POINT
Confidentiality is Paramount in Any Therapeutic Relationship RHONDA ANDREWS, LCSW, RPT-S
when minor clients exhibit maladaptive coping skills that are not life and parental rights. Kottman (2011) compares the child’s need for privacy in play therapy with the privacy adults enjoy in adult talk therapy sessions, stating “the therapist must balance the parents’ legal right to know what is happening in their child’s life so as to make appropriate decisions with the child’s ethical right to preserve [their] clients may also be informed by agency policies, informed consent documents, and the practitioner’s theoretical perspective.
According to the Association for Play Therapy (2020) “clients
an explanation of its limitations…” (p. 4). An ethical play therapist using developmentally appropriate language during the intake and informed consent process. It is important that the child have input aspects of their therapeutic conversations be private” (Konrad, 2020, p. 123). Caregivers may feel upset or concerned that the child’s sessions may be kept private (Konrad 2020). However, it is the responsibility of the therapist “to thoughtfully put into words why assurance of age-appropriate privacy aids the goals of therapeutic conversations” (Konrad, 2020, p. 123).
The therapeutic alliance is foundational to any professional mental health relationship. It is well-known among mental health professionals that “the therapeutic relationship accounts for why clients improve (or fail to improve) as much as the particular method” (Norcross and Lampert 2010, takes several sessions to build a therapeutic relationship with children, understand their unique dynamics, and help them to make changes” (p. 20). One of the key issues when building a therapeutic relationship with clients may have had broken trust with adults and learning to trust safe adults may be a direct or indirect goal of play therapy. As the therapist strengthens trust with the child by protectively honoring the child’s coping as the child’s resources expand to include safe adults and trusting relationships.
When faced with this type of ethical dilemma the therapist might invite the child client to share with their caregiver about their maladaptive coping skills, circumventing the need for the therapist to disclose information that the client would be safe to tell their caregivers, and the caregivers will have a safe response, the practitioner may encourage and support sharing with caregivers through a text, a note, a story, a piece of artwork, or a mutual session with the therapist. Alternatively, the play therapist might ask the child for permission to share with the caregiver. In these ways practitioners are able to honor maladaptive coping skills that are not imminently dangerous.
THE MIDDLE GROUND Multiple Factors Contribute to the Decision-Making
Process for Breaking Confidentiality MICHELLE M. PLISKE, DSW, LCSW, RPT-S
multiple factors should be weighed by play therapists in this process. The therapist’s level of experience, supervision and consultation with colleagues, knowledge of local community supports, knowledge and assessment of the family system, and use of best practice assessment tools and qualitative evaluation methods all guide therapist decision making.
After discussing this topic with graduate students, early career professionals in play therapy, and seasoned play therapists, their answers appeared to differ depending upon experience. Students and new practitioners of play therapy leaned more closely to the side of safety being paramount. They offered statements about safety
16 | PLAYTHERAPY | Spetember 2022 |
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of the child and the need for family involvement in therapy, followed up with concern about professional liability (Aasheim, 2011; Jenkins, 2017). Alternatively, seasoned play therapists focused on the idea of shortcomings of the child welfare system (Bergman, 2018; Theriault, 2016), family systems (Karson, 2013), and school support systems (Chatterjee, 2022). Concerns centered around outside supports being ill purpose in the long term and only damaged the therapeutic relationship and the child’s progress.
in the therapeutic process. They discussed use of standardized
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