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Permission from Children: The Ethics of Consent versus Assent

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1.  When initiating counseling services with a 17-year-old client who has mental capacity and is deemed to be legally competent, a social worker should obtain: Consent from the client Consent from the client’s attorney Assent from the client Assent from the client’s attorney

2.  When serving a client who is 10 years old, social workers should typically request the client’s assent because: State laws always require social workers to obtain assent The National Association Code of Ethics requires social workers to always obtain assent Requesting assent supports the principle of respect for the dignity and worth of all people Parents and guardians are not able to provide consent on behalf of a minor

3.  Reba (14 years old) would like to speak with a clinical social worker (CSW) about possible birth control methods. She says her parents will not provide consent. Which of the following statements is true? The CSW may provide services to Reba as long as Reba provides assent. The CSW is obliged to report Reba to child protection services immediately. The CSW should advise Reba that teenagers should not use birth control until they are at least 18 years old. The CSW should check state laws to determine whether 14-year-old can consent to these types of services without parental consent.

4.  In which of the following situations would it be INAPPROPRIATE to ask an 8-year-old client for assent to services? The client is too young to consent to services, but still has some ability to understand the nature of the services being offered. Given her age and mental capacity, the client is unable to engage in a meaningful discussion about the nature of services being offered. A client’s parents are willing to consent to services. The client is mature and fully understands the nature of services, including potential benefits and risks.

5.  When determining whether to ask a child for assent to services, which of the following factors should the social worker consider? Whether the person providing consent is a relative of the client. Whether the client is likely to provide assent. Whether it would be helpful for the client to provide assent because services cannot be effective if the client does not cooperate. Whether the services are being paid for by private insurance, Medicaid, Medicare, or fee for service.

6.  If a young child is not willing to provide assent to services, which of the following options is the most ethical? Requiring the child to participate in services because the parents’ consent is more important than the child’s assent. Talking to the parents about other options, such as delaying services or referral to other services that the child might accept. Reporting the parents to child protection services for trying to obtain services to a child who does not want them. Advising the parents to tell the child that they will use punishment if the child does not agree to services.

7.  Which of the following explanations of services is best suited to discussing assent with a teenager who was in a car accident and sustained a traumatic brain injury? “Your parents say that you suffered a traumatic brain injury. You need to agree to counseling services or you will be placed in a psychiatric facility for an indefinite period of time.” “I hear that you were in a car accident and you now have had some trouble remembering things. If it’s ok with you, I’d like to talk to you about our services and how we might be able to help you.” “You have suffered from traumatic brain injury which has compromised your cognitive functioning. Although you lack mental capacity to provide consent on your own behalf, I am kindly requesting your assent to services.” “To provide services, I need you to sign here on this document.”

8.  When explaining services to a young child with a limited vocabulary, which of the following types of explanations is generally most helpful? Abstract conceptual explanations Technical professional language Concrete examples Legalese

9.  When explaining assent to a child who lacks decision-making capacity, a social worker should explain that: once the client provides assent, the assent cannot be withdrawn even if the client agrees to services today, the client can ask to end services at any time only the court can decide whether to end services services will continue forever unless the client’s mental capacity improves and the client develops full decision-making capacity

10.  When explaining services to a child who lacks decision-making capacity, a social worker should: invite the child to ask questions to make sure the child understands the services being offered discourage the child from asking clarifying questions explain the benefits of services and minimize the risks or costs of services tell the child that their guardian will be very unhappy if they decline services