Safeguarding Children in the Therapeutic Process
What are some of the specific dilemmas faced by therapists in safeguarding the children and young people with whom they work? As we mark the end of Children’s Mental Health Week 2021, independent social worker Gretchen Precey embarks on an occasional blog addressing some of the common questions and dilemmas that arise in her counsellor trainings and consultation sessions.
This blog on safeguarding children in the therapeutic process is written from my perspective as an independent social worker (ISW) who has worked for many years with troubled children and families who may also be at risk. Although I continue to undertake parenting assessments and work directly with families, usually as an expert witness in care proceedings, much of my work now involves training other professionals, social workers and those from affiliated fields, on various aspects of child welfare.
One of the courses that I offer for which there is considerable demand is safeguarding. Keeping up to date on developments in safeguarding children is a requirement for continuing professional development and, frequently, registration within one’s professional body.
Yet some safeguarding courses are more relevant than others for the particular circumstances of those who work therapeutically with children, be it in private practice, young people’s counselling services or schools. Several years ago, I was approached by a child and adolescent psychotherapist in private practice to design a training programme that addressed some of the specific dilemmas faced by therapists in safeguarding the children and young people with whom they work.
One of the quandaries that looms largest is confidentiality. Although it is standard practice for therapists to discuss confidentiality with the children and young people at the outset of their work together (usually something along the lines of ‘whatever we say in this room is private between you and me unless you tell me something that makes me worry that either you or someone else is at risk’), deciding when and how to take that information out of the room and into the public arena is a difficult step to take.
Often it means that the therapeutic relationship is compromised or even ends, sometimes just at the point when the child needs it most.
Another difficulty is whether and what to tell the parents or carers about what a child has said. Compounding the perils of this decision is the practice exercised by most local authority front line teams that referrals are not accepted without the consent of the parents, unless to do so would increase the risk to the child. And local authorities vary in terms of their willingness to override their obligation to seek parental consent.
A further complication arises if the therapist breaks the boundaries of confidentiality, an assessment is undertaken by children’s services, and the decision is to take no further action and close the case. This leaves the therapist and the child in the worst of all possible worlds; with confidentiality, and possibly their relationship, broken and the child remaining unprotected.
In this series of occasional blogs I will be looking at various aspects of safeguarding children in therapeutic settings, based on issues brought by participants on the courses I facilitate and in the practice consultation sessions I offer to staff groups of several youth counselling agencies across London.
Among the topics I intend to look at are:
- Considering how much of what a child ‘discloses’ may be fantasy, projection or magical thinking and deciding how and when to respond to that information from the perspective of safeguarding.
- Recording of sessions and how much to share with other agencies, especially if the case progresses to legal proceedings.
- Protecting oneself from allegations by the child, what the procedure is if that happens and what the experiences of other professionals have been who find themselves in this situation.
- The safeguarding concerns inherent in doing sessions online.