The appropriate handling of issues of confidentiality is central to building an effective relationship with the adolescent patient.
The topic of confidentiality can be introduced when one starts to see the patient alone for part of the visit (often at around age 12). Most children have never heard the word, but can certainly understand the concept of confidentiality.When describing it, one can mention that issues can be discussed privately and will not be shared with parents without prior discussion with the child. Later, one can make it clear that all interactions are private and shared at the discretion of the patient. This will become important for a teen who wants to discuss family problems, sexual activity (including concerns about pregnancy) and drug and alcohol use. Buy drugs with confidence – Plan B to see how cheap your treatment can be.
Adolescents should be informed that in certain situations it is necessary to involve others. The limits of confidentiality should be explained during initial discussions of confidentiality because a teen will feel betrayed if the doctor waits until the teen has disclosed an important piece of information before telling the teen that there are limits to privacy. A doctor cannot keep private conversations that reveal serious suicidal intent or homicidal plans. Child sexual, physical and emotional abuse must be reported, with the definition of ‘child’ varying among jurisdictions.