Managing the quagmire of counseling in a school: bringing the parents onboard.
It is Monday morning, and you are speaking with a student's mother who is requesting that you see her child for school anxiety issues. You agree and explore further with the student's mother what her concerns are about the student. At the end of the conversation, the student's mother adds, "I would like you to call me each week to let me know what she is talking about with you." What do you do?
The challenging issue in this scenario is how to balance the student's right to confidentiality and the professional school counselor's ability to work effectively with the student without alienating the parent, who has a legitimate interest in the well-being of her child. Professional school counselors (PSCs) often face this ethical dilemma when well-intentioned parents and guardians ask questions about what a student has shared with the counselor. Minors' ethical rights to confidentiality in the counseling relationship often are misunderstood or ignored altogether. The demands of parents to be informed of the specific content of counseling sessions often overshadow the child's right to privacy. This may lead not only to an ethical problem, but also to deterioration in the student-counselor relationship and the potential relationship with other students. School counselors who develop a reputation for arbitrarily sharing students' information with others may find students reluctant to seek counseling (Glosoff & Pate, 2002).
It is therefore imperative for PSCs to develop a good working relationship with parents to promote the importance of privacy, confidentiality, and privileged communication and to ensure that these principles will be managed in a manner that assures that students receive the counseling services they need. Providing support and services to students is a school counselor's highest priority (Davis, 2006), and having a positive relationship with parents can enhance the availability and quality of counseling services to students. Creating a good trusting relationship with parents while working with students can be done with a great deal of education and effective communication.
The first question that needs to be answered is, "Who is the client?" The seemingly obvious answer would be the student because the student is receiving the services, but the situation is more complicated when working with minors. To further illustrate this, Section A.2(g) of the American School Counselor Association's (ASCA, 2004) Ethical Standards for School Counselors dictates that the PSC "recognizes his/her primary obligation for confidentiality is to the student but balances that obligation with an understanding of the legal and inherent rights of parents/guardians to be the guiding voice in their children's lives." In other words, although the student has the ethical right to confidentiality, the parent or guardian of the student has several legal rights that must be respected by the PSC. Ethically, the student is the client, but legally, the parent is the client (Ritchie & Huss, 2000).
The Ethical Standards for School Counselors (ASCA, 2004) further speaks to the dilemma of balancing students' need for confidentiality with parents' desire for information about their children in Section B.2(a), where PSCs are directed to "inform parents/guardians of the counselor's role with emphasis on the confidential nature of the counseling relationship between counselor and students." Later in B.2(c), this responsibility to students is emphasized: "... provides parents/guardians with accurate, comprehensive, and relevant information in an objective and caring manner, as is appropriate and consistent with ethical responsibilities to the student."
The inclusion in the Ethical Standards for School Counselors (ASCA, 2004) of references to the unique circumstances present when working with minors in a school setting demonstrates the importance of PSCs being able to communicate effectively with parents while preserving the integrity of their relationship with their student clients. The challenge of working ethically with students and parents is further supported by the research of Bodenhorn (2006). In a survey of Virginia school counselors, issues of confidentiality and parent rights were found to be among the most common and most challenging ethical dilemmas reported across the K-12 grades.
The creation of an ethical environment enhances the opportunity to work collaboratively with all the stakeholders in a student's life while providing the student with as much confidentiality as possible. PSCs need to create as many collaborative systems as possible to support their students (Bodenhorn, 2005). It is expected that all this be done with a clear understanding of the legal issues involved. The suggestions in this article will enable PSCs to function closer to aspirational ethics rather than mandatory ethics in order to meet the needs of their students.
It is essential that PSCs clearly understand the key concepts that are the core of an ethical environment. PSCs then can communicate these key concepts to parents and students so that effective counseling can occur. These key concepts are privacy, confidentiality, and privileged communication. Another essential in creating a collaborative working relationship with parents is to include a discussion of privacy, confidentiality, and privileged communication in the management agreement (ASCA, 2005) between the PSC and the administration. The task then becomes developing and implementing a plan to create this collaborative relationship with parents where the students can receive the services they need while honoring the "need to know" issues of parents.
UNDERSTANDING KEY ETHICAL CONCEPTS
The key ethical concepts that PSCs need to understand and be able to explain to parents are privacy, confidentiality, and privileged communication. These concepts are integrally related, but it needs to be clearly understood that privacy and confidentiality are ethical concepts imperatively important in counseling relationships. Privileged communication is a statute-provided concept, which is only an issue when there is a legal concern (e.g., custody; Remley & Herlihy, 2007). Although these concepts are integrally related, they should not be used interchangeably. PSCs need to clearly understand these concepts and be able to effectively help parents and students understand how each is related to the counseling relationship.
