Informed Assent and Informed Consent in the Child and Adolescent

Abstract

<p>In the psychiatric evaluation, parents are an essential source of information prior to treatment. However, there is a fine line between children’s and adolescents’ need for privacy, autonomy, and confidentiality and the parents’ right to protect and choose what is best for their child. Therefore, the clinician may be left to wonder who can provide informed consent. This article discusses informed consent in a clinical setting.</p> <h4>ABOUT THE AUTHORS</h4> <p>Anas Alkhatib, MD, is a Child and Adolescent Psychiatrist, Riverbend Center for Mental Health, Florence, Alabama. Judy Regan, MD, MBA, JD, is Associate Clinical Professor, Vanderbilt University, Nashville, Tennessee. John Jackson, MD, is Child and Adolescent Psychiatrist, Office of Mental Health Care, Department of Veterans Affairs, Nashville.</p> <p>Address correspondence to: Anas Alkhatib, MD, <a href="mailto:anasalkhatib@rcmh.org">anasalkhatib@rcmh.org</a>.</p> <p>Dr. Alkhatib, Dr. Regan, and Dr. Jackson have disclosed no relevant financial relationships.</p> <p>The authors thank William Bernet, MD, Professor of Psychiatry, Chief of Forensic Division, Department of Psychiatry, Vanderbilt University, for his help and feedback. They would also like to thank Gagan Dhaliwal, MD, Child and Adolescent, Adult and Forensic Psychiatrist, Huntsville, Alabama, for his support.</p> <h4>EDUCATIONAL OBJECTIVES</h4> <ol><li> Review the complexity of child and adolescent assent.</li> <li>Discuss components of consent and factors that may influence child and adolescent assent. </li> <li>Describe informed dissent and how it is different from adults’ refusal of treatment. </li> </ol>

Findings from a Feasibility Study of an Adapted Cognitive Behavioral Therapy Group Intervention to Reduce Depression among LGBTQ (Lesbian, Gay, Bisexual, Transgender, or Queer) Young People

“…Regarding potential barriers to BOWS implementation, parent-related issues were common. In recent decades, state laws have given minors autonomy to consent to treatment for sensitive and private matters, such as sexually transmitted infections, alcohol or drug use, and mental health problems, which would preclude the need for parental consent [82,83]. Nonetheless, young people may want to tell their parents about their participation in BOWS even though they do not technically need their consent because it is a mental health intervention.…”

The interface of sexuality and gender with mature minor: Ethical considerations and a case illustration.

“…Assent involves many of the key components of informed consent, such as educating the minor about their condition and gauging their understanding, outlining expectations for their treatment course and prognosis, as well as attaining their permission to proceed with the discussed plan (Campbell, 2006; Katz & Webb, 2016). Importantly, the assent process involves tailoring the language and content of the process to a developmentally appropriate manner that matches the intellectual understanding and capacity of the minor (Alkhatib et al, 2008; Coughlin, 2018; Katz & Webb, 2016; Miller & Nelson, 2006). Attaining informed consent and assent must occur in advance of proceeding with any psychological services, thus protecting both the client and the psychologist before any services begin (e.g., Bray et al, 1985).…”

School-Based Interventions for Refugee Children and Adolescents

“…As with other kinds of clients, when offering therapeutic services to refugee children and families, clinicians must obtain informed consent from parents or legal guardians (Alkhatib, Regan, & Jackson, 2008;Redding, 1993). there may be barriers to effective communication regarding informed consent, such as cultural, educational, and linguistic differences between refugee clients and practitioners (fisher, 2004; vitiello, 2008).…”

“…Despite these barriers, practitioners must impart basic information about the risks and benefits of treatment to children or families, the limits of confidentiality, and the rights of the patient (Alkhatib et al, 2008). legally, the age of children or adolescents can become an important factor in determining who gives ultimate consent to treatment and to whom information can be released.…”