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Family Physicians’ Interventions with Young People in Distress and Their Parents: Managing Confidentiality and Levels of Engagement

Received August 1, 2006; revised January 18, May 2, and June 21, 2007; accepted June 27, 2007. Professor Stanley is affiliated with the Department of Social Work at the University of Central Lancashire. Professor Manthorpe is affiliated with the Social Care Workforce Research Unit at King’s College London. Lesley Gillespie is affiliated with the Health Sciences Department at the University of York. Address correspondence to Nicky Stanley, University of Central Lancashire, Social Work Department, Preston, PR1 2HE, United Kingdom; nstanley{at}uclan.ac.uk (e-mail).

OBJECTIVE: This study aimed to interrogate the decisions and approaches used by family doctors in responding to the needs of young people in distress. The research sought to explore how practitioners balanced young people’s needs for confidentiality and self-determination with their parents’ concerns and needs as caregivers. METHODS: Interviews were undertaken with 30 family physicians in the United Kingdom using a semi-structured schedule to elicit reactions to a case scenario. RESULTS: While family physicians identified the ethical and clinical benefits of patient confidentiality for young adults, a wide range of approaches was adopted with respect to providing feedback and reassurance to parents. Likewise, there were substantial variations in the extent to which clinicians were prepared to adopt a proactive stance to engage a young person who was reluctant to seek help. CONCLUSION: These diverging practice examples can be used to inform training programs and offer a means by which the caregiver’s need for information and support can be emphasized in psychiatric and clinical education.

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