Adolescents, Risk Behaviour and Confidentiality: When Would Australian Psychologists Breach Confidentiality to Disclose Information to Parents?

Abstract

The protection of confidentiality in psychological practice is vital. However, confidentiality is not absolute and psychologists are permitted to breach confidentiality under particular circumstances. Ethical challenges surrounding confidentiality are complex with adolescent clients, as assessments often consider the risk that adolescents pose to themselves in addition to the risk posed to others. The current study documented situations in which Australian psychologists would breach adolescents' confidentiality to disclose information about risk behaviour to parents, with a focus on situations where adolescents posed a risk to themselves as opposed to other people putting adolescents at risk. A total of 264 Australian psychologists were surveyed online. They were each presented with 68 variations of a vignette about a 15‐year‐old boy who was engaged in risk behaviour and were asked whether they would breach confidentiality in each case. The vignettes covered six behavioural domains (smoking, sexual behaviour, drinking, drug use, suicide, stealing) and varied in behaviour intensity, frequency and duration. Consensus was reached about breaching confidentiality in 16% of cases (related to sexual behaviour, drug use, and suicide). Consensus was reached about not breaching confidentiality in 41% of cases (relating to smoking, sexual behaviour, drug use, suicide, and stealing). In the remaining 43% of cases, significant disagreement occurred (relating to all six behavioural domains). The findings suggest a high degree of variation in opinion about confidentiality with adolescents, emphasising the importance of transparent communication and informed consent. The findings also raise questions about how important consistency of psychological practice is across Australia.