Privacy is the right of people to decide what information about themselves will be shared or withheld from others (Remley & Herlihy, 2007). Privacy is considered broader in nature than confidentiality (Glosoff & Pate, 2002). Privacy also has been defined as allowing individuals to limit access to information about themselves (Beauchamp & Childress, 2001). This includes people's right to make decisions about sharing or withholding information about their body or mind, thoughts, beliefs, feelings, and fantasies. In a school setting, privacy means that not everyone needs to know everything about each student. PSCs should develop procedures to protect students' right to see the counselor privately. PSCs also should develop procedures for protecting students when that privacy cannot be maintained. Examples might include (a) not calling a student to the counselor's office over the public address system, (b) providing a private sitting area for students waiting to see the counselor, and (c) not posting absentee lists with reasons for absence. Although total privacy is not possible, every effort should be made to protect the privacy of the students and their families.
Confidentiality is a professional's promise or contract to respect a client's privacy by not disclosing anything revealed during counseling except under "agreed-upon conditions" (Glosoff & Pate, 2002). Confidentiality is the cornerstone of the counseling relationship (Linde, 2007). Confidentiality has become such an internalized norm in the counseling profession that it is rarely questioned (Remley & Herlihy, 2007). It is the expectation of students that when information is shared with a counselor, it will be kept secret (Erford, 2007). If this were not the expectation, most students would not seek the support of the school counselor (Stone & Dahir, 2006). The conflict for PSCs is that parents need to be an integral part of a student's educational experience yet students expect that they can talk freely with a counselor without the fear that the information will be shared. Finding a balance between protecting the information shared and collaboratively working with parents and other educators to do what is best for the student is a key issue for professional school counseling program success.
Ethical obligations related to confidentiality may differ depending on the developmental age of the student. Developmental theories (e.g., Piaget) indicate that there is a stage at which the developing young person can understand the concept of secrets and can be involved in making informed decisions about confidentiality. A developmental approach to making decisions about confidentiality should be based on characteristics and abilities of the student involved and the nature of his or her discussion with the school counselor, rather than just relying on the age of the student (Glosoff & Pate, 2002). Welfel (2002) stated that "generally, the more mature the minor, the greater the measure of confidentiality that young person is given in counseling" (p. 102).
Isaacs and Stone (1999) reported that elementary and middle school counselors break confidentiality more frequently than do secondary school counselors. This fits with the developmental theories that suggest younger children tend to be less capable of making informed choices and less concerned with confidentiality than preadolescents and adolescents.
The importance of confidentiality in counseling is illustrated by the number of times it is mentioned in ASCA's (2004) Ethical Standards for School Counselors. The entire section A.2 is about confidentiality and the term "confidentiality" is included in 10 other sections of the standards. The Ethical Standards for School Counselors extends the concept of confidentiality to information shared by parents in B.1(c) where it is stated, "The professional school counselor respects confidentiality of parents/ guardians."
Confidentiality is such a complex issue because, while it is believed to be essential to a successful counseling relationship, confidentiality is not absolute (Remley & Herlihy, 2007). The "agreed-upon conditions" (Glosoff & Pate, 2002) under which confidentiality can ethically be breached include exceptions that are defined by law, ethical codes, and other circumstances decided by the parent, student, and counselor. Examples of other circumstances not defined specifically by law or ethical codes are dropping honors classes, being pregnant, or being bullied. These other circumstances can be anything the parent and student agree upon. Most legal and ethical exceptions relate to harm to self or others. Remley and Herlihy identified at least 15 types of situations in which breaching confidentiality might be permissible or required. Most of those situations have both a legal and ethical component, which requires an understanding of the concept of privileged communication.
Privileged communication is a legal concept and therefore must be awarded by state statute. Privileged communication protects against forced disclosure in legal proceedings. It is the client's right to prevent a counselor (as defined by specific state legislation) from revealing confidential communications in a legal proceeding (Corey, Corey, & Callanan, 2007). The literature indicates that between 16 and 20 states grant clients of school counselors some form of privilege (Fischer & Sorenson, 1996; Sheeley & Herlihy, 1988; Stone, 2005). Therefore, it is important for PSCs to know the law in their particular state.
