Taiwania : an international journal of life science

Confidentiality is vital for building effective therapeutic alliances with clients, yet determining when to breach confidentiality to prevent harm can be challenging. This is especially true when clients are minors, as the primary concern often entails preventing harm to the young person, as opposed to others. The current study sought to explore the considerations that Australian psychologists take into account when making decisions about breaching confidentiality with adolescents. Two hundred sixty-four psychologists responded to an online survey and rated the importance of 13 considerations. Participants were also able to list additional considerations. Factor analysis indicated that four underlying constructs influence psychologists' decisions: (1)the negative nature of the behaviour; (2) maintaining the therapeutic relationship; (3)the dangerousness of the risk-behaviour; and (4) legal protection. Qualitative analysis of the additional considerations uncovered a range of complex and often competing priorities that are also utilised when making decisions about confidentiality with adolescent clients

Refusing to provide a prenatal test: can it ever be ethical?

A couple in which the man carries the mutation for Huntington's disease request prenatal testing during their first pregnancy. Though they would not terminate an affected pregnancy, they would like the information. There is no treatment available that can change the course of the disease so the diagnosis will not result in medical benefit for the chil

Adolescents, risk behaviour and confidentiality: when would Australian psychologists breach confidentiality to disclose information to parents?

The protection of confidentiality in psychological practice is vital. However, confidentiality is not absolute and psychologists are permitted to breach confidentiality under particular circumstances. Ethical challenges surrounding confidentiality are complex with adolescent clients, as assessments often consider the risk that adolescents pose to themselves in addition to the risk posed to others. The current study documented situations in which Australian psychologists would breach adolescents' confidentiality to disclose information about risk behaviour to parents, with a focus on situations where adolescents posed a risk to themselves as opposed to other people putting adolescents at risk. A total of 264 Australian psychologists were surveyed online. They were each presented with 68 variations of a vignette about a 15-year-old boy who was engaged in risk behaviour and were asked whether they would breach confidentiality in each case. The vignettes covered six behavioural domains (smoking, sexual behaviour, drinking, drug use, suicide, stealing) and varied in behaviour intensity, frequency and duration. Consensus was reached about breaching confidentiality in 16% of cases (related to sexual behaviour, drug use, and suicide). Consensus was reached about not breaching confidentiality in 41% of cases (relating to smoking, sexual behaviour, drug use, suicide, and stealing). In the remaining 43% of cases, significant disagreement occurred (relating to all six behavioural domains). The findings suggest a high degree of variation in opinion about confidentiality with adolescents, emphasising the importance of transparent communication and informed consent. The findings also raise questions about how important consistency of psychological practice is across Australia

Breaching confidentiality with adolescent clients: a survey of Australian psychologists about the considerations that influence their decisions

Confidentiality is vital for building effective therapeutic alliances with clients, yet determining when to breach confidentiality to prevent harm can be challenging. This is especially true when clients are minors, as the primary concern often entails preventing harm to the young person, as opposed to others. The current study sought to explore the considerations that Australian psychologists take into account when making decisions about breaching confidentiality with adolescents. Two hundred sixty-four psychologists responded to an online survey and rated the importance of 13 considerations. Participants were also able to list additional considerations. Factor analysis indicated that four underlying constructs influence psychologists' decisions: (1)the negative nature of the behaviour; (2) maintaining the therapeutic relationship; (3)the dangerousness of the risk-behaviour; and (4) legal protection. Qualitative analysis of the additional considerations uncovered a range of complex and often competing priorities that are also utilised when making decisions about confidentiality with adolescent clients

Is my mum going to hear this? Methodological and ethical challenges in qualitative health research with young people

Ethical issues arise in all research settings. However, qualitative research with young people raises specific dilemmas that warrant special attention. In this paper we describe an ethical dilemma that arose during a qualitative project we carried out exploring self-management of chronic illness in adolescents. A participant disclosed details of poor adherence with medication, which had significant health implications. Prior to this disclosure he had been assured of confidentiality and thus we found ourselves unsure of how to proceed. Here, we analyse the case in detail, highlighting the ethically important moments, the options for action and the implications of these. We do this with the aim of facilitating ethical mindfulness and thus, ultimately, ethical research practice. As a backdrop to this case we consider the broader ethical context. We find that qualitative research is susceptible to ethical dilemmas because: (1) it is not always possible to predict all possible questions and responses; (2) the nature of the relationship between researchers and participants is amenable to sensitive disclosures; (3) the process of qualitative research can make it difficult for participants to voice concerns or withdraw; and (4) participants' identities are generally known to researchers, complicating boundary issues. Research with young people is susceptible to ethical dilemmas because: (1) young people have limited life experience; (2) consent is often required from both young people and parents; (3) issues of competence can complicate assumptions about informed consent; and (4) the power differential between researchers and participants is significant. When combining qualitative research methods and young participants, the scope for ethical risk is thus substantial.Australia Adolescent Children Medication non-adherence Qualitative research Ethics Research methodology Chronic illness

"They don't really get heard": A qualitative study of sibling involvement across two forms of family-based treatment for adolescent anorexia nervosa.

Little is known about the involvement of siblings in family-based treatment (FBT) for anorexia nervosa (AN). To explore the experience of families, adolescents who had completed FBT, their siblings, and parents were interviewed. Siblings reported that involvement in FBT enhanced their understanding of anorexia and that they supported their family in various ways. While siblings often wished they had attended more sessions, there was no consensus among parents and patients regarding sibling attendance and many were concerned about potential negative impacts on siblings. Clinicians should discuss sibling roles and expectations early in FBT and work actively with families to address concerns

SWIFF: Space weather integrated forecasting framework

SWIFF is a project funded by the Seventh Framework Programme of the European Commission to study the mathematical-physics models that form the basis for space weather forecasting. The phenomena of space weather span a tremendous scale of densities and temperature with scales ranging 10 orders of magnitude in space and time. Additionally even in local regions there are concurrent processes developing at the electron, ion and global scales strongly interacting with each other. The fundamental challenge in modelling space weather is the need to address multiple physics and multiple scales. Here we present our approach to take existing expertise in fluid and kinetic models to produce an integrated mathematical approach and software infrastructure that allows fluid and kinetic processes to be modelled together. SWIFF aims also at using this new infrastructure to model specific coupled processes at the Solar Corona, in the interplanetary space and in the interaction at the Earth magnetosphere