Master Therapists' Decision Making Process Concerning Adolescent Confidentiality: A Grounded Theory Approach

Abstract

Ethical codes and laws provide counselors with guidance for how to approach confidentiality, but there is a gap in the literature surrounding counselors' process of decision-making when managing confidentiality with a adolescent clients. This study explored the decision-making process of master therapists concerning adolescent clients. I conducted semi-structured interviews with peer identified master therapist (N=10), all of whom were licensed professional counselors with 15 or more years of counseling experience and whose case load contained 25% or more adolescent clients. Participants included seven females and three males; nine participants identified as Caucasian, and one participant identified as Hispanic. Participants ages ranged from 39-61. I analyzed the data, along with two research partner, according to Grounded Theory (GT) methodology. Through constant comparative analysis, a grounded theory emerged from the data in which participants converged understanding of client safety, relationships, clinical intuition in a process of integrated experience and consultation. With the exception of mandated reported and mortal danger, ethical guidelines and laws did not seem to factor into participants' decision making. Implications for counseling practice, preparation, and research are provided.