These important ethical concepts (privacy, confidentiality, and privileged communication) must be clearly understood by the counselor and then communicated to the many stakeholders in a school setting. These ethical concepts need to not only be understood by the PSC but also be understood and supported by the administration. Having a management agreement between the PSC and the administration provides a vehicle for developing this important understanding and support.
Management agreements between the administration and PSCs are recommended in the ASCA National Model[R] (2005). These management agreements are designed to ensure effective implementation of the school counseling program delivery system to meet students' needs. The agreements address how the school counseling program is organized and what will be accomplished. Management agreements should be developed with the administration at the beginning of the year. By including an understanding of the concepts of privacy, confidentiality, and privileged communication; confidentiality agreement form(s); and a plan for creating an ethical environment, these agreements will establish support from the administration as well as a collaborative atmosphere.
Dollarhide (2007) found that "establishing a positive relationship with the principal is the most powerful tool at the counselor's disposal" (p. 367). Lambie (2004) reported the need for a supportive principal in the implementation and maintenance of an effective school counseling program. Developing management agreements will increase the support of the administration in doing the activities needed to work collaboratively with parents.
PLAN FOR CREATING A COLLABORATIVE RELATIONSHIP
The next element in creating collaborative relationships with parents is to develop a plan to ensure that parents understand the role of the counseling program and the important ethical issues involved. The plan should include strategies for helping parents recognize the importance of privacy, confidentiality, and privileged communication in creating effective counseling relationships with students. This plan can include many activities to educate parents, such as statements in newsletters, on the school Web site, and in pamphlets created for parents; brief discussions at parent meetings; and programs for parent groups. The action plan should include a timeline for implementation of these activities.
Pertinent information can be included on the school Web site, in the student handbook, in newsletters, and in the signature of e-mails. Furthermore, information about the role of confidentiality when counseling students should be included in any informational programs presented by PSCs for parents (e.g., orientation night, parent-teacher association program) and/or community groups (e.g., Rotary, Kiwanis). Finally, in all personal interactions between parents and counselors, there needs to be a discussion about confidentiality, privacy, and privileged communication. This discussion should include a Parent Confidentiality Management Agreement (see Appendix A) as part of the informed consent process. This discussion helps parents gain a sense of trust that the counselor will notify them when they need to be informed. Although not all-inclusive, these suggestions provide the basic outline for a workable plan to be accomplished over time. The suggestions all will be discussed further with examples of how to implement them.
There are many "highways" for making important confidentiality information about the counseling process available to parents. New electronic highways as well as traditional printed highways will be discussed.
School counselors have been encouraged to use technology to disseminate information and to enhance the effectiveness of their counseling programs (Carlson, 2006; Milsom & Bryant, 2006; Van Horn & Myrick, 2001; Wilczenski, 2006). Use of technology is a convenient and efficient way to get information to stakeholders. Being a part of the school district Web site or school building Web site, or developing a separate Web site for the counseling department, provides opportunities to create an ethical school environment as well as to advocate for the school counseling program.
In a study of 456 school counseling departmental Web sites, Milsom and Bryant (2006) found that these Web sites were not used effectively to advocate for the counseling program but were very effective in sharing information. Their findings indicate that school Web sites are a generally unused "highway" that counselors can take advantage of. One of the resources provided by Milsom and Bryant is a list of links to a variety of model school counseling departmental Web sites (ASCA, 2007). We examined all those Web sites to determine whether any mentioned issues of confidentiality. Only two did very briefly, and those two referenced the ASCA Ethical Standards for School Counselors. Thus, a currently underutilized opportunity is available to provide information about privacy, confidentiality, and privileged communication. A Web-site statement should be state law and school policy specific, but a generic statement is included below as a sample:
Privacy and confidentiality are essential to having an effective school counseling program. [Name of your school] recognizes the importance of good communication and good working relationships between students, parents, and the school. Therefore, every effort will be made to protect student and parent privacy rights except under certain limited conditions. These conditions generally include safety issues (harm to self and/or others), legal issues, and professional responsibilities (see the ASCA Ethical Standards for School Counselors at www. schoolcounselor.org).
