Latest / Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy / 442 | When Parents Feel Kept in the Dark: Protecting Confidentiality in CCPT

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442 | When Parents Feel Kept in the Dark: Protecting Confidentiality in CCPT · Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy

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  You're listening to the Play Therapy Podcast with Dr.
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  Brenna Hicks,
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  your source for centered and focused play therapy coaching.
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  Hi,
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  I'm Dr.
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  Brenna Hicks,
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  The Kid Counselor.
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  This is the Play Therapy Podcast where you get
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  a master class in child-centered play therapy
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  and practical support and application for your
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  work with children and their families.
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  In today's episode,
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  I am reading
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  an email from Taylor in Florida.
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  My Floridians,
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  it's so nice to hear from someone in Florida.
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  By the way,
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  y'all,
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  speaking of Florida,
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  the Rays,
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  can I just like brag on them for like 8 seconds?
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  Oh my gosh,
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  this has been a season,
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  and
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  I'm,
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  I'm hoping we're in the World Series soon,
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  and I'm hoping it's against the Brewers.
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  So all,
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  all you Wisconsinites,
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  I don't know what you call yourselves,
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  Wisconsiners,
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  Wisconsin-
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  -ions,
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  I don't know,
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  whatever y'all are called,
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  all you Brewers fans.
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  I hope that
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  we are going head to head on a small ball club World Series
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  with small payroll and with scrappy ball teams,
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  and neither one of us have ever won a World Series.
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  That is what I'm praying for.
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  So I hope that it's a Ray's Brewers World Series.
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  I'm just throwing that out there right now.
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  But anyway,
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  it's fun to be in Florida right now if you're a baseball fan.
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  Moral of that story.
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  OK,
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  so Taylor,
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  thank you for emailing from Florida.
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  This is about
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  what we share with parents
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  as far as confidentiality and their concerns that they're being kept in the dark.
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  This is actually a really helpful question,
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  so I'm glad that we're able to process this together.
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  So let me read parts of it and then we will tackle it.
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  I recently began working at a children's agency,
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  and one of my child clients I will be working with is coming in
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  after experiencing sexual abuse.
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  During the initial parent consult,
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  the mom was really sad and surprised that her
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  child did not come to her with the information.
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  As I was talking
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  them through the process of CCPT and therapy in general,
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  I mentioned that the content of the child's play
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  would remain confidential,
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  but we would discuss themes and progress,
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  etc.
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  I then wondered if this was the wrong thing to say,
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  and then it raised a question for me.
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  When it is not abuse,
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  which is of course reportable,
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  how do you bring comfort to parents who bring in
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  concerns specifically about their children
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  hiding important information from them
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  while still setting the expectation that as the therapist
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  it is not your role,
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  nor is it ethical to disclose what a child shares with you in session?
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  OK.
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  So this is gonna be a really helpful
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  topic for us to discuss.
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  So,
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  let's start with
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  We're all mandatory reporters.
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  And we know when a report needs to be made.
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  And when a report is made,
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  that goes directly to
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  the reportable agency.
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  So for us,
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  it's DCF.
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  I know there's different acronyms in different states and places,
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  but
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  for us,
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  we report to the Department of children and Families.
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  And there's a hotline specifically for it,
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  and
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  you file the report,
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  you can choose to be anonymous or not.
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  My policy personally and at my center has always been,
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  I informed the parent that I had to make a report.
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  I do not inform the parent.
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  What
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  the report
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  was about.
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  But for customer service and for trust and for relationship and for transparency.
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  I let the parent know
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  because what I don't want to happen is
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  CPS shows up,
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  sorry,
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  Child Protective Services shows up on their doorstep.
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  And the investigator says,
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  yeah,
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  so a report was filed by a Dr. Brenna Hicks,
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  and they feel completely betrayed,
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  and they feel like I was not honest and open with them.
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  I would never want that.
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  That would probably be a permanent rupture that would never be repaired.
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  So
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  I always absolute on purpose,
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  reach out to the family once the report has been made,
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  and I say I want to let you know,
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  as you're aware,
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  I'm a mandatory reporter.
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  So when certain things
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  come up in session,
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  I am legally obligated to make the report whether I think they're true or not.
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  This is not about whether I believe.
