Ethical Considerations in Counseling Adolescents

Counseling adolescents presents ethical issues. Many children and teenager who enter counseling have not yet reach the age of majority, reside in families that include other people with emotional difficulties, and attend school. Confidentiality is a frequent concern in work with children. Therapeutic confidentiality is key to effective treatment for numerous reasons, including building and having a strong therapeutic bond. Once you lose a child’s trust it’s hard to get it back. Staying within your boundaries allows you to ensure that are strictly to the point and to know limits are set. Boundaries are needed to be established on day one, letting clients know that crossing boundaries will not be tolerated. Another important ethical issue is the disclosure of client’s protected health information (PHI). Their information should be stored and kept in a lock location. When dealing PHI, you must make sure if your sending their document it goes to the person, you’re sending it to.

Keywords: Adolescents, confidentiality, boundaries, PHI

What are ethical issues in counseling adolescents? Before we can discuss the ethical issues in counseling adolescents, we must get to the source of where it begins. Usually In order for therapy to be effective, a client must have the option of revealing their considerations, feelings, encounters, and practices without judgment. They should be certain that their counselor won't share their information to outsiders. The ability to be vulnerable in therapy can support a strong therapeutic bond and can help a person recover more quickly. It is assumed that without confidentiality and legal privilege, the effectiveness of therapy will be compromised because the client will not disclose intimate and important information (Gustafon & McNamara, 1987, 503). Advantages of secrecy is allowing more participation in counseling.

Secrecy is one moral issue that we're confronting today particularly with teenagers and adolescents. A kid or teenager has little motivation to share feelings with their parents if there is no guarantee that it’s kept with them. Yet, frequently, the information they don't need revealed is the information that is most significant for them to seek in advising. If a kid can't securely unveil anything they desire, the counselor will not have enough information to comprehend what sort of assistance the child needs. Classified information can be utilized for a wide scope of direction harassing, showcasing, or taking an individual's personality. When working with minors, who are unable to give voluntary, informed consent, counselor’s take special care to protect the client’s best interest (Gustafon & McNamara, 1987, 503).

At the point when a minor has no privilege to secrecy from a parent, despite everything they still have an option to privacy from outsiders. The privilege to protection in treatment is associated with the privilege to agree to treatment. Since a kid can't lawfully agree to treatment, the parent often acts as a personal representative for the child. A parent has the right to request a child’s medical record. This may incorporate a child's analysis, symptoms, and treatment plan. However, the parent doesn't have the privilege to see treatment notes except if a court request generally. Now and again, a parent might not have the option to information about their kid's treatment.

When a parent has consented to an arrangement to regard the secrecy between the counselor and the minor guardians aren't permitted to have information about the child's treatment. At the point when a parent has lost or surrendered their parental rights for instance, the biological parent of the child would not have a right to treatment information. At the point when a court request explicitly disallows the parent from getting to the child information is another example of how a parent can't have the right to information about their child’s treatment. One of a counselor most significant moral obligations when guiding minors is to talk about confidentiality worries with the parent(s) and the child.

The counselor should be clear about the law and their very own privacy arrangements. A few counselors expect guardians to agree to a specific degree of secrecy, even when state or government law gives the kid less privacy rights. The conditions under which a counselor would reveal information the child partook in treatment should be talked about. At the point when guardians comprehend that secrecy is vital to successful treatment, they might be more eager to respect their child's requirement for protection. Numerous kids don't talk about challenging problems with their parents since they deal with judgment or discipline. At the point when guardians comprehend the significance of open correspondence, they might be less inclined to overreact. This can support better parent-kid connections.

At the point when a counselor accepts a child is in harm, they have a legitimate obligation to reveal certain information, even if when the child generally has an option to privacy. For instance, mandated reporters must uncover suspected child abuse to child protective services. Similarly, a counselor must act to protect the kid if they accept the child may participate in self-harm or hurt others. Even when a counselor must act to protect a kid, the counselor must utilize a conservative approach, unveiling just that information which is important and revealing just to the suitable individual or people. For instance, if a counselor fears a kid might design a school shooting, the counselor will be required to tell police or school specialists.

In any case, the counselor is required to protect the secrecy of other treatment details, for example, the kid's sexual direction or history of abuse. The obligation to caution others when a client represents a fast approaching risk can exhibit a few moral difficulties. Counselors should guarantee they comprehend state laws and their authorizing board's morals rules. Learning about one's obligations can settle on choices simpler during an emergency. Secrecy among clients and counselors for quite some time been thought of as fundamental to the restorative relationship.

