Minor consent for treatment is a topic I get questions on multiple times per week as an LCSW coach. So what is informed consent?
Informed Consent Definition
Informed consent is defined as the process for getting formal permission for treatment and services before engaging in treatment with a client(s). What makes minor consent for treatment so challenging is that rules and laws surrounding informed consent for minors vary state to state and this is a national exam. While you are licensed by your individual state, the licensure exam is the same across all 50 states. Because this is a national exam, it doesn't test specific state laws. The exam does recognize that some laws vary state to state (like the age of consent for treatment and at what age parents can access their child's records).
How to approach informed consent questions regarding minors on the exam
Because the age of consent for therapy varies state to state, if you get a question about this and there is an answer to refer to state/local/jurisdictional laws, that is a good answer option to go with. Beyond that, you want to keep in mind that even if you feel sharing information could be damaging, you still have to follow local laws (if that is an answer option). If there is an answer to follow local/state laws, that is what you want to go with.
Factors to consider when getting minor informed consent
The age at which a child/teen can consent varies state to state. In some states, no one under the age of 18 can consent for their own mental health treatment and a parent or legal guardian must consent to treatment. In other states, children as young as 12 can consent to their own treatment if the clinician deems them capable of such consent.
If a minor gives consent for their own treatment, generally parents cannot access their records without permission from the minor client. On the other hand, if the parents of a minor are the ones who consented to treatment, they have a right to access their child's records. You always want to cover this with the parent and child/adolescent at the beginning of treatment so that all parties are aware of what will be shared and what will be kept confidential between the therapist and the minor (this is especially important when working with adolescents). As children move into their teenage years, there is often an increased desire for privacy; so it is even more important to be very clear with all parties on what will be shared with parents and what will be kept confidential.
Below is a FREE ASWB practice question regarding minor consent to treatment. Let’s see how you do!
ASWB Practice Question:
A social worker meets with a 14-year-old client who shares with the social worker that she is pregnant. She does not want her parents to know she is pregnant. The social worker practices in a jurisdiction where social workers are required to share this information with the parents of a minor child. What should the social worker do FIRST:
A. Maintain confidentiality per the client’s request
B. Maintain confidentiality due to safety issues that may arise if the parents are informed of her pregnancy
C. Inform the client that she is required to disclose this information with the client’s parents
D. Inform the client’s parents of the client’s pregnancy
(Scroll down for answer)
Answer and Rationale:
The correct answer is C. While we may want to honor our client’s self-determination and her wishes to have confidentiality maintained (A), the question stem specifies that the social worker practices in a jurisdiction where we must inform the client’s parents of her pregnancy. Despite our own beliefs about this, we are required to follow the law. (B) is incorrect because nothing in the question stem states that a safety issue is present regarding telling the parents. While her parents will need to be informed of her pregnancy (D), telling the client about this (C) should come first. Additionally, we should explore with the client how she wants her parents to be informed; she may want to be a part of this rather than the social worker disclosing this on her behalf.
ASWB Masters and Clinical Exam Preparation
Hopefully, this month’s blog on minor informed consent has you feeling ready to tackle questions around this top on your LMSW and LCSW exams. Our program provides more practice with these types of questions. If you haven’t already signed up for one of our ASWB exam prep programs, we encourage you to check out some of the testimonials of the thousands of social workers who have passed their exams using our programs. If you need more information for your specific state, check out our social worker license broken out by state.
One of the things I loved about TDC when I was a customer (and as a coach today!) is that every customer has access to a coach they can email with questions anytime they arise during the exam prep process. Are you ready to PASS your exam with CONFIDENCE?
Hello! For the purpose of the ASWB exam, what would occur if a 16-year-old female tells the Social Work that she is pregnant? Do I keep it confidential or tell the parents? Also, what occurs if disclosing the information to the parents will cause distress or harm to the minor client? Thank you :)
You would be looking for an answer option to follow jurisdictional regulations, as this is going to vary state to state (and the exam is national). If that isn't an answer option, you would typically help the client work on disclosing to her parent(s) if it were not a safety issue.
If social worker has a client that is an 11 yr old boy who informs that his father sexually abused him. The social worker reports this to CPS. The father request the child's records. What should the social worker do? Should she discuss the records first then show the records to the father? Tell the father the records need to be court subpoenaed? Refuse to give the records because it could be a health and safety risk to your client?
This is one of those rare situations where you would likely not share the record with the parent and document the risk to the client as the reason. If it is court ordered, then it would need to be shared.
Hi, what if the client is a 14-year old female and she discloses this information in California? Thank you!
I can't speak to specific CA law (I don't practice in CA and don't have that information); the LCSW exam is national and specific state laws are not tested.
Are there legal repercussions to reporting teen pregnancies to parents? Can social workers be sued for violating confidentiality? Can there be disciplinary action taken by the licensing board for violating confidentiality? In the context of school social work, can a district punish or fire a social worker who fails to report to parents?
This is where it is really important to know and follow your state's laws around this topic. This would vary state by state.