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  What came up in session,
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  it's about I'm mandated to report it
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  and then I'm
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  turning that over to let
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  people that are going to
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  determine whether or not
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  it's a valid report or not.
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  I'm turning it over to them.
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  I just wanted to let you know
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  if they say,
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  Well,
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  what was that?
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  Well,
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  I'm not able to disclose that.
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  You know that I'm bound by confidentiality.
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  I just want to let you know
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  what happened in session required a report,
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  and so you will likely be hearing from
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  Whatever the agency or the organization is.
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  OK,
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  that preserves relationship as far as the PCs.
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  So
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  When
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  parents
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  are meeting with you,
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  I mean,
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  this mom's already sensitive to it because she was already sad and surprised that
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  the child didn't come to her.
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  So there's already a sensitivity and obviously she's gonna
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  want to know like if things are coming up,
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  you have to tell me.
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  Well,
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  this is why we have to be really clear.
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  Clear is kind.
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  We have to be really clear to parents.
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  My confidentiality lies with your child.
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  And I typically explain that that is different
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  than other disciplines because a parent doesn't understand this.
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  If they take their child to a medical doctor,
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  They have rights and access to everything,
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  the records,
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  the records,
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  the notes,
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  the documentation,
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  everything.
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  Mental health is the outlier.
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  So
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  it's important for us to be able to say
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  mental health confidentiality is different.
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  My confidentiality lies with your child even though they are a minor.
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  And I am legally bound by confidentiality expectations.
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  That doesn't mean that I'm going to keep you in the dark.
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  It doesn't mean I'm not going to inform you if something needs to be shared.
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  If a topic comes up,
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  I'm able to discuss
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  broad themes and the topic with you.
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  I'm not able to give you specificity and detail.
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  So,
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  it's really important that we help a parent understand,
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  I'm not just not going to tell you things.
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  I just have to be very cautious and intentional with the way that I present issues.
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  So,
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  if a kid comes in and is perpetually talking about bullying,
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  That's something that a parent wants to know.
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  We're not obviously going to say
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  your child said this and your child said this
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  has happened and your child is worried about X,
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  Y,
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  Z.
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  That's a violation of confidentiality,
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  but you can certainly say
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  one of the things that keeps coming up is the way that your child is treated
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  by peers.
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  So,
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  we've been working on that quite a bit.
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  We've been addressing that quite a bit.
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  That's been coming up a lot.
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  OK,
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  so you can definitely communicate.
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  That there are overarching things happening and then my
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  follow-up question to the bullying scenario would be,
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  I wonder if you're aware of
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  any peers or
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  or friends or anyone in the social group that
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  you know of that has a tendency to
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  have issues
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  with your child or other kids.
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  Because sometimes parents know more than they think.
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  Sometimes a kid comes in and says,
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  Billy,
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  X Y Z.
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  Billy hits me on the bus,
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  Billy calls me names,
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  Billy shoves me into the locker,
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  Billy blah blah blah blah.
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  And then without breaking any confidentiality whatsoever,
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  you say,
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  I wonder if you're aware of any specific kids or or friend groups
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  or anyone that your child knows that like you're kind of aware
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  tends to be aggressive or tends to be mean or tends to have like issues.
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  Well,
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  I mean,
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  I know that the name Billy has come up quite a bit.
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  OK,
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  so
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  often they know more than they think they know.
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  Just because a kid doesn't sit down and stare them in the eye and say,
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  Billy is being mean to me and I think he's being a bully,
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  it doesn't mean that they're not in any kind of awareness whatsoever.
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  So I think you also often give parents an
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  opportunity to share what they think or know,
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  and that opens up more channels for discussion because once
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  a parent says,
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  Well,
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  Billy has come up a lot,
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  you can say,
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  OK,
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  well that's also being processed with me.
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  OK,
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  so now there's a little bit more communication.
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  And then also,
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  when you said you weren't sure if that was the wrong thing to say,
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  when you said that you would discuss themes in progress,
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  etc.
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  that's setting expectations,
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  that is what you're going to discuss.
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  You're not going to give detail,
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  but you will talk about themes
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  and symbolic play
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  and progress and shifts and things that you're seeing.
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  Of course those are the things that you're going to say.
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  And then
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  how do you bring comfort to parents who
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  bring in concerns about their children hiding information,
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  but it's not our role to discuss that.
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  And or it's not ethical.
