Counseling Session or Salesman
Creative Commons License photo credit: SalFalko

Taking control over a loved one’s mental health care is extremely important. Families or caregivers of an individual with a severe or untreated mental illness often believe that they will automatically have the legal authority to make decisions on their loved one’s behalf in the event they cannot make decisions themselves. The reality is that parents, families, and caregivers have limited to no legal control over an individual by the time they turn 14. In many states, an adolescent as young as 14 years old can make legal decisions on their mental health treatment and refuse to be compliant.In cases where your family member may be in individual or group therapy, they have rights to confidentiality. Confidentiality says that “I will not share anything you share with me, as your therapist, outside of this office.” Confidentiality offers individuals an opportunity to share personal details without the fear of others finding out. For youngsters, it also offers security. Usually, therapists will not reveal sensitive details of a session unless your child or family member:

  1. Threatens to kill or seriously harm him/herself
  2. Threatens to kill or seriously harm someone else
  3. Reports abuse

Some therapists use discretion in reporting cases involving chronic substance abuse or promiscuity. However, in many instances, a client is legally entitled to confidentiality. In regards to children and adolescents, State laws and counseling centers vary when it comes to reporting details of a counseling session. Most situations will require a therapist utilize previous experiences to arrive at appropriate decisions to report certain details. For younger children, ages 5-13, retrieving information will be a tad easier. The older the child gets in this nation, the harder it is to know about what’s going on in counseling.

In the event of noncompliance, the most a therapist can do is try to encourage a youngster or adult family member to give treatment a try. Some therapists are really good at dissuading the negative perception of treatment. In more complicated cases, adolescents and adult family members can avoid treatment until they are in need of involuntary commitment (committed against will).

Being committed against one’s will is known as civil commitment or involuntary commitment and requires that an individual be in imminent danger and has threatened harm to him/herself or someone else. The person must be extremely incapable of remaining safe.


Unfortunately, during severe mental impairment, families end up realizing the little legal control they have over an adolescent or adult. This is why I recommend that ALL families seek what is known as: Mental Health Advanced Directives. Mental health advanced directives is basically a “living will” and it allows the individual with a severe or untreated mental illness to sign rights over to another individual (family, friend, or caregiver) who can make legal and healthcare decisions on their behalf.


The living will document is quite long but doesn’t require an attorney or complicated information. You can complete a mental health advanced directive form in the company of your case manager, mental health therapist, or a notary.

If you feel safer seeking legal advice, I encourage you to do so. The main purpose of a living will is to document, in writing, who will take care of the person who may become too impaired to make decisions.


If you live in Pennsylvania, you can find the mental health “living will” at: Mental Health Association In Pennsylvania.  If you are in another state, you can:


The goal is to stay informed and know what your legal rights are.


I wish you all the best