Part of the job of a child therapist or clinical psychologist is to interview, evaluate, diagnose and treat minor children but this can mean that you find yourself in the middle of a heated argument between divorcees who dispute consenting to such sessions and treatment.

What does one do if one parent (the non-consenting parent) refuses to consent to the treatment to be provided by you?

This happens often. It is always wise to enquire about the marital status of parents when children require therapy. Knowing these facts will determine whose consent you may need to obtain prior to rendering the treatment. If parents are divorced, one may need to understand the terms of the settlement agreement to see how the parental responsibilities are split. Once you have this information, you can contact a non-consenting parent with a view to understanding the reasons for objecting to the proposed treatment.

The reasons for refusing consent may be due to a number of factors such as a feeling that the therapist or clinical psychologist has not been selected independently; that the therapist or clinical psychologist might show bias towards the parent paying the bill, a view that therapy is not required (e.g the child has not expressed the desire or need to attend therapy in front of the non-consenting parent), or possibly even by design to continue the relationship malice to upset or derail ex-spouse.

Should the non-consenting parent’s view be considered?

Yes, ,most definitely before the consenting parent wishes to have his/ her child enter the therapeutic relationship, the non-consenting parent’s views should be considered. As the therapist, you could and should try to understand the reasons behind the non-consenting parent’s refusal of consent.

In the absence of joint consent, can the minor child still attend therapy?

Yes. The consenting parent can still send the minor child for therapy once the consenting parent :

  1. has reasonably applied his/her mind to the minor child’s and the non-consenting parent’s wishes;
  2. is strongly of the view that the sessions with the proposed therapist will assist in determining the “best interests of the minor child”; and
  3. understands that the therapist (after consulting with the minor child), may not make final conclusions and/or recommendations without consulting the non-consenting parent
  4. where disclosures concerning the non-consenting parent are made in the course of a session, a formal opinion should be prepared and brought to the attention of the non-consenting Feedback sessions should also be encouraged with the non- consenting parent to discuss the disclosures and the management of the child’s emotions and behaviour thereafter.

Does the minor child have any say?

Yes, Section 31 of the Children’s Act 38 of 2005 states that “before a person with parental responsibilities and rights in respect of a child takes any decision involving a minor child, that person must consider the views and wishes expressed by the child, bearing in mind the child’s age, maturity and stage of development.”

The Children’s Act also specifies that a child who is 12 years of age is legally competent to consent to medical treatment including therapy where he/she is of sufficient maturity and has the mental capacity to understand the benefits, risks, social and other implications of the therapy.

What is meant by decisions involving a minor child?

A decision in this context is any decision which is likely to significantly change, or have an adverse effect on, the child’s health and wellbeing.

 

How should I manage the conflict?

  1. The Children’s Act states that in any matter concerning a child, an approach that is conducive to conciliation and problem-solving should be followed
  2. Openly ask the consenting parent about marital status, how their parental responsibilities are shared or split and if consent is jointly given
  3. Contact the non-consenting parent, preferably following a prepared script to ensure that all concerns or questions can be addressed in an open and transparent way with a view to legitimising feelings, addressing problem areas and finding
  4. Record the outcomes of any feedback sessions or conversations as part of the [minor]
  5. Follow up the discussions with a written report of the agreement/consensus/lack of consensus
  6. Using a prepared template/checklist, decide on the best/most appropriate therapeutic approach that may include referral of the patient, involvement of social services or other health care professionals
  7. Document everything