Another form of electronic communication that can be used to create the collaborative working relationship is e-mail. E-mail can assist students and parents by providing direct means of communication. While e-mail has become an accepted form of communication, there are some ethical issues related to its use. E-mail is never confidential (particularly in a school setting), and those who choose to use it need to know this. Therefore, PSCs using e-mail need to take two steps. First, written permission needs to be obtained from parents and students that communication can occur by e-mail, and they need to indicate they understand that e-mail is not absolutely confidential. Second, there needs to be a statement at the bottom of each e-mail sent by the PSC as part of the signature indicating that e-mail is not confidential. This statement may be as simple as "confidentiality cannot be guaranteed in this e-mail." In addition, all school personnel who communicate via e-mail need to be informed about the limits of confidentiality using this electronic system.
If the ethical concerns with the use of e-mail are adequately addressed, e-mail can be another valuable means through which PSCs can educate stakeholders about the school counseling program and the limits involved in confidentiality. This can be done with a statement or two at the end of each e-mail, again making it part of the signature and giving the school's Web-site link for additional information. A sample statement is included, although statements must be tailored to the specific policies of the school.
Confidentiality is a key component for working with students and parents. Every effort will be made to maintain that confidentiality. Confidentiality is the counselor's commitment to respect students' privacy by not divulging anything shared in a counseling session except under "agreed-upon conditions." See the school Web site and student handbook for more information.
Similar kinds of statements can be included in the traditional "printed highways" such as the student handbook, newsletters, and printed information about the school counseling program. Also, any time the PCS gives a presentation, information about confidentiality and privacy can be briefly mentioned and a reminder given about where more information can be found (Web site, handbook, etc.).
The actual conversations between the parent(s) and the PSC are the most critical aspect in developing a trusting relationship. These conversations are where it becomes apparent whether the parent and the student truly understand confidentiality and its limits and whether they fully understand the "rules" of counseling relationships (Wheeler & Bertram, 2008). This is where the PSC uses his or her communication and persuasion skills to help parents understand the importance of confidentiality in the counseling relationship. These conversations also include the development of the "agreed-upon conditions" to be listed in the Parent Confidentiality Management Agreement (see Appendix A for example).
If the information related to confidentiality and privacy is shared in all the formats suggested, PSCs can easily reference them as they discuss mutual concern for the student's welfare. There must be a sense of trust between the parent and the PSC that when any of the "agreed-upon conditions" occur, the parent will be contacted. It is an absolute, then, that the parents are appropriately involved when any of the "agreed-upon conditions" occur and at other times when the student and the PSC think it would be beneficial. This climate of trust may take a long time to establish, but once it is, the conflict between parent, counselor, and student around confidentiality will likely be reduced.
In conclusion, confidentiality between school counselors and student clients creates a safe and productive environment essential to the school counseling profession. Working collaboratively with parents, students, and administrators to ensure a full and shared understanding of confidentiality, the limits to confidentiality, and the importance of confidentiality to the student and counselor relationship will help alleviate this ethical challenge for PSCs. By having information readily available through Web sites, email, and printed material distributed by the school counselor and through public forums, PSCs can communicate to the community their commitment to confidentiality and prevent confusing situations regarding privacy. Finally, parental involvement whenever appropriate is an absolute. As stated in Section A.1(a) of ASCA's (2004) Ethical Standards for School Counselors, the best interests of the student should be the primary obligation of professional school counselors.
Parent Confidentiality Management Agreement
I,--, understand that what my child--shares with the school counselor is confidential. This means that what my child shares with the school counselor is private and will not be shared with me or others unless certain conditions exist. Confidentiality can be maintained unless possible harm to self or others, court orders, or permission is granted by student and parent.
* I understand that if my child shares any information that indicates he or she is at risk to self or others, I will be informed and the police and/or children's protective services will be informed in the interest of keeping all students safe.
* I am aware that any information shared with me about my child will be discussed with my child first to protect the counseling relationship with the student.
* I understand that anything I share with you will be treated with the same respect of confidentiality as my child receives.
Parent signature Date School counsellor signature Date
Note. Sometimes it may be good to have the student also sign this form. Other "agreed-upon conditions" can be added.
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Susan Norris Huss, Ph.D., is an associate professor at Bowling Green State University, Bowling Green, OH. E-mail: email@example.com
Amanda Bryant is an elementary counselor at Field Elementary School, Fostoria, OH.
Suzanne Mulet is a graduate student at Bowling Green State University.
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|Author:||Huss, Susan Norris; Bryant, Amanda; Mulet, Suzanne|
|Publication:||Professional School Counseling|
|Date:||Aug 1, 2008|
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