How should confidentiality be handled when working with a minor?

• A. Parents have no rights to information; therapist withholds all information
• B. Parents/guardians have rights to information, but therapists may withhold certain information to protect the minor, and assent should be obtained when appropriate; confidentiality boundaries and exceptions explained
• C. Therapist must disclose all information to parents
• D. Assent is not necessary; only parental consent matters

Answer: (B)

When working with a minor, confidentiality is about protecting the child’s privacy while recognizing that parents or guardians have a stake in and access to information about their child’s care. The therapist explains clearly what will be kept confidential and what will be shared, and sets boundaries and exceptions up front. The best approach also respects the minor’s developing autonomy by seeking assent whenever appropriate and involving the parent or guardian in information-sharing decisions, while still protecting the minor’s safety and well-being. In practice, this means that parents/guardians generally have rights to information, but the therapist may withhold or carefully limit certain details to protect the minor, and assent from the minor should be sought when appropriate; all confidentiality boundaries and exceptions should be explained so the minor understands what could trigger disclosure. This approach balances parental involvement with the minor’s trust and rights, and it aligns with safety and reporting requirements that may require disclosure in specific circumstances.