Yorkville University

The Case

• For the past two months, you have provided counselling services to Tammy, a 14-year-old girl with Type 1 diabetes.
• Prior to coming to see you, Tammy had been to three other counsellors in the last year, all of whom she quickly dismissed as “idiots.”
• Although a very reluctant participant initially, the therapeutic alliance with Tammy has strengthened over time to the point where she often discloses very personal information.
• Tammy’s parents are thrilled that their daughter has finally found a counsellor she likes and trusts.
• During your most recent session, Tammy hints that she drinks heavily at parties.
• When you probe further, Tammy quickly retracts her comments and changes the subject.
• Repeated attempts to get her to say more about her drinking get nowhere.
• You are very concerned about Tammy's medical safety if she misuses using alcohol regularly.

The Standards of Practice

From p. 16:

B2. Confidentiality

Children and Confidentiality

Counsellors/therapists who work with children have the difficult task of protecting the minor’s right to privacy while at the same time respecting the parent’s or guardian’s right to information. Counsellors/therapists can be assisted in such dilemmas by the following considerations:

• Parents and guardians do not have an absolute right to know all the details of their child’s counselling/therapy, but rather, each request should be evaluated on a ‘need to know’ basis.
• As a child grows and matures, the parent’s right to know will diminish and may even terminate when the child achieves the capacity and sufficient understanding to give informed consent.

From p. 20:

Children and Persons with Diminished Capacity

The parents and guardians of younger children have the legal authority to give consent on their behalf. However, the parental right to give consent diminishes and may even terminate as the child grows older and acquires sufficient understanding and intelligence to fully comprehend the conditions for informed consent. Counsellors/therapists should be vigilant to keep themselves informed of their statutory obligations with respect to the rights of children, including their right to privacy and self-determination commensurate with their ability and with regard to their best interests.