Divorced Parents, a Subpoena, and a Teenager’s Therapy Records
Dr. Priya Chen has treated Maya, age 16, for 14 months for depression and self-harm. Maya’s parents divorced; they share joint legal custody, and both signed the intake consent. Maya’s father has requested “the complete file, including everything her mother told you” after Maya disclosed that her father drinks and drives with her in the car. An attorney for the father serves a subpoena for all records and Dr. Chen’s notes. Maya’s mother objects and says Maya will stop therapy if her father sees her journal entries, which Dr. Chen summarized. Maya, who is 16, asks Dr. Chen not to release anything. Dr. Chen’s records include psychotherapy notes, test data, and a safety plan. The subpoena is signed by a clerk, not a judge, and no court order authorizes release.
1. Does the subpoena by itself require Dr. Chen to release the entire record? What should she do first?
Read the worked answer
No. A subpoena signed by a clerk is a demand for production, not a court order overriding privilege. Dr. Chen should first verify that the subpoena is valid, that it was properly served, and what it commands. She should notify both parents and Maya’s attorney or guardian ad litem, assert privilege and confidentiality, and seek a protective order if needed. She should not ignore the subpoena, but she also should not dump the entire file. Psychotherapy notes and test data receive heightened protection and should not be released without a valid authorization or court order. She can release only the specific, non-privileged materials that are properly authorized or ordered, with redactions of third-party information. Because both parents share joint legal custody, both generally have rights to the child’s records, but that does not eliminate the need to follow the subpoena process or protect particularly sensitive material. Dr. Chen should document her reasoning, the notices given, and any objections filed.
2. How should Maya’s age and request for confidentiality affect Dr. Chen’s response?
Read the worked answer
Maya’s wishes matter clinically and ethically, but they do not automatically override her parents’ legal authority. With joint legal custody, both parents ordinarily have access to the minor’s health information unless a court order limits that access. Dr. Chen should not promise Maya absolute confidentiality. She should explain the limits at the outset and again now, including that a subpoena or parental request may require disclosure. At the same time, Nevada law and professional standards allow clinicians to protect an adolescent’s therapeutic space where possible. Dr. Chen can ask the parents to agree to a limited release, provide a summary rather than the full file, or let Maya’s therapist discuss concerns with them. If the parents disagree, Dr. Chen may seek court guidance or a protective order. The safety issue-father drinking and driving with Maya-also requires clinical attention and possibly a child-protection report if there is reasonable suspicion of abuse or neglect. The response should separate the legal access question from the clinical question of how to keep Maya engaged in treatment.
3. What should be released, withheld, or handled differently regarding psychotherapy notes, test data, and the safety plan?
Read the worked answer
These categories are not treated identically. Psychotherapy notes-Dr. Chen’s process notes and journal summaries-are generally afforded extra protection and should be withheld unless there is a valid authorization specifically permitting their release or a court order. Test data and protocols should be released only to a qualified professional or as required by court order; unrestricted release can compromise test security and be misleading to a lay reader. The safety plan is part of the treatment record and may be relevant to the father’s request, but it can be summarized rather than copied if the full document would reveal sensitive disclosures. Dr. Chen should prepare a privilege log identifying what she is withholding and why. If the court orders release, she should comply with the order’s exact scope, redact third-party information, and mark the records confidential. Throughout, she should document the legal advice received, the notices sent, and her attempts to balance parental rights, Maya’s safety, and the therapeutic relationship.