Discussion: Ethical Issues in Child and Adolescent Counseling

Ethical Issues in Child and Adolescent CounselingName:
Institutional Affiliation
Summarize the main ethical issues that differentiate child and adolescent counseling from adult counseling.
Decisional competence. Whereas adults are considered legally competent to make their own decisions in regards to psychotherapy, children and adolescent only bear limited or no legal expertise whatsoever. The judicial system assumes adults to be more competent (de facto), but considers adolescents and children as people who have not attained the age of legal majority incompetent or de jure. Hence, in many situations, minors are not legally capable of making health and privacy decisions.
In contrast to adults who are legible in consenting in matters to do with psychotherapy, children and adolescents rarely seek counsel on their own will or accord. In many cases, authority figures decide on when and why a child’s or an adolescent’s behavior needs to change. In short, psychotherapy consent or permission emanates from parents or legal guardians when it comes to children and adolescents.
Confidentiality. In comparison to adults who enjoy utmost confidentiality during counseling, children and adolescents confidentiality considerations during counseling are limited to important secrets.
Competing interests. As opposed to adult counseling which entails voluntary single or dual relationships, children and adolescent counseling is somewhat forced and involves multiple-relationship model. There are a plethora of interested parties for the former, who might have pressed for their enrolment to psychotherapy.

Use what you have learned from the child development readings to discuss how development impacts ethical issues in child and adolescent counseling.
Cognitive development affects the decisional competence of children and adolescents. Children below the age of seven years are classified as pre-logical in that they possess little adult idea of cause and impacts ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/j.chc.2007.07.008”, “ISBN” : “1056-4993 (Print)\n1056-4993 (Linking)”, “ISSN” : “10564993”, “PMID” : “18036477”, “abstract” : “Core ethical principles for the conduct of psychotherapy with children and adolescents transcend times, trends, and jurisdictions. Advances in technology, variations in state law, and the evolution of federal law should stimulate consideration of how these ethical principles apply to new situations; however, the guiding compass remains the psychotherapist’s obligation to create and protect the integrity of the psychotherapeutic space to provide the child or adolescent the freedom to identify, examine, explore, and hopefully resolve the issues that bring one to treatment. Boundaries, privacy, confidentiality, and the patient’s autonomy are components of this space. Together, they reflect a basic respect for the patient central to professional conduct and essential to any effective treatment process. u00a9 2008 Elsevier Inc. All rights reserved.”, “author” : [ { “dropping-particle” : “”, “family” : “Ascherman”, “given” : “Lee I.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Rubin”, “given” : “Samuel”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Child and Adolescent Psychiatric Clinics of North America”, “id” : “ITEM-1”, “issue” : “1”, “issued” : { “date-parts” : [ [ “2008” ] ] }, “page” : “21-35”, “title” : “Current Ethical Issues in Child and Adolescent Psychotherapy”, “type” : “article”, “volume” : “17” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=574c7769-c0a0-40d3-98e0-246d9c3dc64f” ] } ], “mendeley” : { “formattedCitation” : “(Ascherman & Rubin, 2008)”, “plainTextFormattedCitation” : “(Ascherman & Rubin, 2008)”, “previouslyFormattedCitation” : “(Ascherman & Rubin, 2008)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Ascherman & Rubin, 2008). Their ideas are primarily based on immediate perception hence they tend to be intuitive and very inconsistent. Past the age of seven, the views of cause and effect become more concrete, and as from the age of twelve, children’s understanding of abstract ideas becomes more concrete ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1097/00004583-199205000-00002”, “ISSN” : “08908567”, “PMID” : “11643000”, “author” : [ { “dropping-particle” : “”, “family” : “FASSLER”, “given” : “DAVID”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Journal of the American Academy of Child and Adolescent Psychiatry”, “id” : “ITEM-1”, “issue” : “3”, “issued” : { “date-parts” : [ [ “1992” ] ] }, “page” : “392-397”, “title” : “ETHICAL ISSUES IN CHILD