Adolescent and Parent Perspectives on Confidentiality After Adolescent Relationship Abuse Disclosure

Abstract

This study aimed to assess adolescent and parent perspectives on parent notification after disclosure of adolescent relationship abuse (ARA) to a health care provider. Methods: A computerized survey was administered to a convenience sample of adolescents aged 14e18 years and their parents presenting to three Midwestern pediatric emergency departments. The survey assessed the acceptability of parent notification after hypothetical adolescent disclosure of different forms of ARA (i.e., physical, cyber, psychological and sexual ARA, reproductive coercion, controlling behavior, and feeling unsafe) to a health care provider. Chi-square and Fisher's exact tests were used to examine possible relationships between acceptability of parent notification and prior ARA victimization, adolescent dating relationship status, and demographic factors. Results: One-hundred fifty adolescenteparent dyads and 53 individual adolescents participated in this study. Most adolescents and parents found it acceptable to inform parents after disclosure of any type of ARA, although acceptability was higher among parents for all types of abuse assessed. Adolescenteparent dyads were more likely to both agree that parent notification was acceptable after disclosure of physical ARA, compared with other forms of ARA. Acceptability of parent notification after some types of ARA disclosure was less common among adolescents reporting previous sexual activity, prior ARA victimization, and adolescents currently in a dating relationship. Conclusions: Most adolescents and parents found parent notification after ARA disclosure acceptable. However, adolescents most at risk, including those who reported previous sexual activity, prior ARA victimization, and those in a dating relationship, were less likely to find parent notification acceptable. Further study to assess barriers or concerns with parent involvement is crucial to optimizing provider response after ARA disclosure.

Adolescent Relationship Abuse: Challenges in Confidentiality, Disclosure, and Protection

“…The support of a parent or another trusted adult is especially important when an adolescent is experiencing harmful interactions such as ARA. Noteworthy in the study by Weibelhaus et al is that even though a majority of both adolescents and parents did find parental notification acceptable, adolescents who were most at risk were the least likely to find it acceptable: adolescents with prior sexual activity or prior ARA victimization or those in current dating relationships [2]. Unfortunately, although most adolescents have supportive parents, not all do and, among the parents reported in the study by Wiebelhaus et al, 35% of the participating parents had themselves experienced intimate partner violence, which might complicate their capacity to support a victimized adolescent child [2].…”

“…Noteworthy in the study by Weibelhaus et al is that even though a majority of both adolescents and parents did find parental notification acceptable, adolescents who were most at risk were the least likely to find it acceptable: adolescents with prior sexual activity or prior ARA victimization or those in current dating relationships [2]. Unfortunately, although most adolescents have supportive parents, not all do and, among the parents reported in the study by Wiebelhaus et al, 35% of the participating parents had themselves experienced intimate partner violence, which might complicate their capacity to support a victimized adolescent child [2]. Consideration of alternatives to parental notification may be necessary to ensure that adolescents experiencing ARA victimization have the support they need to navigate a difficult situation with potentially long-term adverse effects on their health and well-being.…”

“…A recent study by Jennifer Wiebelhaus et al [2] explored the perspectives of adolescents and parents about parental notification after an adolescent discloses ARA to a healthcare provider. The types of abuse in their study were physical, cyber, psychological, and sexual ARA; reproductive coercion; controlling behavior; and feeling unsafe.…”

“…The types of abuse in their study were physical, cyber, psychological, and sexual ARA; reproductive coercion; controlling behavior; and feeling unsafe. As Wiebelhaus et al [2] explain, ARA is multifaceted and complex. It includes some behaviors that are criminal, others that are legally considered child abuse, and many that are associated with serious short-and long-term adverse physical and psychological outcomes [3].…”

Addressing Adolescent Relationship Abuse in the Context of Reproductive Health Care

“…A recent study found that adolescents and parents find it acceptable for a healthcare provider to inform parents about ARA disclosure, particularly for physical ARA. 86 When discussing ARA after disclosure, healthcare providers should ask youth if there is an adult support with whom they would feel comfortable sharing their ARA experiences. This person may be a parent or another trusted adult.…”