Mini Workshop 18 - Protecting Our Youngest Patients: Ethical Considerations in Child & Adolescent Therapy

As per the 2022 National Healthcare Quality and Disparities Report, 20% of children and adolescents in the United States (between the ages of 3 and 17) experience some form of emotional, developmental, or behavioral disorder. Even before the COVID-19 pandemic, suicide rates among high schoolers had increased by over 40% in the preceding decade.

While ethical dilemmas are inherent in the practice of child and adolescent clinical psychology, the escalating prevalence of mental health disorders among children and adolescents necessitates that clinical leaders and providers maintain a robust understanding of best practices that are supported by evidence. This is especially true when working with high-risk patients.

This presentation explores critical ethical issues encountered in various clinical settings while examining best practices for navigating these complex clinical situations. Through case presentations and clinical examples, we will address the unique challenges presented by high-risk patients and complex clinical situations. Furthermore, the presentation will delve into ethical considerations surrounding high risk patient considerations, responding to emergencies, and managing issues of confidentiality while working with children and adolescents. This presentation aims to provide attendees with practical guidance and ethical frameworks for navigating these complex issues in child and adolescent psychological practice.

Additionally, specific areas of focus will include (1) high-risk patient criteria, (2) treatment considerations, (3) evidence-based risk assessment, (4) safety planning, (5) responding to acute patient safety events, (6) trainee case determination and guidelines, (7) termination of care, and (8) best practices related to open notes. These topics will be presented and discussed in the context of clinical situations and supported by documents and experience via quality and patient safety team members from an academic medical center. Audience members will have an opportunity to discuss each topic and ask questions. Presenters will then guide audience participants to discuss these strategies in small work groups to better understand how to effectively utilize these strategies within their own practices.

Recommended Reading 1: Svensson, J. (2022). Patient safety strategies in psychiatry and how they construct the notion of preventable harm: a scoping review. Journal of patient safety, 18(3), 245-252.

Recommended Reading 2: Duncan, R. E., Hall, A. C., & Knowles, A. (2014). Ethical Dilemmas of Confidentiality With Adolescent Clients: Case Studies From Psychologists. Ethics & Behavior, 25(3), 197–221.

Recommended Reading 3: O’Neill, S., Chimowitz, H., Leveille, S., & Walker, J. (2019). Embracing the new age of transparency: mental health patients reading their psychotherapy notes online. Journal of Mental Health, 28(5), 527-535.