Anonymous wrote:

Anonymous wrote:From legal.perspecrive, The only way for a minor teen to get alcohol or drugs is via child abuse by someone, so I don't understand how it's legal for mandatory reporter like a therapist to keep it secret.

???

Or from a friend. Or sampling parents’ alcohol after they’ve gone to bed. Plenty of ways to get alcohol without “child abuse.”

Use your common sense. Kid isn't discussing a sip of beer with a therapist. An alcoholic kid is at the end of chain where some adult is doing something wrong to a childm

Anonymous wrote:14:15 follow up. And if they are using in such a way that I AM concerned with their actual physical safety (i.e., them dying) then I remind them of the exceptions to confidentiality and again push for THEM to lead the disclosure, but if not acknowledge that my #1 job is to keep them safe, and as such either they or I need to disclose in order to initiate a safety plan.

How is it possible to not be concerned about them dying? It is impossible for a minor to obtain drugs from a verifiably trustworthy source.

14:15 follow up. And if they are using in such a way that I AM concerned with their actual physical safety (i.e., them dying) then I remind them of the exceptions to confidentiality and again push for THEM to lead the disclosure, but if not acknowledge that my #1 job is to keep them safe, and as such either they or I need to disclose in order to initiate a safety plan.

Psychologist here. As a general rule, I have a similar policy. However, if in my professional opinion the use exceeds casual experimentation (i.e., negative consequences or functional impairment are repeatedly occurring), I will encourage the teen disclosing to the parent, and offer to participate in the discussion. I always do this from a place of concern, helping create a safe plan, etc. as opposed to an air of "I'm gonna tell on you."

This is tricky legally. They have to tell you if your child is harming him or herself and at risk of killing him or herself. Especially with drugs today, even pot could kill you thanks to fentanyl. If the therapist knew your kid was smoking weed and he died of a fentanyl overdose you would have a case. So, I think that therapist is making a mistake. The ideal situation is for the therapist to help create a situation where you come into the session, your child shares the substance use and the therapist helps you process it and respond.

Anonymous wrote:The above posters are correct. The only time a therapist may break confidentiality is if the teen is suicidal or a danger to others.

Nope. There are three major areas to which confidentiality does not apply:

-Danger to self or others
-Potential harm to a child or vulnerable adult
-Certain legal situations

It's unlikely that drug/alcohol use would fall under these criteria. I'd like to think the therapist in question has the judgment to determine when it could become an issue requiring disclosure. Those situations aren't common, but the blanket "I don't tell..." isn't ideal.

Anonymous wrote:Why would you want to derail your child’s therapeutic relationship with her therapist? Isn’t the goal for the therapist to help the person with their psychological issues? Imagine if you substitute spouse for child - would you want your therapist telling your spouse something you shared in a therapeutic setting? Those boundaries exist for a reason.

A spouse is so not the same as a minor child.

We understand the concept of trust (child-to-parent, child-to-therapist) but at the end of the day, we are the parents and are responsible physically and financially. Ages 14-18 are a very grey area, it seems, esp according to the medical profession. They want us to pay for services but don't want us necessarily involved in the process....until they do. They cannot have it both ways. And, if illegal activities (and underaged drinking and drug use definitely are!) are discussed, we really want to know about them.

If we suspect use, we will test. If confirmed, we would also ask the therapist and, if they knew, they can choose to (a) tell us they knew and withheld it, (b) lie about knowing, or (c) admit it and offer to broker a joint (no puns intended!) discussion between all of us. Choices (a) and (b) would have us seeking a different professional. It's a fine and delicate line sadly in situations that seldom lend themselves to subtlety.

Why would you want to derail your child’s therapeutic relationship with her therapist? Isn’t the goal for the therapist to help the person with their psychological issues? Imagine if you substitute spouse for child - would you want your therapist telling your spouse something you shared in a therapeutic setting? Those boundaries exist for a reason.

Our therapist is the same and I think she's fantastic. She made it clear that if my teen is in actual danger she will inform me, but beyond that any talk of drugs/alcohol/sex is between them. And she has had me in a few sessions for areas that she thought I needed to be a part of (with my chid's approval) so I trust her to reach out when it seems appropriate.