AND ADOLESCENT PSYCHIATRY”, “type” : “article-journal”, “volume” : “31” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=d2c32de5-67ac-4735-853a-48a63bb9b930” ] } ], “mendeley” : { “formattedCitation” : “(FASSLER, 1992)”, “plainTextFormattedCitation” : “(FASSLER, 1992)”, “previouslyFormattedCitation” : “(FASSLER, 1992)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(FASSLER, 1992). Adolescents are more developed cognitively. Therefore, it is necessary to value their ethical values such as confidentiality and consent during psychotherapy. Also, the moral development also impacts ethical issues in children and adolescents. Piaget in his book Moral Judgement of the Child points that children pass through two stages in their moral development namely; moral realism and moral relativism ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/S0079-7421(08)00408-8”, “ISBN” : “9780123744883”, “ISSN” : “00797421”, “abstract” : “We review how the construct of the moral self has arisen within moral development theory and discuss the search for integrative linkages with other domains of psychology, including personality. Next, we describe moral personality and then programs and approaches to developing moral identity in children. Moral schema development and moral information-processing research is outlined, including mapping expert-novice differences. Finally, we conclude with two emerging integrative theories, one on educational intervention for moral skill development and the other a neurobiological model of moral functioning which draws on evolutionary themes in the development of a moral brain.”, “author” : [ { “dropping-particle” : “”, “family” : “Narvaez”, “given” : “Darcia”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Lapsley”, “given” : “Daniel K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “The Psychology of Learning and Motivation”, “id” : “ITEM-1”, “issue” : “08”, “issued” : { “date-parts” : [ [ “2009” ] ] }, “number-of-pages” : “237-274”, “title” : “Moral Identity, Moral Functioning, and the Development of Moral Character”, “type” : “book”, “volume” : “50” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=129303a6-9b54-4675-b4b4-33f2839b704b” ] } ], “mendeley” : { “formattedCitation” : “(Narvaez & Lapsley, 2009)”, “plainTextFormattedCitation” : “(Narvaez & Lapsley, 2009)”, “previouslyFormattedCitation” : “(Narvaez & Lapsley, 2009)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Narvaez & Lapsley, 2009). This transition begins at the age of seven and eight. Before these stages, parents have the right to give ethical input in all the four ethical consideration. Past this age, however, psychologists, as well as other interested parties, should take into account the information or concerns of children during counseling.
Choose one of the brief case examples provided in the Koocher article and describe your reaction to it. What is especially painful about this pattern? Do you agree with the author’s recommendations regarding how to respond to this situation? Why or why not?
Example: – Parents bring a 10-year-old to treatment at the behest of school authorities, concerned about the child’s behavior. The parents ask the psychologist to help solve the school behavior problem, but specify strict limits on communicating with the school.
The problematic aspect of this example is the fact that the psychologist might be on the school’s payroll. Yes, I agree with Koocher’s recommendation because to alleviate the potential conflict of interest, the therapist should encourage full disclosure before the treatment process starts.
If you were to face an ethical dilemma (a situation involving two or more competing ethical principles that required you to respond most ethically) while counseling a child or adolescent, what tools and resources would you use to help you?
Psychotherapy consent forms.
The use of separated records.
Obeying the law of practice to the letter.
Reflecting on your values, attitudes, and beliefs, what ethical aspects of child and adolescent counseling would you find most challenging?
Dealing with parents who seek to impose their preferences on their children against their will and in objection to their (children) reasonable choices.
Dealing with racist parents who are against their child dating or forming friendships with persons of a different race.
Holding onto the ethical confidentiality clause when a minor or an adolescent is about to engage in dangerous sexual activity with persons over the age of 18.
How are cultural issues (race, ethnicity, gender identity, etc.) related to professional ethics when counseling children and adolescents?
