and autonomy to their professional practices by seeking informed consent to establish a school psychologist–client relationship and by ensuring that the individuals with whom they work have “a voice and a choice” in decisions that affect them.
School psychologists sometimes ask the question, “Who is the client?” In the school setting, multiple different parties may be recipients of school psychological services or affected indirectly by their decisions. NASP’s code of ethics identifies the client or clients as the individuals who have entered into a school psychologist–client relationship for the purpose of receiving services. A school psychologist–client relationship is established by an informed agreement with a client about the school psychologist’s duties to each party in the professional relationship (NASP, 2020, p. 41). Often more than one individual is a primary client, such as when the school psychologist-client professional services relationship involves parents and their child (also CPA, 2017).
Except for urgent situations, school psychologists generally seek the informed consent of an adult (the parent or guardian of a child) to establish a school psychologist–client relationship (NASP Standard I.1.2). They respect the right of the individual providing consent to choose or decline the services offered (NASP Standard I.1.5), and they “reopen discussion of consent when appropriate, such as when there is a significant change in previously agreed on goals and services, or when decisions must be made regarding the sharing of sensitive information with others” (NASP Guiding Principle I.1). School psychologists also honor, to the maximum extent appropriate, the right of children to assent to or decline school psychological services (see Chapters 3 and 7).
However, when working with children, sometimes it is necessary to balance the rights of self-determination and autonomy against concerns for the welfare of the child. The NASP’s code of ethics states: “Ordinarily, school psychologists seek the student’s assent to services; however, it is ethically permissible to bypass student assent to services if the service is considered to be of direct benefit to the student and/or is required by law” (NASP Standard I.1.4; also CPA, 2017, I.35). If a child’s assent is not solicited, school psychologists nevertheless ensure that the child is informed about the nature of the services being provided and is afforded opportunities to participate in decisions that affect them (NASP Standard I.1.4, II.3.14).
As noted, school psychologists often provide services within the framework of an established school psychologist–client relationship. However, as members of a school’s instructional support team, practitioners also provide consultative services to student assistance teams, classrooms, or schools that do not fall within the scope of an established school psychologist–client relationship (NASP, 2020, p. 41). Thus, while school practitioners encourage parental participation in school decisions affecting their children (NASP Standard I.1.1, II.3.13), not all of their consultative services require informed parent consent, particularly if the resulting interventions are under the authority of the teacher and within the scope of typical classroom interventions (NASP Standard I.1.1) (also see Chapter 7).
During their careers, school psychologists will encounter dilemmas regarding how to balance the rights of parents to make informed decisions about their children with the rights and needs of those children. For example: Under what circumstances should minors have the right to seek school psychological services on their own, without parent permission? When should a minor be afforded the opportunity to make a choice whether to participate in or refuse the psychological services being offered? We will be exploring these issues in the chapters ahead.
Privacy and Confidentiality
Psychologists “respect the right of persons to choose for themselves whether to disclose their private thoughts, feelings, beliefs, and behaviors” (NASP Guiding Principle 1.2; also APA Principle E), and every effort is made to avoid undue invasion of privacy (APA Principle E; NASP Standard I.2.1). School psychologists “do not seek or store private information about clients that is not needed in the provision of services” (NASP Standard I.2.2; also APA Standard 4.04).
Practitioners also use appropriate safeguards to protect the confidentiality of client disclosures. Except for urgent situations, they inform clients of the boundaries of confidentiality at the outset of establishing a school psychologist–client relationship. They seek a shared understanding with clients regarding the types of information that will and will not be shared with third parties and recognize that it may be necessary to discuss how confidential information will be managed at multiple points in an ongoing professional relationship (NASP Standard I.2.2). Read and consider Case 1.1.
Samantha’s first- and second-grade teachers observed that she experienced difficulties with concentration and memory. She frequently failed to remember letter sounds and math facts she had previously mastered. Now, in third grade, Samantha continues to perform well below grade level even after multiple individualized interventions were attempted in the classroom. Samantha’s mother, Joanne, agrees with the third-grade teacher that Samantha should be evaluated to determine whether she is eligible for special education services. Carrie Johnson, the school psychologist, meets with Joanne to ensure she is informed about the nature and scope of the psychoeducational evaluation and to gather information about Samantha’s developmental history. Joanne is employed as a classroom teacher aide at the same small, rural school her daughter attends. In the meeting with Carrie, Joanne discloses that she was involved “with the wrong boyfriend” during her first semester away at college. She “partied a lot, used all kinds of drugs, and got pregnant.” Because she was “too messed up” to realize she was pregnant, she continued to use drugs during the early months of her pregnancy but then moved back home with her parents and “got straightened out.” Joanne went on to tell the psychologist: “Please don’t tell anyone about this. I’ve never even told any of my doctors because my mom said it would be difficult for me to get a good job if drug abuse showed up in my medical records. And if my drug use history gets out at this school—you know how this community is and how people talk—it could hurt Samantha and I might even lose my job.”
Carrie Johnson (Case 1.1) will assure Joanne that her disclosure of drug use during pregnancy will be held in strict confidence and not shared with anyone else, and not included in Samantha’s school psychology records (NASP Standard I.2.2; also APA Standard 4.04). Carrie recognizes that she has a special ethical obligation to safeguard the confidentiality of sensitive and private medical information (NASP Standard I.2.6). Furthermore, the information that Joanne disclosed about her pregnancy is not needed for the purpose of determining Samantha’s eligibility for special education services or for planning appropriate educational interventions for her (NASP Standard I.2.1, I.2.4), and could have negative repercussions for Joanne and Samantha if made available to others.
In situations in which confidentiality is promised or implied, school psychologists do not reveal information to third parties “without the agreement of a minor child’s parent, legal guardian, or of an adult student, except in those situations in which failure to release information would result in danger to the student or others, or where otherwise required by law” (NASP Standard I.2.3). Furthermore, when practitioners share information with third parties, they “discuss and/or release confidential information only for professional purposes and only with persons who have a legitimate need to know” (NASP Standard I.2.4).
The ethical and legal issues of privacy, confidentiality, and privilege will create challenges for practitioners. For example, what information do teachers and other instructional staff need to know about a child’s physical health, mental health, and family background to provide effective individualized instruction? Do parents have a right to know what their child tells a school psychologist? What if a young teenager discloses
