Tips to explain confidentiality to children

Understanding the concept of confidentiality

Confidentiality is the principle of keeping sensitive information private and ensuring it is not shared without consent. It is a crucial element in many fields, particularly in healthcare, where patients must trust that their personal details will be kept secure. Legally, healthcare providers are required to protect patient information, and failure to do so can have serious consequences. In this context, confidentiality helps foster trust and allows individuals to openly communicate about their health, ensuring they receive the best possible care.

Confidentiality helps protect patients' privacy, facilitating a trusting environment that enables open communication. Most adults have a basic understanding of confidentiality in healthcare and are usually comfortable sharing information with practitioners. However, this is not always true for children.

Explaining confidentiality to a child can be difficult, so finding out the best way to inform them of their rights regarding confidentiality is necessary. This can be a complicated conversation to raise, but it's a critical aspect of developing a trusting relationship. Regardless of whether your young client is learning anger management, emotional regulation, unlearning risk behaviors, or any other intervention skill, teaching them about confidentiality should always be a priority.

Confidentiality in a medical health setting

Confidentiality has specific legal regulations that dictate what information can and cannot be shared. These regulations ensure that patients' privacy is always protected, enabling them to be honest without fearing that information will be passed on to unauthorized individuals.

There is a very strict code of ethics that is taught to all practicing healthcare physicians, including confidentiality. If practitioners are found to be in breach of these ethics, there are serious consequences, including fines and, if the breach is deemed severe enough, even a loss of license. If you think your patient isn't aware of these confidentiality rules, then informing them early into treatment is a good idea. This will help show your patient that you have their best interests at heart and are bound by ethics to maintain their privacy.

It is also important to understand variations in rules so as not to break confidentiality. For example, confidentiality and privacy become slightly more complicated depending on the age of your patient. There is a certain age when adolescents are allowed to consent to mental or medical healthcare without parental consent, but this age differs between states.

As a licensed practitioner, it is your responsibility to be aware of this age and inform your patients of their rights. Whether you specialize in therapeutic activities for teens and kids, work with children with autism, or are in a medical health field, understanding these regulations is an essential component of treating young people.

Additionally, there are certain situations where mandatory reporting is a requirement. These include if the practitioner suspects child abuse or if they are genuinely concerned for the health and safety of the patient or others.

Importance of confidentiality during therapy

As a therapist in mental health counseling, you may find that confidentiality impacts your work more significantly than other healthcare fields. Often, therapeutic work requires patients to be extremely open about their emotions and thoughts, which can be very challenging, particularly for children. As such, it is your responsibility to ensure your patients know they are in a safe and confidential environment, where the things they say won't be reported back to both the parents.

If you are a therapist specializing in treating children, you will likely be aware of how important trust is in the counseling process. Instead of assuming that your patients immediately trust you, you must demonstrate that you are trustworthy and have their best interests at heart. One of the best ways to do this is to explain how confidentiality works in your first session with a new patient. 

There are certain situations where confidentiality is revoked, and mandatory reporting takes its place – relevant to severe situations such as a child experiencing abuse, self-harm, or suicide intent.  In every other instance, maintaining the privacy of your patients should be your absolute highest priority.

Tips to Explain Confidentiality to Children

Sometimes, it can be challenging to explain how confidentiality works. You want to make sure your explanations are coherent and simple enough to be understood. Still, at the same time, your patients must have a comprehensive understanding of how confidentiality applies to their sessions with you. To help you navigate this difficult process, we have a few tips and strategies that you can easily employ:

Understand the laws and regulations of your state

Specific regulations regarding confidentiality differ between states. Any breach of confidentiality laws will have legal repercussions for the practicing therapist, so you must have a sound understanding of what laws apply to your work.

Involve the patient

Although, in most situations, minors aren't able to give informed consent for medical treatment, they should still be involved in clinical decision-making processes. To help develop a child's coping skills in monitoring their health, you should keep them engaged in the care delivery process. Giving children the opportunity to participate in the decision-making process is, therefore, both reasonable and ethical. As your patient gets older, you will likely find their ability to participate in these discussions increases significantly, and you should adjust your treatment method to suit their intellectual and emotional capabilities.

Inform your patient of the limitations of confidentiality

After you explain what confidentiality is to your patients, you should inform them of the limitations of these laws. This will ensure that your patients are informed and aware of what information may be shared with other parties, including healthcare practitioners and family members.

Remember that informed consent is a process

Obtaining informed consent for a child patient will involve the child's parents or guardians. You should keep in mind that consent should be an ever-occurring conversation that involves the minor as well. This means that every time there is a reasonably significant change to the treatment plan or intervention for the patient, you should have another conversation with the relevant parties and obtain informed consent.

Take home message

Navigating professional therapeutic relationships with young patients can be challenging: situations including working on anger management, developing a safe environment, encouraging questions, and informing them of their confidentiality rights aren't always as easy as you want them to be. However, the key to any good relationship is communication skills, and provided you consistently inform your patients of the rights afforded to them, there's no reason why these conversations wouldn't go smoothly. We recommend developing your understanding of how confidentiality works and then applying your knowledge to your conversations with patients. Therapy should be an environment where patients feel safe and comfortable, and fostering a positive relationship begins with you.