Ethics, Legal and Professional Issues, and Cultural Responsiveness
What to master
Ethics and law are interwoven in child practice. Know the APA Ethics Code principles-beneficence/nonmaleficence, fidelity/responsibility, integrity, justice, and respect for rights and dignity-and the standards most often tested: informed consent and assent, confidentiality and its limits, mandated reporting, duty to protect, multiple relationships, competence, test security, record keeping, and telepsychology. Know the legal frameworks: IDEA, Section 504, ADA, HIPAA, FERPA, and state reporting laws. Cultural responsiveness requires using the cultural formulation interview, understanding idioms of distress, acculturation, and structural stigma, working with interpreters, and avoiding both overpathologizing and underpathologizing. Minors' confidentiality is limited by caregiver rights and safety concerns; assent is not consent.
Traps
Questions test whether you report suspicion of abuse, not certainty; whether you recognize that school confidentiality is not absolute; whether you avoid dual roles; and whether you use validated translations rather than ad hoc ones. Another trap is assuming adolescents' confidentiality is absolute.
Worked example / rule of thumb
A 14-year-old discloses self-harm and asks you not to tell parents. Conduct a risk assessment, create a safety plan, explain the limits of confidentiality in advance, involve caregivers as safety partners while preserving the alliance, and document. Rule of thumb: safety over secrecy, but involve the family collaboratively whenever possible.