I’m under the Age of 18; Does My Parent Have to Give Permission for Me to Go to Therapy?

Lynn Somerstein, PhD, E-RYT: People under the age of 18 need parental consent for medical and psychological treatment. This law is devised to protect minors, although there are some variations in the United States depending on the state where you live. Some people under the age of 18 may be considered “mature” by legal standards and so don’t need parental consent. These people may be married or in the military.

A good way to find help is to go to your school’s guidance counselor and ask. Alternatively, you can speak privately with your pediatrician, religious or youth leader, or a trusted teacher who will perhaps direct you to someone who can see you for therapy, although legal consent is still an issue.

Payment, of course, is also an issue. Usually the parent pays. This is difficult for everybody, because the parents will feel entitled to information that they are paying for, that is their legal right. The clinician will have to develop appropriate approaches, consulting the parents and the child under 18, to protect the child’s privacy.

Andrea M. Risi, LPC: Each state can differ slightly on this rule. In regard to mental health treatment in Colorado:

• “A minor who is fifteen years of age or older may consent to receive mental health services to be rendered by a facility or a professional person. Colo. Rev. Stat. § 27-65-103(2).”

In regard to treatment of addiction to or use of drugs in Colorado:

• “Minors may voluntarily apply for admission to alcohol/other drug abuse treatment, regardless of their age, with or without parental or legal guardian consent providing the treatment agency demonstrates adherence to its policy regarding admission of minors without parental or legal guardian consent. …Minors’ signatures shall suffice to authorize treatment, releases of information, fee payment (if minors have personal control of adequate financial resources), and other documents requiring client signatures. 6 Colo. Code Regs. § 1008-1 (15.225.2)1”

To summarize, in Colorado minors older than 15 years may seek mental health counseling without consent of a parent and any minor may seek treatment for substance abuse. Remember that when parents do give permission for you to attend counseling, that doesn’t mean they have access to your counselor’s records, nor can they talk to your counselor without your consent. I usually tell minors I am providing therapy to something like, “Everything we talk about is confidential unless you talk about hurting yourself or someone else, but we may want to include your parents on occasion with your permission.”

Deb Hirschhorn, PhD: According to a document produced in 2004 by the New York Civil Liberties Union, minors can obtain therapy without parental permission provided they have the ability to understand the “nature and consequences of a proposed treatment, including its risks, benefits and alternatives, and to reach an informed decision.” This is called informed consent.

The minor is entitled to confidentiality as well, meaning that the substance of the treatment, and the fact of being in treatment, is not disclosed without the person’s consent.

New York, however, includes a catch. There are three conditions, any one of which needs to be met:

1. There is no parent or guardian
2. Including the parent or guardian would be detrimental to the therapy
3. The parent or guardian has refused to consent and a physician (medical doctor) decides that the therapy is necessary. The physician must notify the parents, but only if he or she thinks doing so is “clinically appropriate.”

An exception to these requirement is if the minor is living independently (called “emancipated”), married, pregnant, or the parent of a child.