#MICHIGAN LAW THERAPIST DUTY TO INFORM CODE#

Standard 4.01, 'Structuring the Relationship,' states that 'Psychologists discuss with clients or patients as early as is feasible in the therapeutic relationship.the nature.of therapy, fees, and confidentiality.' Standard 4.02, 'Informed Consent to Therapy,' states that when an individual cannot provide informed consent (such as a minor), psychologists 'consider such person's preferences and best interests.' Standard 4.03, 'Couple and Family Relationships,' states that psychologists 'attempt to clarify at the outset (1) which of the individuals are patients or clients and (2) the relationship the psychologist will have to each person.'

#MICHIGAN LAW THERAPIST DUTY TO INFORM CODE#

Can our Ethics Code ease the apparent tension between law and clinical practice? Still, she struggled with whether she had an obligation to disclose something to Michael's mother.Įthics. Michael's therapist shared her concerns with Michael about these activities and about what she perceived to be his excessive fear that his mother 'couldn't know anything about' these activities. Michael insisted that his mother not hear any of this. Michael's first sexual experience occurred when, after a rave, he followed home a girl whom he had recently met and entered her bedroom through a window. On several occasions he and a friend shoplifted snacks from a local 24-hour convenience store. In his junior year, Michael began to experiment with drugs at all-night parties ('raves') attended by his high school classmates, which he was able to attend by telling his mother he was spending the night with a friend. Michael wished to continue therapy in high school, but did not want his mother involved and did not want his therapist and mother speaking unless he were included in the conversation. As the therapy progressed, contact between Michael's mother and his therapist occurred only as needed. Telephone contact between mother and therapist continued while Michael was in middle school, but lessened as Michael began to feel he had more control over the nature and timing of visits. Michael's mother wanted help in deciding whether Michael should go for each scheduled visit. At the outset of psychotherapy, Michael's mother and his therapist had frequent telephone and in-person consultations. Michael's mother, to support Michael's relationship with his father, adhered to the visitation plan strictly, but her son's anxiety and physical complaints worried her. Michael, age 8, developed headaches and other signs of anxiety around visits to his father, who divorced his mother several years earlier. A paradox thus arises: Good clinical treatment may require what the law generally refuses, that is, a zone of privacy.Ĭonsider the following vignette (identifying information has been changed): As a child grows into adolescence and adulthood, the surrounding zone of privacy should increase, thus making room for a more defined sense of self and a greater sense of autonomy. An important aspect of treatment is to foster an individual's autonomy, and a great pleasure of treating adolescents is to watch as they come to enjoy their growing independence.

From a clinical perspective, the situation is more complex. Until that time, the law will normally give the parent access to the child's treatment.Ĭlinical practice. This state of affairs changes when the minor reaches the age of majority.

The exceptions are few, however, and prove the rule that the law deems individuals under a certain age (often 18) not sufficiently mature to make treatment decisions.Ī parent who consents on the minor's behalf generally has the right to know the content of the child's treatment. Certain states allow minors whom the law deems especially mature, such as those who are married or in the armed services, to consent to treatment, and sometimes minors may consent to treatment for substance abuse or sexually transmitted diseases. Minors generally cannot consent to treatment a parent or guardian consents on the minor's behalf. The law is a blunt instrument, as the issue of minors and confidentiality well illustrates. Does the APA Ethics Code provide guidance?Ī: It is most helpful to consider this question from three perspectives: that of law, of clinical practice and of ethics. What to do when an adolescent becomes sexually active, of course, is often a difficult issue. The issue seems especially pointed when adolescents talk about activities that, while not necessarily dangerous, are illegal, such as shoplifting, the recreational use of alcohol or experimenting with drugs. With adolescents, though, I sometimes struggle with whether to share information with a parent. When treating young children, the issue rarely arises. Q: I work with adolescents, and am not clear about my ethical obligations concerning confidentiality.

Michigan law therapist duty to inform