Just because some one asks you to tell them where a certain youth is going each week, does not mean you have to tell them that the youth is seeing a counselor.  The reality is that if you have knowledge that a youth is attending weekly counseling sessions and you disclose this information to others, it can be harmful similar to the reasons that confidentiality is important for the therapist to maintain.  If other students (or even other adults) learn that a certain youth attends counseling sessions there is the potential that conflicts could arise. 

 

There have been instances in school settings where peers use the participation of another youth in counseling as a means of insult and attack.  This can be avoided by simply NOT discussing a youth’s participation in counseling.  There have also been times when the counselor contacts a teacher and asks the teacher to send a student to the office or to guidance and the teacher calls the student out of the class saying something like “Susan it is time for you to go to counseling right now.”  In the above instance, the classroom of other students learns that Susan is seeing a counselor, and what happened is that they began to make comments to Susan every week – something that became quite hurtful and harmful to Susan.     

 

One thing that adults can do when people ask about the whereabouts of youth who are called out of class each week, is re-direct the inquiring student to stay on task with their own work in the classroom.  Sometimes the inquiring student will be persistent and it may become necessary to be more direct saying something like this: “Jonathan, you may want to worry more about yourself and not ask so many questions about Susan.”    

When counseling services begin in the academic setting there are usually expectations that people have; sometimes these expectations are reasonable, and sometimes they are not.  The purpose of the following information is to address common questions, concerns, and ideas that teachers, school administrators, parents, guardians, and even the youth themselves have when counseling services begin.  And while most of the information contained in the following pages is designed to address counseling services in the academic setting, this information will likely offer helpful points to consider, related to any counseling program.

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Youth can be referred to counseling, if it is believed they will benefit from the service, by any authorized person (school staff, parents, guardians, etc).  They will be seen, provided the school makes the referral, which sometimes cannot happen due to program limitations (for example some schools only provide counseling to special needs youth, and not to mainstream youth – determined usually by the funding source).  Children are referred to counseling usually through contacts made with guidance counselors.  Parental/Guardian consent must be obtained using a written authorization form, called the PERMISSION SLIP FOR SCHOOL COUNSELING SERVICES. But what adults are not always aware of, is that in order for counseling services to continue, the youth must also agree to participate – no matter how badly it is believed that counseling is needed. 

 

If the student does not want to participate in counseling, they will be encouraged to do so based upon referral information.  Many times, when youth are confronted with the reasons it is believed they might benefit from counseling, they often agree to try it out - but not always.  When the child refuses counseling, the counselor cannot force participation.  When the school refers a youth for counseling and the parents have given authorization, but the youth declines, the youth is informed that the counselor will notify the parents and the school so that everyone is aware why services are not being provided. 

 

There are times when a child refuses counseling, and services are provided anyway.  If counseling is mandated via legal sanction (by a judge, court order, or juvenile/probation officers), the youth is seen whether there is consent or not, because in these cases, counseling is no longer optional. 

 

In either case, whether the youth is voluntary or mandated into counseling, both kinds of youth can be served with equal effectiveness.  In fact, some of the mandated youth will excel in counseling benefits.

School counselors often get asked why it is that the kids who act up the most get to leave the classroom.  As one teacher put is; “aren’t you simply rewarding negative behavior?”  Whenever a youth, who is usually oppositional and resistant to adult instruction and help, suddenly becomes excited to attend weekly counseling sessions, such questions are understandable.  There’s good reason for the striking difference (and it’s not about reinforcing negative behavior), it is because counseling is designed to be relatively fun - at best, and highly encouraging - at least.  It is important for referring parties and other interested adults to remember that counseling is really about addressing the “root of the problem” that otherwise has not been resolved in standard day-to-day settings.  By getting to the “root of the problem” many day-to-day problems begin to see resolve.  For example, if a child is having outbursts in the classroom that includes verbal and physical aggression, and the school and parents have been unsuccessful in getting the youth to stop the unacceptable behavior, a counselor might work with the youth and discover that the child has an underlying problem.  The problem could be a recent familial change (separation, divorce, or blending of two families into one), grief and loss related to a death in the family, or maybe even a mental disorder might be discovered.

Talking – children in counseling discuss many of the same things that adults in counseling discuss.  For example nearly every session includes a time when youth are invited to talk about what things are going good for them, and what things not going so good.  Feelings are identified, and they are encouraged for the purposes of expression in a place where they really are allowed to do so.

 

Games, Music, Art, Play – youth who are unable or unwilling (due to age or simply defiance) to express how things are going for them might be encouraged to do so via non-traditional methods.  Board games, paper folding exercises, art work and music can all be effective ways to assist youth in expressing and identifying past, present, and future anxieties, concerns, fears, joys, excitement, etc. etc.  The focus of many sessions is on themes related to expression and problem solving.  These themes apply to practically all humans (not just children): thinking, feeling, work (such as academics), peer relations, and family.  What is important to remember is that with every activity, even those that might seem foolish or silly, they all have a clinical purpose.

many people think that confidentiality applies only to adults; however, Florida law protects confidentiality between the therapist and the client.  Just as the law limits what can and cannot be disclosed, so does a professional code of ethics.  Therapists who meet the minimum legal standards, by which they are allowed to practice in the State of Florida, also prescribe to a standard of professional conduct.  Clinical Social Workers are governed by the NASW Code of Ethics.  But the law and ethics are not the only consideration when it comes to confidentiality. 

 

Another variable that is involved in the issue of confidentiality is what is sometimes called “The Standard of Care.”  The standard of care is much more subjective than Florida law and the Code of Ethics, however confidentiality is considered a minimal expectation in the profession of mental health counseling and it serves many purposes.  Mainly, confidentiality provides for an environment that builds trust and rapport, which allows for open, honest and frank dialogue between the youth and the counselor.  And just as adults often deal with sensitive topics such as drugs, alcohol, sexual behavior, abuse, and stress, the same holds true for youth.  Discussing these kinds of topics outside of the counselor/client relationship can damage the ability of the counselor to help the client adapt and resolve their various responses.  For these reasons, when anyone asks what is being addressed and discussed during counseling sessions the counselor will decline to answer based upon the legal, ethical and professional standards related to confidentiality.

 

There are exceptions to the confidentiality standard.  Florida Law, the Code of Ethics, and the Standard of Care all agree that when the safety of a youth is at issue, confidentiality should be breached.  If a child is going to hurt themselves, hurt someone else, or is being hurt by someone - then other parties must be notified and confidentiality is subject to violation.  Lastly, what parents, guardians, and school personnel should know, if there are other sensitive issues that come up in session that the counselor believes would be important to disclose, the youth will be encouraged to do so – while also being reminded that they have every legal right to decline disclosure.     

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“The goal is to help youth succeed. In a sense their lives are very much like that of a ball player—there are practices to show up for, rules to follow, someone usually keeps score, the referee might be wrong, everyone at bat wants to hear the crowd go wild, and there are wins and there are losses—no matter what your coach says to you or what your team mates might think, every now and then you’ve got to stop the game and take a little time to talk.”          K. LaRose

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Text Box: “ My work in rural schools has allowed for the implementation of mental health  programs in academic settings that traditionally did not use these kinds of services.  The schools have been delighted with the behavioral impact that counseling has brought about in their most problematic students.”  
               
               K. LaRose

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