Adolescent health risk behavior: When do pediatric psychologists break confidentiality?

Objective: To determine the circumstances under which pediatric psychologists believe it is ethical to break confidentiality when presented with adolescent health risk behavior. Method: Members of the Society of Pediatric Psychology (N = 92) responded to a survey containing a vignette about an adolescent patient engaging in health-compromising behaviors. Participants rated the degree to which it is ethical to break confidentiality for health risk behaviors of varying frequency, intensity, and duration. Results: Respondents generally find it ethical to break confidentiality when health risk behaviors are more intense, more frequent, and of longer duration. Respondents also find it more ethical to break confidentiality for female smoking than for male smoking. Similarly, they find it more ethical to break confidentiality for female sexual behavior than for male sexual behavior, but only as the frequency/duration increases. Conclusions: At a certain point, maintaining the adolescent's health is more important for pediatric psychologists than maintaining confidentiality.