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Clinical Supervision: Models, Role, Legal & Ethical, Cultural Competency, & Transference
Environmental Manipulation Treatment Approach
This broad treatment approach, however, raises some confidentiality issues. The supervisee, as a matter of good practice, makes clear to both the child (if he or she is old enough) and the parents the type of rapport the supervisee will have with each. The supervisee in this situation is working with persons who are directly responsible for the patient and who can assist in the treatment. Parents, after all, are legally responsible for their children.
There are times, however, when it may be necessary to dismiss the parents and to rely on others. The parents may not be rational about the treatment of their child. We have all encountered parents who deny treatment to an acutely ill child or who are otherwise devastating to the child’s development.
Many people have expressed the view that such laws would be useless without a clause protecting them from retaliation by irate parents or guardians who are investigated. Hence, the laws that have been enacted contain provisions protecting those reporting against any civil liability that might arise out of compliance with the statutory requirement. By involving children, parents, and the legal system, the question becomes where do you draw the line of confidentiality and with whom?
Consider custody cases and other cases involving minors - it is often quite difficult to establish, to the satisfaction of a judge, that parents are so cruel to their children as to warrant judicial action, or when such a fact is established, there is little the court can do about it (except remove the child from custody of the parents). While the court cannot command good parenthood, social casework in conjunction with legal action may sometimes help.
As you know, it may happen that abusive parents will not bring their child to therapy for fear of a report, or they may take their child out of therapy should abuse be reported. When making a judgment call regarding abuse or possible abuse, the rights of the child regarding confidentiality may be in conflict.
Child Abuse Law
Although this law is only a partial answer to the problem of child abuse, it is helping to illuminate the startling size of the problem. There are many answers to the question of how to stop the problem of child abuse.
Once the child is found, it is up to the whole network of community agencies, which exist for the protection of children, to assume their appropriate roles in being sure that the child is kept from being either killed or maimed by any further action on the part of his parents.
Recent reports show that there is at least a 50/50 chance that a beaten child will suffer further damage if vigorous action is not taken on his behalf. If it is necessary to remove him permanently from his home, another home must be found. What is urgently needed now is a general public understanding that these services must exist in every community.
The problem of child abuse is not a simple one. Of course, if the child's parents can be rehabilitated, every effort should be made to be sure that they receive all the help they can use. But, the basic need is to protect the child. In this involvement of a whole network of community agencies and removal from the home, confidentiality risks increase.
Use of a Case Study to Teach an Ethical Thought Process
Susie, age 12, tells the supervisee during a session that she has been sexually abused by her father. Susie immediately breaks into tears as she fears the supervisee will report it. The first response of the supervisee should be to:
The best answer is A. The question was, "What should be your first response?" The possible case of abuse will need first to be verified. Once it is verified the steps outlined in B, C, and D can be considered.
Juvenile Court Philosophy, Mental Abuse, and Psychological Age
What Should Parents Know? Civil Parental Liability
The requirement that a therapist notify the parents of all minors who consult the therapist would destroy service at once. As a consequence, student health services, for example, usually treat students as though they were adults.
In addition, records of the juvenile court are not open to public scrutiny. Under traditional juvenile court philosophy, a veil of secrecy is drawn over its proceedings and records.
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