Consent in Child Psychotherapy: The Conflicts for Child Patients, Parents and Professionals

Samantha, a nine year old patient, fell asleep during a session. I let her sleep for a few minutes, then woke her, and sat next to her as she collected herself. It was nearly time to go, and I talked briefly of what I felt was her depression and her need to block out the pain of what we had earlier talked about in the session.

Two hours later, Samantha's mother, Mrs. H. phoned and asked “Did you hypnotize Samantha?” The unexpectedness of the question, about a technique so outside my own practice of psychotherapy, nearly prompted me into a facetious reply, but in fact I answered seriously that I had not done so, that I did not know how to hypnotize, that, as far as I knew, no-one in our building used hypnosis, and that if it were used on children it would be with parents' knowledge and consent. Mrs. H. had only my word to go on, but appeared satisfied by this interchange. The question remains, how is a responsible parent to evaluate what goes on between a professional and their child, when the professional insists on working in privacy and confidentiality that excludes the parent?

In the H. family's case the difficulty was real. Samantha was referred for depression which had started at the time of her father's death. Mrs. H. quarrelled with the clinic psychiatrist working with herself and refused to go on seeing him. She had been unable to let him raise the question of the loss of her husband. However, she was so anxious for Samantha to continue therapy that we agreed to do so, with many misgivings about working without close contact with a parent. Our misgivings were soon justified. It was obvious that, without the chance to check with us personally at the clinic, Mrs. H. was doing her checking outside. Conversations with a psychologist uncle prompted Samantha to say to me, “Harold Lloyd isn't approved of.” An imaginative leap I was rather proud of prompted me to ask, “Do you mean Sigmund Freud?” She did mean Freud, and was conveying to me the doubts in her family cir