Case Study
Patient Demographic: Client Age: 12 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual Counseling Presenting Problem: Withdrawn and Avoidant Behavior Diagnosis: Undetermined
Mental Status Exam: Mental Status Exam: The client appears oriented to person, place, time, and situation. The client is dressed appropriately for the weather and appears to be maintaining appropriate hygiene. The client was withdrawn for most of the session but was able to open up slightly about what was going on with
Presenting Problem: You are a licensed therapist working in private practice. A 12-year-old female client comes into your office for the intake session and is accompanied by her parents. The client’s parents report that their daughter has been withdrawn and has refused to return to school for the past 6 school days. The client is avoiding eye contact with anyone and is slouching with her arms crossed. You try to engage the client in open questions to initiate the intake session with her, and she does not answer you or look at you. You ask her if privacy would make her more comfortable, and she nods, so you ask her parents if they would mind waiting in the lobby, and they agree. The client continues to refuse to talk about school, but she does engage in conversation with you about other topics.
Other Contexts:     her. Family History: The client says that she has a good relationship with her parents. She says that they are encouraging and supportive of her. The client says that she has a younger brother who is 6 years old and an older brother who is 16 years old. The client states that she has a good group of friends and spends time with them regularly.  Following the session, the client’s parents ask you for the details of your session with their daughter

Question: Following the session, the client’s parents ask you for the details of your session with their daughter. What would be both the most ethical and clinically appropriate response?
(A): You respect your client’s right to privacy and tell the parents you do not think it would be best for treatment to share information without the client’s consent.
(B): You ask the client if you can talk with the parents, and she says “no,” but you are able to talk with them anyway because she is a minor.
(C): First, you ask if you can talk with the client for permission and encourage the parents to provide their daughter with the space to speak freely during sessions.
(D): The parents have a right to all information because the client is a minor, so you meet with them to discuss the details of the session.

Correct Answer: First, you ask if you can talk with the client for permission and encourage the parents to provide their daughter with the space to speak freely during sessions.
Explanation: You are balancing ethical and clinical concerns, and, in this situation, it is best for the client to be willing for you to talk with her parents and for the parents to accept a level of confidentiality for the client. If the client feels that she can talk with a level of confidentiality in the counseling sessions, then she is most likely to engage fully in treatment. The parents do have a right to all of the information, but this would not necessarily be clinically beneficial because the client may not trust you if you share all of the given information with her parents. If the client declines that you share information with the parents and the parents continue to request it, they do have a right to information, but it may not benefit treatment to do so. It is important to note that different states have different laws regarding the rights of minors in treatment. Therefore, the correct answer is (C)
Competency: professional practice and ethics