CONTENTS

About This Course

Table of Contents

1. School Bullying: What It Is and Why It Hurts
2. The Role of Bullies, Victims, and Witnesses
3. Factors Contributing to Bullying and Violence
4. Screening and Assessment
5. Treatment For Children and Adolescents
6. Prevention and Intervention
7. Legal and Ethical Issues

Supplements
Case Studies
Fact Sheets
References
Resources

The ABCs of Bullying
Addressing, Blocking, and Curbing School Aggression

Mental Health Professional's Obligations to Clients

What are the obligations of mental health professionals with their adolescent clients? This question can be examined from three perspectives: legal, clinical, and ethical.

• The Law. Under the law, minors (usually defined as those under 18) cannot consent to treatment. A parent or guardian is needed to consent for them. Certain states allow some exceptions for minors who are married, in the armed forces, and in cases where the minor is seeking treatment related to sexually transmitted diseases or substance abuse. The exceptions are rare.
• Clinical Practice. From the clinical perspective, however, a mental health professional's obligations to clients who are minors are complex. A clinician aims to empower adolescents to attain autonomy, responsibility, and independence. Privacy is an aspect of independence. So instead of an adolescent's privacy increasing as they mature and age, the law says it should decrease or disappear.
• Ethics. This issue is complex and could warrant an entire course. All licensed mental health professionals are covered under a code of ethics. This code includes issues of confidentiality and informed consent, and also should specify cases when there are exceptions. However, there are some clear principles therapists can keep in mind. These include:
  
  
  1. The clinician needs to make a judgment call as to what extent maintaining an adolescent's privacy is central to the treatment.
  2. The clinician needs to weigh the disruption to the therapeutic process that disclosure would entail. This is especially true if the adolescent was not told beforehand that the information needed to be shared. It usually makes both clinical and ethical sense to discuss with the client what information will be shared, and when.
  3. Adolescents need to understand, up front, the limits to confidentiality as discussed above.
  4. Many behaviors of adolescents do not fall in the clear range of reportable activities, though some may be right on the edge. In this case, the clinician needs to make a judgment call (with full knowledge of state mandatory reporting requirements) and use consultation freely.
  5. There may be times when a parent requests information that the therapist feels would be better kept confidential for the treatment or health of the patient. A refusal may be legally allowed, though the professional should consult with an attorney and colleagues.

Adapted from:
Excerpts from APA Monitor, Volume 33, No. 3 March 2002
By Stephen H. Behnke, J.D., PH.D., and Elizabeth Warner, P.S.Y.D.