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The following case summary is provided as an educational resource for registrants. This type of case has been selected because it reflects issues that arise in complaints and concerns reviewed by the College and highlights areas of practice where registrants may face increased risk. By sharing these examples, CRPO aims to support safe, ethical and effective practice through reflection on real-world regulatory issues.
The College received a complaint from the Complainant, alleging that the Registrant provided psychotherapy to his two minor children without his knowledge, involvement, or consent, and that the Registrant failed to provide the Complainant with access to the children’s clinical records. The Complainant stated that he and his children’s mother are involved in divorce proceedings, and there is no court order granting their mother sole decision-making authority. In this case, the children did not have capacity to provide consent to their own treatment, or regarding the handling of their personal health information.
The Registrant stated that the children’s mother told her she held legal decision-making authority regarding the children’s medical care, and she provided consent for her children to receive psychotherapy. The Registrant acknowledged that she did not confirm the custody order or consult her supervisor regarding shared parental decision-making authority. The Registrant stated that she now recognizes that when decision-making is shared or unclear, it is best practice to proactively confirm custody arrangements and secure consent from both guardians prior to initiating psychotherapy, when possible. The Registrant stated that clinical discretion should be exercised when considering the release of records, and ultimately, she declined to provide the Complainant with the children’s clinical records to protect the therapeutic alliance and the children’s safety.
The Panel of the Inquires, Complaints and Reports Committee (ICRC) decided to provide the Registrant with written advice. While obtaining one parent’s consent may be acceptable in some circumstances, it carries risk of future disputes, especially if the parents are separated and a court order or custody agreement is in place. Therefore, before psychotherapy begins, it is generally recommended to obtain consent from both parents and review any relevant court order, custody agreement, or other legal document addressing decision-making authority for the child’s healthcare.
The Panel was concerned that the Registrant did not request a copy of any relevant court documentation to verify whether consent from both parents was required. The Panel was also concerned that the Registrant did not document her consent process for assessing and treating the clients.
The Panel believed that the Registrant’s rationale for not releasing the children’s clinical records to the Complainant was valid. Mental health professionals may decline to release such records if they believe doing so could cause significant harm to minor clients; in cases of separation or divorce, this is often the case, as the information within these records can never be unread by the parents and may affect the parent-child relationship moving forward. However, the Panel was concerned that there was no indication that the Registrant offered or provided a summary of the themes and treatment goals to the Complainant, which is considered an acceptable practice when working with minor clients.
When treating children whose parents are separated or divorced, it is important to properly engage both parents to the extent reasonably possible to avoid the perception of bias. It is also important to consult with a clinical supervisor or experienced peer, particularly if there appears to be conflict between the parents.
For further information regarding this topic, please see:
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