Ethics with Minors for North Carolina Mental Health Professionals: How to Navigate the Most Challenging Issues – Terry Casey

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Those of us who treat minors and their families experience a flood of emotions. There is confusion over changing ethical codes and laws, fear that the actions that we take will lead to long-term developmental damage, and anxiety that at any moment we might unintentionally cross a line that could jeopardize our professional license and put us in legal peril. In this environment, we can find ourselves impaired in our ability to function as professionals and help our clients.

Combining a step-by-step guide to an effective decision-making model, the most updated ethical codes and legal statutes, and lessons from 30 years as a clinician and ethics professor, Terry Casey, PhD, HSP will give you a solid foundation for evaluating the ethical options when working with minors and their families. You will have much more confidence about the course of action you take involving mandatory reporting, access to minors’ records, parental rights, boundary issues, touch, and others. 

1. Identify the five primary perspectives of the Multiple Perspective Model of ethical decision-making when working with minors.
2. Summarize the difference between consent and assent and how they apply to working with minors.
3. Apply ethics code and statutory requirements related to confidentiality standards to situations regarding minor clients.
4. Evaluate the potential ethical courses of action to take in situations involving minor clients, using the Multiple Perspectives Model.
5. Explain the state laws that govern mandatory reporting and how these impact ethical decision making in clinical practice.
6. Evaluate current clinical practice policies to ensure adequate protection involving issues of boundaries and physical touch.

WHY WORKING WITH MINORS IS DIFFERENT

• Vulnerability and power differentials
• Federal and state laws outlining legal responsibilities
• Issues involved with older adolescents

CONSENT RULES AND ISSUES INVOLVING MINORS

• Consent vs. assent
• Who can provide consent?
• Parental rights and consent rules
• Special rules for older adolescents
• Informed consent process

WHEN A MINOR IS (AND IS NOT) A CLIENT

• When does an individual become a client?
• Personal representatives
• Ethical vs. legal considerations

CONFIDENTIALITY STANDARDS AND LIMITS WITH MINORS

• Limits of confidentiality
• Communications with minors and parents
• Progressive scenarios technique
• Parental agreements

PARENTAL RIGHTS…AND WRONGS

• Default rights
• Special situations
• Exceptions

CONTROL OF MINORS’ RECORDS

• Health care vs. educational records
• HIPAA vs. FERPA
• Who has access?
• Responding to requests for records
• Clinical records and psychotherapy notes

CAUGHT IN THE MIDDLE OF DIVORCED PARENTS

• Informed consent process
• Parenting plans
• Other legal considerations
• Case example

MANDATORY REPORTING: THE “WHAT”, “WHEN” AND “TO WHOM”

• Mandatory reporting laws
• Federal definition of child abuse
• State laws
• Ethical considerations
• Case example

BOUNDARY ISSUES WITH MINORS

• Social media policies
• Multiple relationships
• Power differentials
• Virtual relationships
• Texting and messaging
• Case examples

PHYSICAL TOUCH

• When it is appropriate, and when it is not
• Informed consent
• Organizational policies
• Case example