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Posted by Roushan Martens, Jun 4 2008 1:16PM

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Working with Clients under 18

Does anyone know what the guidelines are regarding working with under-18s? I've done a little work with children before, and always have the parent present. I would always do this, for my protection and theirs, with anyone under 16. A client recently asked me, however, what the position would be with her soon-to-be 16 year old daughter, who she suspects would not come if she had to have her mum in on the session. I said I'd check it out. I'm not sure where I stand legally and professionally on this. I have an enhanced disclosure check, for what it's worth. Does anyone know what the official position is...?
Mike Colquhoun
Jun 7 2008 8:43PM
Hi Roushan
With any patient legally you are responsible for your decisions and your work and no amount of disclosure - consent - or whatever can change that.
If you obtain consent to an unsafe practice explaining the associated risks and then go ahead and do it, you, as a professional, are held responsible for your actions and the consent, even though it explains the risks, is worthless and set aside.
However you can write up a record of what has been said and done and get the patient to sign every page. It gets a bit ludicrous.
Consent would be required for any form of recording.
Under 16 you are dealing with a child [legally, though not always mentally] and though the parent's presence is not a requirement, a responsible adult's presence is the only way you are going to have even half a leg to stand on if a dispute arises especially if there is any suggestion of impropriety. Remember you are going to work with lesbians and there is no age barrier.
As a man I have to be particularly careful [our denial is less likely to be believed] and under 18 I require the presence of a responsible adult appointed by the parents if it's not them themselves. Under 21 I much prefer an adult to be present, though I will allow next door if I feel confidence in both the people concerned.

So there sat her boyfriend through about ten sessions. Her shoulders did relax during each session but were just as bad at the start of the next session. Eventually the boyfriend got his marching orders and her shoulders released the next day.

If Mum can’t be there, a parentally appointed adult is about the only compromise, though no one need be present during the interview, they must be within shouting distance at all times, and in the room if there is any disrobing, for your peace of mind, after all how can you help someone if you are worried about the situation?
Oh and all exits must be unlocked so they have the opportunity to run to the street.

Hope this helps
Yours aye Mike
Roushan Martens
Jun 12 2008 8:23PM
Thanks so much for that reply Mike, really useful to see how someone else manages it. I have been meaning to say that I got a call from someone in the insurance section at Embody, who was extremely helpful in outlining the ins and outs from an insurance perspective. I can't reproduce here what she said, as its complex, but I would advise anyone with the same questions to ring Embody - the information they gave me was invaluable.
Angela Rawlins
Jul 4 2008 8:01PM
Hi

I have treated several under 16's, the youngest was 5 and had her mother and father present at different times. I have two young lads whose mothers left them with me whilst they fetched other siblings from school.

One day, I had my insurance document to hand, I asked my husband to read through it for me as he had considerable expertise in Insurance, who pointed out that I must have an adult present! So, I would make sure you check your insurance documents before treating without an adult!

I have since made sure that an adult is present on the premises, sometimes outside on a chair if need be.

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