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Confidentiality & Children

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Consider the below statements by Father Theodore Hesburgh, President, University of Notre Dame?

"My basic principle is that you don't make decisions because they are easy, you don't make them because they are cheap, you don't make them because they are popular; you make them because they are right. Not distinguishing between rightness and wrongness is where administrators get into trouble."

Such statements evoke images within me of those times when I felt as if I was in a dilemma of sort with confidentiality. Confidentiality is not always an easy concept in terms of working with children. Often students will talk with the school counselor, social worker, or psychologist because of the promise of confidentiality. Typically, they are told what they say will remain confidential, unless there is concern of suicide, homicide, or child abuse.

These are important points that may not be directly related to testing but worthy of mention in terms of maintaining confidentiality, which is directly related to testing. However, the bottom line is that the helper's general responsibility to maintain confidentiality might be waived when grave harm may come to the client or others.

Thus said, what should be done when a 13 y/o girl or boy confides that she or he is sexually active? Do we have a responsibility to inform the parents? Same reasoning regarding a revelation of substance abuse? What if a little girl or boy tells you that she or he is "gay." Do you tell anyone what the child shares with you? If so, then who do you tell?

There are many moments such as these in the psychological helping community, and responding is never easy. Standards? Ethics? Laws? Who do you serve, and when?

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Ethical issues involving confidentiality & children are explored in this post.

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Confidentiality & Children

This is an interesting topic and one which has raised a lot of debate within the psychological community and helping professions. There are many issues to think about when deciding when to break confidentiality, these include:

? What circumstances do we need to break confidentiality?
? How can we explain when we need to break confidentiality to our client?
? Who do we need to tell - why do those people need to know?
? What do we need to do to protect ourselves?

What circumstances do we need to break confidentiality?

You have stated that 'the bottom line is that the helper's general responsibility to maintain confidentiality might be waived when grave harm may come to the client or others'. This is a really important point and is generally accepted as the point at which we need to break confidentiality: when someone is may come to some harm (the client or another person). This covers harm to the self, others and harm that may be inflicted by another person (e.g., abuse). If a clinician feels that their client may come to harm then they have a duty to act.

Given the above let's think about the example that you gave: 'what should be done when a 13 y/o girl or boy confides that she or he is sexually active?' It is important that we have to think about all the different elements when deciding to break confidentiality. Let's think about the important things within this case:

? Firstly, being sexually active at this age is against the law - the young person and their sexual partner may get into trouble with the authorities for continuing to be sexually active.
? Who is the young person's sexual partner? Are they older? Is this an appropriate relationship?
? Is ...

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