Parents of Children in Therapy

Many times a parent that has a child in therapy will want some time with the therapist to discuss their child's progress.  Although this in and of itself is not a problem, many parents go at it in a problematic way.  How a parent requests this time can say a lot about the parent.  A therapist must keep the child's best theraputic needs in mind when dealing with a parent who is requesting information.

First and foremost the limits of confidentiality between child, therapist and parent should be discussed at the beginning of the process.  Parents can be a part of the first session, or can meet with the therapist before therapy begins.  At that time, parents can address thier concerns and goals for therapy and the therapist can discuss age-appropriate expectations.  A therapist will need to reevalute the limits of their confidentiality constantly as issues arrise and children age.  The child's best interests need to be maintained.  Standard 4.01 on maintaining confidentiality does often permit paretns access to treatment records or disclosure of nformation in order to protect the child or others from harm.  Therapists need to work with parents and children to establish boundaries and to provide a trusting place for the child to feel heard and understood. 

That being said, parents need to respect the boundaries of their child's therapy.  It's not unusual for a parent to want to talk to the therapist before their child's scheduled time.  Most time they want to talk to the therapist and discuss the previous week's activities and things they want the therapist to address during thier session.  Sometimes the parent will try to do this in the waiting room.  Parents who do this are jeapardizing their child's confidentiality because other patients could be waiting and listening to the conversation.  A therapist would need to stop the parent from discussing their child in the waiting room.  Other times, a parent may insist on going into the therapy room and taking up some of their child's time with the therapist to discuss these issus.  Although they are not breaking confidentiality, they are disrespecting their childs time and theraputic space.  If a therapist would allow this, it would distort the child's freedom to begin the session on their own agenda, and could confuse the child on who the client truely is.

When a parent insists on talking to the therapist at the end of the session, it can be even more detrimental to the process.  If the therapist does allow the parent to talk to them after the session, the child can feel that everything they just told the therpist is then being relayed to the parent.  To do this, the therpist is harming the child's sense of trust.  The child could feel that the therapist is reporting to the parent and will not confide in future sessions. 

When a therapist enounters a parent who is so eager to disregard their children's boundaries, it can tell a lot about the child's environment.  For example, a parent that insists on taking up the beginning of thier child's session could have issues of envey of the attention being shown to their child by the therapist.  It could also show anxiety about the child's privacy with the therapist, possibly shedding light on the parent's own inadequecies.  Another option as to why a parent would insist on breaking through these boundaries could be that the parent is using the therapist to fulfill the role of an absent parent. 

The solution to satisfying a parent's need for time with the therapist, and not violating the child's theraputic space, is to schedule a time when just the parent can come in to discuss issues and progress.  Structuring a time that is seperate from their child's time will remain respectful to all parties involved and maintain a theraputic and safe environment for the child. 

Sources:
Decoding the Ethics Code 3rd Edition Celia B. Fisher (2013)

Ascherman MD., L.I., & Rubin MD., S. (2008) Current Ethical Issues in Child and Adolescent Psychology. Child and Adolescent Psychiatric Clinics of North America. (2008) Vol. 17, 21-35. retrieved online at http://web.up.ac.za/sitefiles/file/43/2561/childpsychotherapyethics.pdf