This shouldn’t surprise us. The human brain is perhaps the world’s most complex and least understood organic structure. Fixing the problems of the human mind is incomparably more difficult than setting a broken bone. We can’t expect therapists to fail less often than medical doctors. But we can expect more transparency and humility than practitioners typically bring to discussions of therapy’s limitations.
“In psychotherapy, psychologists help people of all ages live happier, healthier, and more productive lives,” declares the American Psychological Association.
There is, alas, no proof that they accomplish any of that in aggregate. Wanting to help is just not the same as helping...
There’s a problem with in-school therapy, an ethical compromise, which arguably corrupts its very heart. In a remarkably underregulated profession, therapists still have a few ethical bright lines. And among the clearest is—or was—the prohibition on “dual relationships.”
As psychologist and author Lori Gottlieb explains, “The relationship in the therapy room needs to be its own, distinct and apart,” she writes. “To avoid an ethical breach known as a dual relationship, I can’t treat or receive treatment from any person in my orbit—not a parent of a kid in my son’s class, not the sister of coworkers, not a friend’s mom, not my neighbor.”
This ethical guardrail exists to protect a patient from exploitation. A patient may reveal her deepest secrets and vulnerabilities to her therapist. Anyone possessing this much knowledge of a patient’s private life may be tempted to exert undue power. And so the profession makes “dual relationships” off limits.
Except that school counselors, school psychologists, and social workers enjoy a dual relationship with every kid who comes to see them. They know all a kid’s best friends; they may even treat a few of them with therapy. They know a kid’s parents and their friends’ parents. They know the boy a girl has a crush on, what romantically transpired between them, and how the relationship ended. They know a kid’s teammates and coaches and the teacher who’s giving him a hard time. And they report, not to a kid’s parents, but to the school administration. It’s a wonder we allow these in- school relationships at all.
he American Counseling Association appears to have noticed the obvious problem. In 2006, it revised the ACA Code of Ethics. While still prohibiting sexual relationships with current clients, it decided that “nonsexual” dual relationships were no longer prohibited—especially those that “could be beneficial to the client.”
As school counselors and psychologists came to see themselves as students’ “advocates,” they slipped into a dual relationship with their students: part therapist; part academic intermediary; part parenting coach. Today, school counselors and psychologists commonly evaluate, diagnose, and treat students with individual therapy; meet with their friends; intervene with their teachers; and pass them in the lunchroom. A teen who has just spent a tear-soaked hour telling the school counselor her deepest secrets might reasonably be fearful of upsetting anyone with that much power over her life.
But are school counselors and social workers exerting undue influence over kids?
Over the past two years, so inundated have I been with parents’ stories of school counselors encouraging a child to try on a variant gender identity, even changing the child’s name without telling the parents, that I’ve almost wondered if there are any good school counselors. One parent I interviewed told me that her son’s high school counselor had given him the address of a local LGBTQ youth shelter where he might seek asylum and attempt to legally liberate himself from loving parents.
There are good school counselors; I interviewed several. But the power structure’s all wrong. Grant a leader the powers of a monarch, and he may gift his subjects freedom—but what’s to tether him to his promises? That’s placing a whole lot of trust in an individual counselor’s conscience.
You might respond at this point: Fortunately, my child has never been to see the school counselor. But more likely, you don’t know. In California, Illinois, Washington, Colorado, Florida, and Maryland, minors twelve or thirteen and up are statutorily entitled to access mental health care without parental permission. Schools are not only under no obligation to inform parents that their kids are meeting regularly with a school counselor, they may even be barred from doing so.
As long as a parent has not specifically forbidden it, a school counselor may be able to conduct a therapy session with a minor child without parental consent. School counselors are encouraged to make “judgment calls” about what information, gleaned in sessions with minor children, they may keep secret from the children’s parents.
Even in states that require parents to be notified of their kids’ in-school therapy, school social workers remain free to meet informally with a child and inquire about her sexual orientation, gender identity, or parents’ divorce; such conversations often do not count as “therapy.”"
--- Bad Therapy: Why the Kids Aren't Growing Up Kindle Edition / Abigail Shrier
