In treatment with minors, what is the role of assent and how does it relate to confidentiality?

• A. Assent implies the child agrees to treatment decisions and replaces consent
• B. Assent is not required for information sharing
• C. Assent constraints can limit parental access to information in treatment, balancing confidentiality with safety
• D. Assent replaces parental consent entirely

Answer: (C)

Working with minors involves respecting their growing ability to participate in decisions about their care while also recognizing that parents typically remain responsible for consent. Assent means the child or adolescent is invited to understand what treatment involves and to agree to participate in a developmentally appropriate way. It does not replace parental consent; it works alongside it to honor the young person’s voice without removing the parent’s legal role in authorization.

Confidentiality in therapy with youth is not absolute. Clinicians share information with parents as needed for safety, coordination, and care, but the details of sensitive conversations are often kept private to protect the minor’s privacy. Assent can shape how much information is disclosed to parents: the clinician can involve the young person in decisions and limit what is shared about private disclosures, especially when there is no safety risk, thereby balancing confidentiality with the need to keep minors engaged in treatment.

So, the role of assent is to involve the minor in decisions without replacing parental consent, and it can lead to withholding or limiting certain information from parents to protect the adolescent’s confidentiality while still addressing safety and care needs.