Informed consent for groups and families

“Obtain informed consent appropriate to clientele (e.g., group, family)” (NBCC, 2027 task 2A.6)

When counseling involves more than one person, informed consent has extra elements: who the client is, how confidentiality works among members, and how information shared individually will be handled. Getting this right at the start prevents conflict and protects everyone involved. The exam tests consent issues specific to group, couples and family work.

Key points

In couples and family counseling, clarify who is considered the client and the counselor's role with each person (ACA A.8 addresses multiple clients).
Discuss the policy on secrets: some counselors use a no-secrets policy, others hold individual disclosures in confidence; either way, explain it before individual information is shared.
In group counseling, explain that the counselor will keep confidentiality but cannot guarantee that other members will; set group norms about confidentiality.
Screen prospective group members to protect the group and ensure fit (ACA A.9.a addresses screening).
Each adult participant gives consent; for minors in family or group work, obtain guardian consent and the minor's assent.
Explain how records will be kept, who can access them, and how a release from one family member affects others.
Revisit consent when membership changes, such as a new family member joining sessions.

In practice

Before a couple's first joint session, the counselor explains that the couple is the client and that she does not keep secrets between partners; if one partner shares something relevant in an individual call, she will help them bring it into joint sessions.

At the first meeting of a grief group, the facilitator explains that she will keep what members share confidential, except for safety exceptions, but cannot guarantee other members will. The group agrees on ground rules about not discussing members outside the group.

Check yourself

What confidentiality limitation must be explained in group counseling?

The counselor cannot guarantee that other group members will keep information confidential.

Why discuss a secrets policy before couples counseling starts?

So partners know how individual disclosures will be handled before they share anything, preventing a later conflict of loyalty.

What should happen before a client joins a counseling group?

Screening, to confirm the person's needs fit the group and that they will not harm or be harmed by the group.

NBCC's knowledge and skills for 2A. Intake

Knowledge of: Barriers to service; Components of informed consent; Client suitability for telemental health services.

Skill in: Discussing informed consent; Explaining policies and procedures; Conducting a clinical/diagnostic interview.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.