LIBERTY UNIVERSITY JOHN W. RAWLINGS SCHOOL OF DIVINITY
Counselor-client confidentiality
A Paper Submitted to
the Faculty of the School of Divinity
in Candidacy for the Degree of
Doctor of Education in Christian Leadership (Ed. D) Department of Christian Leadership and
Church Ministries
By
Mary Gracias
Lynchburg, Virginia
14/2022
Counselor-client confidentiality
What is said between a counselor and an individual client is confidential, even when the
client is a minor. But parents often want to be kept in the loop about their child’s progress in
therapy. This can put the counselor in a tricky situation, especially when the parents want to
control or influence the counseling process. The only scenario in which counselor-client
confidentiality can be broken is in situations that necessitate protecting the client or others
“from serious and foreseeable harm,” such as suicidal intent. (For more on this, see Standard
B.2.a. of the 2014 ACA Code of Ethics.)
Marcy Adams Sznewajs, a licensed professional counselor (LPC) who often works with
teenage and young adult clients at her group therapy practice in Beverly Hills, Michigan, says
she empathizes with parents who ask about what she’s covering in counseling sessions with
their child. However, she finds it helpful — and necessary — to offer a firm explanation of
counselor-client confidentiality whenever she begins counseling a young client.
Sznewajs says that she emphasizes to parents that she will let them know if their child
discloses anything that will put the child in danger. She also makes it clear to both parties that
she will only invite parents into the counseling sessions if the young client grants permission.
This conversation is often not what the parents want to hear, Sznewajs admits, but it is
important because it spells out the boundaries of what the counselor is obligated to tell the
parents and reassures the client that their privacy will be respected.
Sznewajs stresses to families that they all must trust the process for her work to be
effective. “It’s important for the teenager to trust an adult with these difficult thoughts and
feelings, and legally and ethically I have to keep it confidential,” says Sznewajs. “I’d be doing my
client a huge disservice [if I disclosed session details to the parents]. That’s not only unethical,
it’s damaging — and what does it teach the kid? That this person that you’re supposed to trust,
you can’t.”
The feelings behind the questions
Parents’ concerns and questions about the work their child is doing in therapy are often
rooted in fear, says Martina Moore, a licensed professional clinical counselor supervisor with a
mediation and counseling practice in Euclid, Ohio. Not only do parents worry that the
challenging behaviors that caused their child to seek counseling, such as rule breaking,
isolation, defiance or problems at school, will have negative long-term outcomes in the child’s
life, but they might also feel these issues are a reflection of their parenting abilities.
“Parents sometimes have such anxiety about their children it’s [gotten] to the point where
they are increasing their child’s anxiety,” notes Moore, president of the International
Association of Marriage and Family Counselors, a division of the American Counseling
Association. Although Moore makes a point to validate these fears with parents, she also
emphasizes that it’s good for the child to grow and build autonomy through counseling on their
own. She applauds parents for seeking help while explaining that she needs the freedom to
work with the child alone for the counseling process to work.
“I also spend time with parents to dig into what their fear is. They’ve come to counseling
[with their child], so they must believe that there is benefit in this process,” Moore says. She
emphasizes to parents that they need to trust the process. “I spend a lot of time with parents
getting their buy-in,” she notes. In addition to fear, parents may also struggle with strong
feelings of shame for having a child who is engaging in risky behavior and failing to thrive.
Le’Ann Solmonson, an LPC in Texas who has extensive experience working with children
and adolescents, says she makes a point to acknowledge and normalize parents’ feelings of
vulnerability and worry. If appropriate, Solmonson says she will sometimes disclose that she’s
experienced similar feelings when her adult children sought therapy.
“No parent is perfect, and you worry over feeling like they are talking [in therapy] about
what you’ve done wrong,” says Solmonson, the immediate past president of the Association for
Child and Adolescent Counseling, a division of ACA. “It’s a very vulnerable thing to have your
child go to counseling. You can’t help but feel that it’s a reflection on you as a parent and feeds
into fears that you’re ‘screwing your kids up.’”