Children's and adolescent's rights regarding confidentiality in the therapeutic relationship, however, are less clear. Minors are unable to give voluntary informed consent, and it is the psychologist's obligation to determine the best interests of the minor and to then take the necessary steps to protect those interests. Regarding the first implication, the word 'unable' suggests either that the minor is not afforded this legal privilege or that he or she lacks the developmental maturity or capacity to determine his or her own best interests.

[bookmark: _Hlk20093239]Increasingly, minors are legally allowed to pursue treatment without parental consent. Most jurisdictions allow minors to consent to treatment without parental knowledge in specific situations in which obtaining parental consent may jeopardize the likelihood that the minor will receive that treatment. These specific situations include counseling or medical care for sexual abuse, substance abuse, pregnancy, sexually transmitted diseases. The law has recognized four general exceptions to the requirement of parent consent for treatment of minors. The first, the 'mature minor' exception, pertains to minors with enough maturity to understand the nature and consequences of treatment (Gustafon & McNamara, 1987, 503).

The second, 'emancipated minor,' is basically minors who are legally entitled to the rights and duties of adulthood for reasons that vary from state to state. 'Emergency treatment' is the third circumstance in which parental consent is not necessary. It is assumed that parental consent is implied because of the urgency of the situation the final exception to obtaining parental consent is when treatment is court ordered (Gustafon & McNamara, 1987, 503).

Ethics is defined as a system of moral principles and rules of conduct recognized with respect to a class of human actions or a group (De Sousa, 2010). Ethical issues in child and teenage psychotherapy and psychiatry have been addressed by organizations related with child psychiatry, around the world. These principles and guidelines tie kid and immature therapists to a code that supports quality consideration for the correct treatment of children and teenager mental issues. These principles are fundamental for the improvement of kids, their families, and society on the loose. Securing the kid's protection can be a test as we work with guardians to find out about their child's improvement with regards to family dynamics; with the school to evaluate the child's instructive strengths and weaknesses, and with the justice system and other agencies to advocate for the kid's need.

The child and teenager therapist assume a fundamental job as the expert who coordinates, teaches, directs and advises the child and the family regarding the alternatives for treatment. A portion of the morals-based standards that apply to the act of child and teenager psychiatry are clear; most clinicians know about them and have an accord about them. For instance, rules against sexual contact or cruel or injurious treatment are encoded as 'limit infringement'. They depend on the acknowledgment that such encounters damage the child, contorting and harming the child's trust, confidence, and limit with respect to suggest connections.

Boundary violation is another ethical issue it has for some time been perceived that boundary violation by medical services experts represent a potential for danger to their clients. Boundary behaviors are defined as those behaviors or activities that mark the limits or parameters of appropriate, good, and ethical practice, including both structural and process (Lamb &Catanzaro, 1998, 498). Especially tricky limit practices incorporate social, monetary, or work environment associations with present or previous customers. Clinicians should consistently strive to improve a client's independence and freedom. Proper maintenance of treatment boundaries fosters autonomy and independence in clients, whereas progressive boundary violations restrict their freedom to explore and choose.

The significance of keeping up enough treatment limits up evident when one thinks about the idea of the therapeutic procedure. A huge collection of research has reliably indicated the nature of the restorative union as a basic factor in successful therapy result. Proper limits give an establishment to this relationship by cultivating a feeling of security and the trust that the clinician will consistently act in the customer's well-being. This establishment allows the client to create trust in the counselor and to transparently express mystery fears and wants without dreading negative results. Besides, setting up clear limits about what is and isn't satisfactory inside the therapeutic setting sets a standard for unambiguous correspondence among the counselor and client and diminishes the likelihood for misinterpretations of the specialist's messages, thought processes, and practices

The issue of physical contact with clients in treatment isn't effectively settled. On one side, a delicate, consoling touch or embrace can be the most suitable reaction at specific occasions or with specific clients. Then again, clinicians rehearsing such conduct risk having it interpreted as a lewd gesture, prompting undesired consequences for both the counselor and the client. There are cultural factors to be considered. For instance, in other countries where the predominant culture is French-Canadian, kissing on the two cheeks is a broadly practice as welcome among companions and even casual people. Ethical and legal boundaries are hard for clients and even therapists to comprehend or actualize since there is a great deal of wrongdoing. There are no black and white answers or perfect ways of doing anything in therapy. But there are common sense ways to protect everyone involved the right way.

