Confidentiality of child counseling/therapy

[Ohiogal]

I absolutely agree, Stealth....And my sister wants her to go....she is just afraid this is going to become something that the CP will fight her about

Then the fight is about counseling and not about anything else. And counseling is a good thing that will reflect well on your sister if the child is deemed to need counseling help.

 

[proud_parent]

Yes, particularly with adolescents, counselors are very protective (and rightly so) of privacy and trust in the therapeutic relationship. But that wouldn't bar a parent with rights to the minor's protected health information from gaining access, if the parent wanted to press the point.

Previous posters were wondering about state-specific HIPAA laws. As OhReally correctly stated, HIPAA (including the Privacy Rule) is federal legislation, so there are no state-specific versions. However, HIPAA cannot cover every conceivable scenario. Wherever HIPAA is not specific, it defers to state statutes.

Texas Family Code §153.073 is very clear on who has access: unless limited by a court order, a parent appointed as a "conservator" (managing or possessory) of a child has at all times the following rights:
- Right of access to medical, dental, psychological, and education records of the child,
- Right to consult with a physician, dentist, or psychologist of the child, and
- Right to be designate on the child's records as a person to be notified in case of an emergency, and
- Right to consent to medical, dental, and surgical treatment during an emergency involving an immediate danger to the health and safety of the child

Because the child in this case is an adolescent, anticipate that any therapist who becomes involved may elect not to disclose all details of the child's treatment to the parent(s), based on the therapist's judgment as to what degree of confidentiality is clinically appropriate. Even if the therapist would elect to keep some information private, the parents would be legally entitled to full disclosure -- it just could take some hoop-jumping (e.g., a formal request through the Texas Dept. of Health) to get it.

Here are some links:

Texas Family Code - CHAPTER 153 Conservatorship, Possession, and Access / SECTION 153.073
http://tlo2.tlc.state.tx.us/statutes/fa.toc.htm

Texas Administrative Code - TITLE 25 Health Services / PART 1 Dept. of State Health Services / CHAPTER 1 Texas Board of Health / SUBCHAPTER 25 Privacy Policy / RULE §1.501 Privacy of Health Information
http://info.sos.state.tx.us/pls/pub/readtac$ext.viewtac

 

[txrose1998]

Then the fight is about counseling and not about anything else. And counseling is a good thing that will reflect well on your sister if the child is deemed to need counseling help.

Well....she figures that the child is in need of help because she spent all day last Friday crying and carrying on about not wanting to go to her mother's (my sister) and because she is hearing her mom being bashed by stepmom's family.

 

[OhReally?]

Well, actually, many therapists will not share anything specific with EITHER parent, unless it is an issue of the child's safety/well-being. Even when mine were very young, the therapists were very clear that what the child said would be confidential, and we would only know what was going on in generalities.

Interesting. I wasn't thinking about some of the other details when I was answering. Thanks.

 

[stealth2]

I absolutely agree, Stealth....And my sister wants her to go....she is just afraid this is going to become something that the CP will fight her about

Okay, now I'm confused. Because you said what she was worried about was that Dad would use what the child said against her (Mom).

But honestly - the child's emotional well-being needs to come first. Whether she says stuff good/bad about Dad OR Mom.

 

[txrose1998]

Okay, now I'm confused. Because you said what she was worried about was that Dad would use what the child said against her (Mom).

But honestly - the child's emotional well-being needs to come first. Whether she says stuff good/bad about Dad OR Mom.

Well, it is a combination of both. She is afraid if daughter tells the therapist that she does not like going to mom's house sometime and therapist tells CP, that he will use that and run with it.
She is also afraid that he just will not approve of couseling because he has stated before in the past...in fact, he yanked her out of it when daugter was younger

 

[escape2paradise]

Actually, HIPAA is federal, so they apply in all states, IIRC.

Yes, HIPAA is federal but each individual state also has there own laws/regs added to it. HIPAA does not determine age of consent for a child but regulations in each state added to HIPAA do. So in WA the HIPAA regulations handed out are federal, but WA has added there own regs as well and those are stated on the HIPAA forms we have to sign off on at the doctors office. TX will have there own regs as well and I would imagine those to are added to the HIPAA forms that Texans sign off on when they go to the doctor. Thus the reason I told her to find the HIPAA regs for Texas, the consent info she is seeking should be on that form.

 

[escape2paradise]

Yes, particularly with adolescents, counselors are very protective (and rightly so) of privacy and trust in the therapeutic relationship. But that wouldn't bar a parent with rights to the minor's protected health information from gaining access, if the parent wanted to press the point.

Previous posters were wondering about state-specific HIPPA laws. As OhReally correctly stated, HIPPA (including the Privacy Rule) is federal legislation, so there are no state-specific versions. However, HIPPA cannot cover every conceivable scenario. Wherever HIPPA is not specific, it defers to state statutes.

