Confidentiality and Disclosure Dilemmas in Psychotherapy with Adolescents

Dr. Adam Fried
Dr. Adam Fried

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Psychologists who provide mental health services to adolescents and their families must navigate complex ethical challenges with respect to confidentiality and disclosure decision-making.

How do mental health clinicians develop confidentiality policies that serve to protect minors from serious harm, fulfill professional and legal responsibilities, and preserve the therapeutic relationship with the adolescent and parents/ guardians?

Fordham University Center for Ethics Education Assistant Director Dr. Adam Fried is the editor of the ethics column of The Clinical Psychologist, a publication of the American Psychological Association (APA) and addressed that subject in his most recent column.

Fried’s third column addresses confidentiality and disclosure ethical dilemmas in psychotherapy with adolescents.

“Confidentiality policies and disclosure decisions always require careful ethical analysis by clinicians,” Fried writes in his column. “Disclosure dilemmas related to treatment with adolescents and their families may raise unique ethical concerns and seemingly competing moral principles.”

“Therapists may understandably experience tension when confronted by difficult disclosure decisions that require consideration of both professional/ legal obligations and the adolescent’s expectation to privacy (as well as the potential impact to the therapeutic relationship that may be associated with disclosure),” he continues. “Therapist promises of absolute confidentiality, while intended perhaps to help clients and/or facilitate positive therapeutic change, may in actuality endanger the safety and well being of clients, threaten the integrity of the professional work, and place the psychologist at increased professional liability risk.”

Dr. Adam Fried is the Assistant Director of the Fordham University Center for Ethics Education, and the Director of the M.A. in Ethics & Society and Interdisciplinary Bioethics Minor.

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