When a therapist communicates his thoughts, feelings, beliefs, or behaviors to a client in a therapy session or therapy relationship, the therapist has crossed a professional boundary. However, it is important for all clients to carefully consider the situation because some therapists share details about themselves to develop a connection. Such an incident is known as self-disclosure. Some self-disclosure is good for building a long-lasting relationship with people. But there are those therapist-client relationships that cross the line and end up making the client the therapist and the therapist the client. I believe it is acceptable to develop a “friendship” within the proper bounds with clients. It is okay to use self-disclosure in appropriate moments.

It is alright to let our guard down as a counselor in the appropriate moment. It is just when limits are abused, client or counselor is disrespected, individual personal feeling become excessively close to home, and threat can result that issue is likely. One specific kind of violation, the sexual misconduct of mental health professionals, has received the most intense scrutiny, a scrutiny that is understandable given its potential for severe and enduring consequences (Smith & Fitzpatrick, 1995, 499). Some individuals believe that transference (when the client begins viewing the therapist outside of his or her professional role) and counter-transference (when a therapist reciprocates feelings of the client) can occur in which a therapist has crossed boundaries, making it difficult for a client to benefit from the transference because the therapist simply enjoys the confusion.

Believe it or not, some therapists end up abusing their power by taking advantage of clients. Some clients flirt with their therapists and therapists reciprocate. Some therapists come on to their clients. Either way, this is a great ethical and legal violation that can lead to total career loss. Some therapists allow clients to text or email them, while others text and email their clients.

This can become a big violation because clients may interfere with the personal lives of therapists or therapists may interfere with the lives of their clients. For me, email is for office hours only and for certain things. Texting is out of the question! But different therapists do different things. Constant texting or emailing should be a red flag. As a counselor you should know your role and stick to the code of ethics. Not sticking to the boundaries in the therapeutic relationship can cause you to lose your career and hurt the client in the long run.

HIPAA is the Health Insurance Portability and Accountability Act of 1996. This law was passed to protect all medical and mental health information from “outsiders (Get help, 2019).” A therapist will make sure that he or she protects the clinical records of clients. Ensuring strong privacy protection is critical to keeping individuals’ trust in their health care providers and willingness to obtain needed health care services. These protections are especially important when sensitive information is concerned, such as mental health information.

Simultaneously, the Privacy Rule perceives conditions emerge where well-being data may be shared to guarantee the patient gets the best treatment and for other significant purposes, for example, for the well-being and security of the patient or others. The Rule is deliberately adjusted to permit uses and disclosures of information including psychological well-being data for treatment and these different purposes with suitable insurances. Proper storage and transfer of client’s information is fundamental, so paying little respect to whether your records are kept on paper or electronically is wrong. Any record containing client information should consistently be put away in a verified area and kept far out from unapproved parties. Unique consideration should likewise be taken when deleting records: essentially erasing a record doesn't adequately delete it from your hard drive and throwing a folded report in the trash doesn't hide the information from unapproved parties.

Disclosing public health information without authorization is one of the most common mistakes a provider can make. Talking with a friend about a mutual acquaintance under your care, discussing a patient with staff at the front desk, and even accidentally filing a document containing public health information in the wrong patient's chart could put you at risk for a breach. Sending client information to the wrong recipient, even if accidental, is also a violation. It should only ever be discussed in private settings with the people who need to know. All staff should be instructed to never discuss client’s information in an open setting and always verify that information is only being delivered to an authorized recipient.

In conclusion, to prevent ethical issues in counseling adolescents we must make sure that we’re respecting boundaries and keeping everything professional. Not only that we keep everything professional we must make sure that we keep everything confidential. A client information should never be disclosed, they’re putting their trust in us to keep everything confidential. Once you betray that trust it’s hard to get it back. For therapy to be effective, a client must be able to disclose their thoughts, feelings, experiences, and behaviors without fear of judgement. They must be confident that their counselor will not share this information with third parties. To avoid ethical issues, we simple just need to stick to the code of ethics and if we’re unsure if we are doing things ethically, we need to refer to it.

References

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