In a session with a minor client exploring sexual orientation who asks the counselor not to disclose information to a parent, what is the appropriate course of action?

• A. Immediately disclose to the parent
• B. Reassure confidentiality but explain limits to disclosure
• C. Promise absolute confidentiality and withhold all information
• D. Refuse to treat

Answer: (B)

Confidentiality with minors rests on building trust while recognizing there are limits. The best approach is to reassure the minor that what they share will be kept private, but you will explain the exceptions where disclosure is allowed or required. In practice, you discuss at the outset what information may be shared, with whom, and under what circumstances. If there’s risk to the minor’s safety, risk of harming someone else, or a legal requirement to report, you would disclose relevant information to the appropriate parties. This approach supports the minor’s autonomy and safety and aligns with ethical responsibilities, without promising absolute confidentiality. It isn’t appropriate to promise absolute secrecy, nor to disclose immediately without a warranted reason, and it wouldn’t be ethical to refuse to treat solely on the basis of a confidentiality request.