Ethical challenges: considering practitioner & stakeholder perspectives on consent & confidentiality

Working with young people, particularly within schools, is complex work for practitioners, both ethically and legally. Little is known about the process by which psychologists and counsellors determine the capacity for young people to provide their own consent for services, such as the role that context and client characteristics plays. Much of the literature focuses on this issue in the medical domain rather than the psychological domain. Further, research has rarely considered parent and teacher expectations of practitioners who work with young people in schools. Aim: The aim of this research was to gain insights into practitioner perspectives and the similarities and differences compared with teacher/parent expectations to inform training of practitioners. In doing so, this research explored whether the perspectives of these groups were congruent or not, to identify and potential sources of conflict. Description of Empirical Methods: This paper presents findings from an Australian study of 108 practitioners and 107 parents/teachers working with young people. Participants of both groups responded to vignettes of young people engaging in therapy who may or may not have the capacity to consent for themselves, and where information may need to be disclosed to other parties. Quantitative analyses of differences were conducted. Results, Outcomes & Implications Responses provided insights into practitioner reasoning and decision-making processes when facing ethical dilemmas with young people as clients. Responses also highlighted teacher and parent attitudes to young people's autonomy in the counselling process. This study demonstrated that parents and educators have differing perspectives and expectations in regards access and knowledge of adolescents using school psychology services. Conclusions: As key stake holders in the lives of young people, these perspectives of the role of school psychologists’ practice when working with young people is essential to understand. Findings from this current study highlight that there is a difference between these group expectations; and highlights a need for more transparency between parties to avoid conflict arising because of differing perspectives. This paper will explore current practice, highlight common challenges for practitioners, and consider the implications for ethics training of pre-service and inservice practitioners.   Keywords: Consent; confidentiality; capacity; mature minors