Economic background: Social class and roles influence patients’ development hence impacts their identification with their strengths and problem expression during the counseling process ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1146/annurev.psych.60.110707.163651”, “ISBN” : “978-0-8243-0260-3”, “ISSN” : “0066-4308”, “PMID” : “18729724”, “abstract” : “Cultural competency practices have been widely adopted in the mental health field because of the disparities in the quality of services delivered to ethnic minority groups. In this review, we examine the meaning of cultural competency, positions that have been taken in favor of and against it, and the guidelines for its practice in the mental health field. Empirical research that tests the benefits of cultural competency is discussed.”, “author” : [ { “dropping-particle” : “”, “family” : “Sue”, “given” : “Stanley”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Zane”, “given” : “Nolan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nagayama Hall”, “given” : “Gordon C.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Berger”, “given” : “Lauren K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Annual Review of Psychology”, “id” : “ITEM-1”, “issue” : “1”, “issued” : { “date-parts” : [ [ “2009” ] ] }, “page” : “525-548”, “title” : “The Case for Cultural Competency in Psychotherapeutic Interventions”, “type” : “article-journal”, “volume” : “60” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=3bd26387-9f85-4dac-a2b3-3d611138cd64” ] } ], “mendeley” : { “formattedCitation” : “(Sue, Zane, Nagayama Hall, & Berger, 2009)”, “plainTextFormattedCitation” : “(Sue, Zane, Nagayama Hall, & Berger, 2009)”, “previouslyFormattedCitation” : “(Sue, Zane, Nagayama Hall, & Berger, 2009)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Sue, Zane, Nagayama Hall, & Berger, 2009).
Sexual or gender identity also impacts personal development ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1037//0012-I649.37.4.45I”, “ISBN” : “1939-0599”, “ISSN” : “0012-1649”, “PMID” : “11444482”, “abstract” : “This study examined the relations between components of gender identity and psychosocial adjustment. The aspects of gender identity assessed were (a) feelings of psychological compatibility with one’s gender (i.e., feeling one is a typical member of one’s sex and feeling content with one’s biological sex), (b) feelings of pressure from parents, peers, and self for conformity to gender stereotypes, and (c) the sentiment that one’s own sex is superior to the other (intergroup bias). Adjustment was assessed in terms of self-esteem and peer acceptance. Participants were 182 children in Grades 4 through 8. Felt gender compatibility (when operationalized as either self-perceived gender typicality or feelings of contentment with one’s biological sex) was positively related to adjustment, whereas felt pressure and intergroup bias were negatively associated with adjustment. The results provide new insights into the role of gender identity in children’s well-being, help identify sources of confusion in previous work, and suggest directions for future inquiry.”, “author” : [ { “dropping-particle” : “”, “family” : “Egan”, “given” : “Sk”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Perry”, “given” : “Dg”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Developmental psychology”, “id” : “ITEM-1”, “issue” : “4”, “issued” : { “date-parts” : [ [ “2001” ] ] }, “page” : “451-463”, “title” : “Gender identity: a multidimensional analysis with implications for psychosocial adjustment.”, “type” : “article-journal”, “volume” : “37” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=86f3e7d0-90b4-4f77-9720-5e1dd14f8aa6” ] } ], “mendeley” : { “formattedCitation” : “(Egan & Perry, 2001)”, “plainTextFormattedCitation” : “(Egan & Perry, 2001)”, “previouslyFormattedCitation” : “(Egan & Perry, 2001)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Egan & Perry, 2001). For instance, children who are or have been oppressed because of their sexuality exhibit reduced the sense of self-worth.
Racial identity also affects professional ethics because some children or adolescents might be experiencing ‘within group’ differences that influence their psychological development.
References
ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Ascherman, L. I., & Rubin, S. (2008). Current Ethical Issues in Child and Adolescent Psychotherapy. Child and Adolescent Psychiatric Clinics of North America. https://doi.org/10.1016/j.chc.2007.07.008
Egan, S., & Perry, D. (2001). Gender identity: a multidimensional analysis with implications for psychosocial adjustment. Developmental Psychology, 37(4), 451–463. https://doi.org/10.1037//0012-I649.37.4.45I
FASSLER, D. (1992). ETHICAL ISSUES IN CHILD AND ADOLESCENT PSYCHIATRY. Journal of the American Academy of Child and Adolescent Psychiatry, 31(3), 392–397. https://doi.org/10.1097/00004583-199205000-00002
Narvaez, D., & Lapsley, D. K. (2009). Moral Identity, Moral Functioning, and the Development of Moral Character. The Psychology of Learning and Motivation (Vol. 50). https://doi.org/10.1016/S0079-7421(08)00408-8
Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The Case for Cultural Competency in Psychotherapeutic Interventions. Annual Review of Psychology, 60(1), 525–548. https://doi.org/10.1146/annurev.psych.60.110707.163651