Texas Family Code §153.073 is very clear on who has access: unless limited by a court order, a parent appointed as a "conservator" (managing or possessory) of a child has at all times the following rights:
- Right of access to medical, dental, psychological, and education records of the child,
- Right to consult with a physician, dentist, or psychologist of the child, and
- Right to be designate on the child's records as a person to be notified in case of an emergency, and
- Right to consent to medical, dental, and surgical treatment during an emergency involving an immediate danger to the health and safety of the child

Because the child in this case is an adolescent, anticipate that any therapist who becomes involved may elect not to disclose all details of the child's treatment to the parent(s), based on the therapist's judgment as to what degree of confidentiality is clinically appropriate. Even if the therapist would elect to keep some information private, the parents would be legally entitled to full disclosure -- it just could take some hoop-jumping (e.g., a formal request through the Texas Dept. of Health) to get it.

Here are some links:

Texas Family Code - CHAPTER 153 Conservatorship, Possession, and Access / SECTION 153.073
http://tlo2.tlc.state.tx.us/statutes/fa.toc.htm

Texas Administrative Code - TITLE 25 Health Services / PART 1 Dept. of State Health Services / CHAPTER 1 Texas Board of Health / SUBCHAPTER 25 Privacy Policy / RULE §1.501 Privacy of Health Information
http://info.sos.state.tx.us/pls/pub/readtac$ext.viewtac

Correct and here in WA, state specific info is listed on the HIPAA forms we sign off on whenever we go see a new doctor etc...I thought Texas may very well have the same system.

 

[Isis1]

if either the NCP or CP wanted the child to go into therapy on their own parenting time, what right does the either parent have to put a stop to it? as a joint legal parent? i think all therapy is beneficial to children when parents are seperated. (but that's my non-attorney opinion) i understand joint legal means decisions making, but when one parent doesn't agree just to say no, would it put the therapist at risk for a lawsuit or would they refuse to take on the child just because one parent says no?

 

[StampGirl]

Its funny how I ran across your thread this morning.

I called and set up my daughter's first counseling appt for next week. Her dad and I have Joint Legal Custody so of course I emailed him last month for "permission". He wanted "more information, appt time etc" before he would "allow" (his words not mine) her to go.

I called and made the appt on Monday and she goes next tuesday. Now the Ex is fighting mad and is demanding to show up on Tues which is all good by me. He is the one who should be there as our daughter is having issues with her dad and step-mom. She is the one who asked to go and wants help. He thinks she is "playing us against each other" which is ironic because its the middle one who is doing it and he doesn't even see it!!

So good for your sister. I think that any parent who would "fight against" their child seeking help is silly. It sends up ALL kinds of red flags when they fight it so hard.

 

[escape2paradise]

if either the NCP or CP wanted the child to go into therapy on their own parenting time, what right does the either parent have to put a stop to it? as a joint legal parent? i think all therapy is beneficial to children when parents are seperated. (but that's my non-attorney opinion) i understand joint legal means decisions making, but when one parent doesn't agree just to say no, would it put the therapist at risk for a lawsuit or would they refuse to take on the child just because one parent says no?

I don't know what legal issues the therapist might have, but I know from experience here that the courts got pissed at my X for putting my DD in counseling without my knowledge. I didn't have a problem with her going to counseling, I just didn't know that the X had taken her and I didn't consent to it. I found out in court and the judge reemed my X for it.

 

[Isis1]

I don't know what legal issues the therapist might have, but I know from experience here that the courts got pissed at my X for putting my DD in counseling without my knowledge. I didn't have a problem with her going to counseling, I just didn't know that the X had taken her and I didn't consent to it. I found out in court and the judge reemed my X for it.

but if the other parent was notifed, given all contact information, would that matter? is being notified more of the issue then "getting permission" such as stampgirl had given an examle of?

 

[escape2paradise]

but if the other parent was notifed, given all contact information, would that matter? is being notified more of the issue then "getting permission" such as stampgirl had given an examle of?

I think as long as the child needs the counseling and dad is aware, then mom will be okay taking her even if dad throws a fit. If I were mom I would ask dad to assist in picking a counselor. If dad refuses and later decides he doesn't like the counselor and tries to say mom hand picked the counselor to her own benefit, the argument won't hold water.

When I found out about DD going to counseling and after the judge telling X that I had a right to select etc...The judge made it clear that he though tcounseling was good thing, but that X and I would both need to approve a counselor and that could be different than the counselor DD was already seeing. I let DD stay with the counselor she was seeing. I checked her out and met with her, then decided she was fine. Besides I was not worried about what would come out in counseling as I have nothing to hide.

 

[StampGirl]

but if the other parent was notifed, given all contact information, would that matter? is being notified more of the issue then "getting permission" such as stampgirl had given an examle of?

If parents have Joint Legal Custody, like we do, then you do need their consent to do counseling (as far as CA law states). If he would have flat out said no, then I would have to file with the courts to get consent.

He is very careful to say "I will let her go" but then he throws things out there like, you can't see the therapist without me present, I want the dr to call etc me with all info and not for you to relay it to me.

For my ex, its a control issue. He thinks I am trying to take visitation away from him but in reality I just want to do what is right for the girls. Even the mediator told him that he needs family counseling with all our girls. He thinks nothing is wrong. So I took the steps to get them the help they need. At least the counseling issue gave him something to rant and rave over and he left my moving issue alone!!

 

[txrose1998]

So.....thanks for all the replies byt the way!

So, if she thinks their daughter should go and properly notifies her ex of the specifics, she would be in the clear?