Breaching confidentiality with adolescent clients: a survey of Australian psychologists about the considerations that influence their decisions

Confidentiality is vital for building effective therapeutic alliances with clients, yet determining when to breach confidentiality to prevent harm can be challenging. This is especially true when clients are minors, as the primary concern often entails preventing harm to the young person, as opposed to others. The current study sought to explore the considerations that Australian psychologists take into account when making decisions about breaching confidentiality with adolescents. Two hundred sixty-four psychologists responded to an online survey and rated the importance of 13 considerations. Participants were also able to list additional considerations. Factor analysis indicated that four underlying constructs influence psychologists' decisions: (1)the negative nature of the behaviour; (2) maintaining the therapeutic relationship; (3)the dangerousness of the risk-behaviour; and (4) legal protection. Qualitative analysis of the additional considerations uncovered a range of complex and often competing priorities that are also utilised when making decisions about confidentiality with adolescent clients