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  Well,
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  one of the most simple ways that I phrase this to parents
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  is
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  children are really protective of the people that they love.
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  They know that their loved ones sometimes can't handle their junk.
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  So if a kid is super,
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  super sad about something.
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  And maybe one time in some random moment
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  they started to be a little bit more vulnerable and started to show
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  that they were sad.
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  And they got a sense that the person they
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  were showing their sadness to couldn't handle it,
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  they're going to stop.
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  If a if a kid
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  out of the blue shows this big moment of anxiety
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  and it makes the other person around them anxious,
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  They'll never be anxious in front of that person again.
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  Kids are super protective of their loved ones because they don't want their
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  loved ones to suffer.
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  So I'm not gonna let you see how angry I am.
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  I'm not gonna let you see how scared I am.
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  I'm not gonna let you see
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  how hurt I am.
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  And that's why the value of the therapist
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  becomes so important
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  because we're third party.
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  We're objective and we're neutral.
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  And I share this with parents.
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  I say,
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  I'm not going to get emotionally charged
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  if your child is any of those things with me.
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  I deeply care about your child
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  and I'm deeply invested in your child's healing,
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  but it's not going to personally affect me if your child is anxious.
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  I'm not going to be sad.
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  If if your child comes in and shows me that they're sad about something.
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  And so the power that we have
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  to preserve that connection.
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  Means that I can't jeopardize your child being
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  willing to be vulnerable in front of me
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  knowing that I am neutral.
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  By then
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  talking about what's happening to the people that
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  may not necessarily be equipped to handle it.
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  The danger of rupturing and fracturing the relationship is too great.
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  So,
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  I will never
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  share something with you that your child has shared with me
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  because they know that I can handle it and no one knows if you can handle it or not.
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  And kids are gonna protect you from that
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  because that's the way that they're wired
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  and almost every parent gets it if you present it that way.
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  And so then they see you as even more valuable in the equation.
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  So now it's not,
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  I can't believe that my kid would tell you that and not me.
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  They start to say,
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  I am so grateful
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  that my kid can tell you that instead of me.
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  It totally flips the perspective
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  where parents are actually
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  super grateful.
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  That their child trusts someone enough
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  and likes someone enough
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  and is willing to be vulnerable with someone enough
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  that
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  they'll tell someone
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  they'll open up about that to someone like look it doesn't have to be me
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  as long as they have someone.
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  I mean,
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  I think ideally parents would still like it to be them,
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  but once they realize the why your kid's not just keeping you in the dark,
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  your kid's not just trying to hide things from you,
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  your kid's protecting you.
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  And they don't need to protect me.
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  That is a very powerful
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  construct that parents will understand,
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  and then their behaviors and their perspective will change.
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  So,
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  Taylor,
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  I hope that that's helpful.
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  You just have to be really clear on
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  what you will and won't do and stick to it.
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  And if they believe that you have a
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  process and you have rationale for your decisions,
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  they will trust you.
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  And then the child trusts you as well,
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  which means
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  then we're able to move forward and the child's
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  able to work through what they need to.
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  So,
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  thanks so much for the question,
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  Taylor.
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  It was nice to chat about that.
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  If y'all wanna reach out,
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  I'd love to hear from you,
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  brenna@thekidcounselor.com.
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  Thank you for
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  I,
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  someone actually sent me pictures.
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  I was gonna say thanks for hanging out with me,
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  but then it reminded me someone sent me pictures
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  of what she's been crocheting
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  while she listens to me.
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  So I mean,
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  I'm like always intrigued by what y'all do when I'm in your ears.
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  So someone was like,
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  thank you for crocheting with me.
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  Thank you for going on dog walks with me.
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  And the little things that she's been crocheting are like little Halloween things.
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  There was like a little
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  ghost.
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  Pumpkin and a little vampire,
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  no,
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  like a little Frankenstein or something.
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  I don't know.
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  Super cute things.
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  So
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  the point is,
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  I'm just grateful that when you're doing the things that are important to you,
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  I get to come alongside you and hang out.
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  So
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  thanks for hanging out with me.
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  I love you all.
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  We'll talk again soon.
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  Bye.
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  Thank you for listening to the Play Therapy Podcast with Dr.
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  Brenna Hicks.
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  For more episodes and resources,
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  please go to www.playtherapypodcast.com.