Navigating the balance
Counselors often need to get creative and act diplomatically to keep parents in the loop
while maintaining young clients’ confidentiality and trust. When parents insist on being
involved in their child’s counseling, Moore negotiates with both the parents and client to find a
plan that they all agree on while staying within ethical boundaries.
This was the case for a teenage client Moore once counseled who had substance use
disorder. The parents were worried about their child and wanted to be involved in the
counseling process. Moore facilitated a discussion and, eventually, they all came to an
agreement that Moore would work with the teen alone but would let the parents know
whenever the client had a relapse or break in recovery, she says.
Keeping lines of communication open and having regular check-ins with parents is
beneficial to the counseling process with young clients, Solmonson notes. She often prompts
child or adolescent clients to identify one small thing they are comfortable sharing with their
parents at the conclusion of each counseling session, such a breathing technique they learned
or new words they discovered to describe their emotions. This keeps the parents in the loop
while ensuring that the client maintains control over the process.
When parents are left completely in the dark about their child’s work in counseling, it can
exacerbate worry, cause them to “fear the worst” and catastrophize about what the child might
be saying, Solmonson adds. Sznewajs notes that talking with young clients about keeping their
parents updated also provides the opportunity to check in with the client and ask what they
feel is going well. She sometimes begins by asking the client how they feel things are going in
counseling and transitions to what (or if) they would want her to share with their parents about
their progress.
Disclosure of life-threatening behavior
When a young client is engaging in risk-taking behaviors that are life threatening (i.e.,
suicidal actions, self-harm), ethically, parents need to be brought into the conversation, says
Hayle Fisher, a licensed professional clinical counselor and director of adolescent services at a
behavioral mental health provider in Mentor, Ohio. While this is crucial to do, it can also impair
the therapeutic relationship with the teen, she adds.
Fisher finds the vignettes in the 2016 British Journal of Psychiatry article “‘Shhh! Please
don’t tell…’ Confidentiality in child and adolescent mental health” particularly helpful for
examples on navigating these conversations. She keeps the following notes for herself, drawn
from that article, for situations when she must disclose a young client’s harmful behavior:
Tell the client what you (the counselor) are planning on disclosing to the parents, with
an emphasis on the full context of why you need to. Ask for their feedback on how they might
like to edit what you plan to say.
Talk through the potential benefits and costs of disclosing to the parents. Ask the client
how they feel about the disclosure and consider their views as you move forward.
Validate any fears the client may have about the disclosure, such as losing access to
resources and freedoms, feeling blamed or ashamed, or being concerned that the police or
social services will become involved.
To maintain trust and a therapeutic alliance with young clients, Fisher emphasizes that it’s
important for a counselor to give the client as much control as possible over how this
communication will occur. If the disclosure happens during an in-person session and the
parents are nearby, she gives the client the choice to either stay in the room or step out and
wait in the lobby when she invites the parent(s) in to tell them.
Fisher also gives young clients the option to tell their parents before she does. However,
this is only appropriate if the client’s risk of harm is not imminent, Fisher stresses. In this
scenario, she tells the client that she will call at a certain time the following day to speak with
their parents, check in and provide support for the parents and client. “This option is especially
powerful,” Fisher explains, because it “reinforces the adolescent taking accountability for their
actions, increases communication skills and fosters independence in the situation so they are
not dependent on the counselor for navigating conflicts with their parents.”
Sznewajs also takes a collaborative approach when it’s necessary to break confidentiality to
inform a client’s parent or guardian about harmful behavior or intent. She says she tries to take
the client’s feelings into consideration while modeling firm boundaries. Although not having the
conversation with the parents isn’t an option, client can choose how and when it happens,
Sznewajs explains. She offers to involve the parents in person, call them on the phone, do a
video chat during the counseling session or wait until after the session ends.
