Ethical principles are an essential aspect of day-to-day delivery of mental health provision.
Different professions that work with children and young people will adhere to ethical frameworks provided by professional bodies such as the British Association of
Counsellors and Psychotherapists (BACP) and Play Therapy UK (PTUK). Practitioners working with children and young people can belong to a range of professional
bodies and each produces their own ethical framework. These are broadly similar, and are based on a set of underpinning values including a respect for human
rights. They also refer to personal moral qualities that need to be fostered by the practitioner themselves. Have a look at the BACP framework of working with children and young people in the counselling professions to get a sense of the core principles.
The article below covers all the key ideas we explore further in this sprint.
Boundaries
When working to support the mental health of children and young people it is ethically responsible to be aware of boundaries. This work is common in professions such as counselling and social care where clear boundaries between the child and the practitioner are essential. Boundaries allow the relationship between the child and adult to be structured and consistent allowing for safe and ethical practice.
Modelling boundaries to a child might also be an important aspect of the work, particularly for children and young people who have not previously experienced consistent boundaries.
Confidentiality
One of the most important boundaries when working with children and young people is confidentiality. Everyone has a right to confidentiality and there are legal and ethical reasons for keeping information confidential. Children and young people may share a range of information with you including their personal and medical history as well as other sensitive information.
Without assurances over confidentiality, children and young people may be reluctant to access mental health support. A relationship of trust between a professional and child is essential if they are going to disclose their experiences and express their feelings.
Sometimes children and young people confuse confidentiality with secrecy. This is not helpful language as there will be circumstances such as supervision or disclosure of safeguarding concerns where there is an obligation to break confidentiality. Children and young people need to understand the concept of confidentiality and how it is different to keeping secrets. Explaining confidentiality to a child, particularly those of a younger age is a difficult task because it can be a hard concept to understand. However, confidentiality does need to be negotiated and agreed in an age-appropriate way when working one-to-one to support the mental health of a child or young person so that they can make an informed choice over what they want to share.
Stop and Reflect:
How might you discuss confidentiality with a child?
You might want to consider the use of drawings for younger children and the language you could use for older children. Try writing down what your approach would be and what you feel would be important aspects to cover prior to starting work to support a child or young person.
Childline’s confidentiality promise might give you some more ideas of how you might help children understand confidentiality and when it might need to be breached.
This complexity is explored further in the article below:
Read: ‘Shhh! Please don’t tell…’ Confidentiality in Child and Adolescent Mental Health
Vallance, Aaron (2016) BJPsychAdvances
This article looks at the complex and challenging topic of confidentiality when working to support children and young people.
Ethical Dilemmas
There are many different ethical dilemmas that professionals may be presented with when working with children and young people. On occasion different ethical principles may compete and the issues are far from black and white. One professional may consider one course of action to be ethical whereas another would disagree.
The research video below helps us to see both sides to an ethical dilemma. Watch it and reflect on whether you consider the use of Facebook as unethical practice or an effective pool in child protection.