CONFIDENTIALITY

With these new HIPAA laws we seem to have become confused about what is to be held in confidence.  I see so many teenagers in therapy I get to hear all their righteous indignation about things.  A common complaint, especially among girls, is that they tell a parent a "secret" and then the parent talks to their friends about it. This feels like a violation of trust for the teenagers.    I always tell them that the parent needs someone to bounce things off and I believe this to be true.  I also tell them that they should not ask their parents to keeps secrets from the other parent.  It is bad role modeling for them, to lead them to believe it is okay to keep secrets from your spouse.  All of that being said, when a teenager tells you something in confidence it is important to respect their issues of privacy and not talk to others about it.  This plays out as a trust issue between kids and their parents.  It is also a way that teenagers establish some boundaries for themselves in a healthy manner.  Since our role of parent is to model the kind of behavior we hope our children will emulate when they are adults we need to see this a good role modeling.  

I hope you summer is going well.  Sherri

Comments

[Marty]

What exceptions to this "Confidentiality" might there be..? What if your teenager tells you about suspected unprotected sex, suspected drug use, suspected theft, suspected cheating, etc? They "should not ask their parents to keeps(sic) secrets from the other parent." But, what about talking to another child or parent..? To get more information. Even therapists, doctors, attorneys, mediators, etc, have exceptions/limits to confidentiality. Generally I agree with you. Also children of divorce in split households sometimes get "bad role modeling" and are impliedly or expressly encouraged to keep "secrets" from the other parent. Likely not positive role modeling for the future... Thanks for the thoughtful posts.

[Sharon Cook, LCSW, LMFT]

Your comments are well taken. I should have been clearer. When our teenagers tell us things that put them in harms way we need to make the appropriate actions to protect that child or as you suggest another child. I was really writing about parents that tell their friends, almost like gossiping. That is the violation of trust for the teen. I appreciate your thoughtful comments. Thanks for writing. Sherri

[C. Dwayne Shafer, MD, PhD]

I once faced the situation of a "new" UTI in a 16yo patient. When I walked in with the results, I asked, "How long have you been sexually active?" She responded, "You can tell that from the Urinalysis?!" "Yes," I replied. She confessed that she had recently had become sexually active, under extreme pressure from a boy friend (who was a popular athlete in High School). I faced treating the UTI, and whether to report what Texas considers statutory rape. After several days of agonizing, I went to her father, a good friend of mine, and told him of the situation. The girl was relieved from the pressure, the father did not press statutory rape charges, and the girl was able to break-up with the "boy-friend" without his slander of her. All-in-all, I feel that I did the best for her, and all parties responded well to the decisions they faced. Some situations are not cut-and-dried. I do most consider most non-sexual matters as confidential, unless the young person brings the parent into the room for the interview and exam.