumstances am I meeting the child for treatment can be vital information if it sets the context and content of our sessions together. If 1 parent is favored or elicits sympathy over the other parent during a custodial rights hearing.
C) management of parental expectations relative to their child's understanding of confidentiality and the child's wishes with regards to their confidential information being shared. For example, I would find out what the parents are expecting, demanding, or insisting on knowing about their child's session content and progress as well as assessing whether the child understands the implications of disclosing their confidential information or that they are displaying rational, age-appropriate, or developmentally-congruent behavior that does not warrant parental concern or involvement.

In other words, I handle this on a case to case basis but always prefer that parents trust my judgment to inform them about things they absolutely need to know, whether law enforcement or other agency intervention is needed or may become involved, and if there are easy, simple, or largely. inconsequential adjustments they can make to better support their child or improve their lives overall. I believe in transparency and being straight forward and honest with clients, which begins with a sincere effort at advocating on their behalf, especially regarding maintaining confidentiality.

Where at all possible, give your child and your child's therapist the benefit of the doubt.
Hi, how are you? The therapist has to disclose treatment options. The therapist does not or will not disclose what is told to him or her, ONLY if there is homicidal or suicidal ideation. Did that answer your question?

Sincerely,

Ayfarah M. Frangieh M.D, FAAP
While this answer may depend on what state you are in, my understanding is that a child under 18 does not have legal confidentiality, and the parent has the legal right to treatment knowledge. In any case, depending on your child's age, most therapists welcome active participation by parents, and would welcome your input and give you feedback. Ask for that before beginning your child's treatment.
That depends. I would speak to the therapist about that and your child. There is confidentiality rules so if your child does not want you to be told of the sessions, then the therapist should legally not tell you except in the case of concerns for harm to self or others
You should be informed by the child's treating provider about the treatment.
You, as a legal guardian of a minor have the right of knowing exactly what is happening with your child. They also have the obligation of keeping you informed and involved in his/her therapy all the way.
The therapist or psychiatrist, etc. should tell you what is going on and what is needed. If they don't, then ask them and if they still wont, then get another therapist or psychiatrist. A psychiatrist is often very busy and doesn't have the time as a therapist will have. Plus a psychiatrist is more apt to give out medications and have a therapist provide therapy.
A psychiatrist provides medication. A psychologist or psychotherapist assist with the emotional process. The answer to your question depends on the age of your child the doctor qualifications and type of treatment. Ask your child's therapist or the psychiatrist. They will provide you with the appropriate answer to you and your child's situation.
Best,

Dr. Claire PSY. D. Sent from iPhone
Definitely. Child therapy (not adolescents) heavily depends on parental involvement. Psychologists differ in treatment modality - some engage in parent-child therapy, while others in play or talk therapy with the child (depending on their age) with parent collateral meetings. Either way, you will play an integral part in the success of your child therapy. I encourage you to bring up these questions openly when choosing a psychologist, and make sure that you feel comfortable with their approach.

Good luck,
Dr. Hirshfeld
A great question!

Each state has different guidelines on when children can seek mental health treatment and be considered an adult in terms of their privacy. Ask the provider what the laws governing privacy in your state are.

For minors, what I do is discuss the law with the parents and child, but create a sense of privacy and safety for the child to be open so they do not feel like I am going to share everything with their parents. I let everyone know that there are certain things I must tell parents, such as anything dangerous or life-threatening going on, but I'd like to keep other less concerning things between the child and this writer. At the end of each session, I will provide an update on areas which we have all agreed is open for discussion. I know I can't develop a good relationship with the child if I am telling their parents everything; it's a balance that parents must learn to tolerate and trust.

I hope this is helpful.

Dr. Crone
Hello, in general if your child is under 18, you must provide written consent for the child to be seen. A good practice is for the therapist to discuss treatment options and goals with the parents. If it's a teen, they will not disclose details about therapy topics to build trust, but will speak with you if there is a serious concern/threat to life or safety.
The age of consent for mental health treatment is 14; so if the child is
under 14 then the therapist or psychiatrist can share information with
you. If the child is 14 or older, he or she has the right to give consent
(or not) for information to be shared, and the treating clinician would
need the client's written permission to do so.

Leslie Dalton
It all depends. How old is your child? If they are capable of demonstrating good insight and judgment, then likely it will be confidential and it should be. It’s natural for a mother to care about her child, however there is something called codependence, which is unhealthily.

Given that I do not know the age of your child or any consent forms signed, I cannot give you a direct answer. However, let’s make an assumption that your child is 16 and deemed competent, has appropriate insight and judgment, then they have the right to confidentiality.

Your heart is in the right place, however sometimes children need to express their feelings in a way they feel comfortable which is where confidentiality comes in. You can certainly ask your child and be there as a parental figure and not their therapist. Also, if deemed competent legally, your child has a right to confidentiality and does not have to tell you, but they may decide to on their own volition.
Some of this will depend on the age of your child. In general, the therapist will mostly see the child alone. Before starting therapy, establish with the therapist how he will communicate with you.

- Will he update you briefly after each session?
- Will he meet with you and your child occasionally?
- Will the entire family need to attend some sessions?
- Are you able to call or email him between appointments for updates?

If you are already in therapy, and don't know the answers to these questions, ask to talk with the therapist for 5 minutes at the beginning of the next appointment.
It would depend on the therapist, the child's age, the nature of the treatment contract, etc.
Dear Patient Privacy,

Child therapists usually handle this issue based on a few factors: state law, the kid's age and ability, the specific concern, and the therapist's work style. For younger children, many therapists keep parents informed about the developments in therapy that occur, when the parent is not present. For tweens and teens who may be addressing issues that are hard to talk about with a parent, the ground rules may be different.

Each state has laws that govern what rights a child and a parent have to manage information and privacy. Because of this, the age a minor can assume responsibility for their information differs depending on where you live and where the therapy is taking place. In some cases, psychiatrists get written permission from a parent to prescribe medication for a minor.

It is usually helpful for the parent and therapist/psychiatrist (and often including the child) to have a discussion about what will be updated to the parent and how. Agreements will differ based on the child's age, your local laws, and the issue being addressed. When looking for a therapist or psychiatrist, this is one of the areas you can ask them about as you are interviewing possible providers. Many child mental health workers also have an informal agreement made between the child and parent about how information will be disclosed as the therapist may feel this is important to help develop trust and a good working relationship with the child.

Sincerely,

Todd Koser, Psy.D.
NJ & PA Licensed Psychologist
Parents have to be involved when their child is being treated.
Usually, the psychiatrist or psychologist will share all information. Until the child is a preteen or teen, then they need to ask permission from the child.