In working with minors (things for parents/ guardians to be aware of): A minor client is under the age of 18, in which all legal guardians are required to give consent for treatment. Every therapist works differently, and every profession has a different set of ethical standards that they are required to abide by. Thus as an LCSW in Louisiana, I am ethically and professionally required to receive the “consent for treatment” to treat a child by both biological parents and/or legal guardians. There are some situations in which this is not required, and I will explain that below. The “consent of treatment” will consist of a verbal agreement (via phone or in person) and a handwritten release that will state that I can legally provide mental health treatment to your child. I also prefer both parents to complete a separate copy of my initial intake paperwork.
Disclaimer: I’m honestly not a difficult therapist to work with. However due to a significant amount of lawsuits and legal/ ethical situations that are trending currently, I have to be diligent in this area. More often than not, working with children is frequently considered “high risk cases” especially if the parents are not together. High risk- meaning me being sued, complained about, or pulled into court.
It is imperative that one of the parents or guardians is present for the initial intake session. It is imperative that all initial paperwork is completed prior to the session, that insurance information be sent and verified, that I am updated if the insurance company changes, and that copayments are made. I am not comfortable with a minor being left at my office during session, unless consent is given for this. It is also not safe to leave children unattended in my office.
What to expect when I work with your child: I work in the clients “best interests.” I try to be accommodating and flexible in regards to if the child wants the parent to remain in the session. But the goal for the most effective treatment is a mixture of individual and family work. It typically takes at a minimum of 3 sessions for a child to feel comfortable with me alone for an entire session. It’s also my goal for your child to look forward to coming to therapy. I try to create a calm, open, and fun environment. Children communicate in different ways than adults. They often communicate through play, artwork, reading, journaling, storytelling, and other creative outlets. But please understand that there is a purpose and intent behind these activities. Your child may feel that they are coming to “play” when actually they are receiving therapy. I do provide “treats” at the end of the therapy session (if your child has food allergies or you would prefer that they not receive a toy or snack please let me know). I also can provide school excuses if needed.
What will I disclose to the parent(s) or guardians? Ultimately a parent has the right to know what is going on with their child. But trust is very important in the therapeutic relationship. If a child feels that I will tell their parents everything that they say, minimal progress will be made in treatment. My hope is that when an uncomfortable and needed topic comes up that I can assist the child in letting the parents know how they are feeling. I also hope that you will trust me to decipher what I believe is relevant information to be disclosed. Obviously anything that requires reporting will be discussed immediately.
I do not typically provide a weekly update on the session content with your child. I also discourage parents from asking children what was discussed in session.
When a child’s biological parents are married or in an active relationship: I truly believe in the importance of “family therapy,” to benefit your child and your family. The best progress is made when both parents are involved in their child’s mental health treatment. I certainly do not expect both parents to be involved in every therapy session. However I would appreciate ongoing and open communication from both parents. I do not require legal custody paperwork in this situation. However if a separation or divorce occurs during the process of treatment then I do require the most current legal copies regarding custody.
In the event that the biological parents are separated or divorced: a copy of the most recent custody judgement is required prior to the initial session. It is also required that I receive a copy of all updated legal judgements during the course of treatment with your child. It is very important that I am able to read clearly what type of custody arrangement is active, what are the medical expectations, the academic expectations, how the parents are to communicate about such issues.
If there is no custody paperwork in place, if a parent is not involved, or additional challenging custody situations: this will need to be discussed. I will require prior to the initial session for the parent or legal guardian to document a clear and specific reason as to why the other parent can not be involved (such as if the parent is deceased or incarcerated). The document will require the reason that the other parent can not be involved in your handwriting, signed, and dated. This will protect both of us legally and ethically.
Legal Guardians: On the other-hand, if a nonbiological guardian(s) has custody of the child, then I will also require a copy of the most current custody agreement. It should be a legal document assigning a nonbiological guardian for care of the child. If no such documentation exists, I will not be agreeable to working with the child.
If one parent/legal guardian wishes to discharge the child under my care: I am not able to legally provide mental health treatment to a child if both parents are not agreeable (unless paperwork says otherwise). Thus if one parent or guardian requests a discharge of the child from treatment, then I will respect that request. Please understand that I am required to notify the other parent/ guardian of your decision.
Custody Issues/ Court proceedings and Court Costs: I am not a custody evaluator, court appointed meditator, family reunification therapist, nor a parenting coordinator. If you are seeking someone for this type of treatment, I can give you an appropriate referral. I also am not considered an “expert witness” and thus if you are seeking someone to support you in a legal suit, a referral will be needed. If you do require that I be present in court (via court subpoena) the costs are quite high and will be discussed in the initial paperwork. This will cover any time spent preparing for the case, for travel, for documentation, for phone calls, and for actual time spent at a court-house.