When we think about consent, most of us picture the beginning of therapy.
Forms are signed. Confidentiality is explained. Parents nod. A file note is made.
And then we move on.
But the 2025 APS guidance on working with children and young people gently challenges that rhythm. It reminds us that consent is not a single administrative moment — it’s developmental. It evolves as the child or young person evolves.
That sounds obvious. But in busy practice, it’s easy to treat consent as something that happens once and is then “done.”
It isn’t.
Even when a parent or guardian provides legal consent, the young person’s assent matters. Not as a courtesy. Not as a tick box. As an ethical position.
Meaningful assent means explaining therapy in language the young person can understand. It means checking whether they actually want to participate. It means noticing when their willingness shifts.
Sometimes children participate because a parent has told them to. Sometimes adolescents comply but disengage quietly. Sometimes they change their mind halfway through therapy.
The ethical question isn’t simply, “Do we have legal consent?”
It’s, “Does this young person understand what’s happening, and are they meaningfully participating?”
That’s a different lens.
A 12-year-old at intake is not the same person at 13 and a half.
Cognitive development, emotional maturity, social awareness — all of these shift. Sometimes quickly.
The guidelines emphasise that consent should be revisited over time. That doesn’t mean redoing paperwork every month.
It means being alert to developmental change.It might sound like:
- “Let’s revisit what confidentiality means now.”
- “Has anything changed about what you’d like your parents to know?”
- “Do you still feel comfortable with how we’re working together?”
Those small conversations protect everyone.
Working with children often means holding three perspectives at once:
- The parent’s rights and concerns
- The young person’s privacy and autonomy
- The child’s best interests
These don’t always align neatly.
The 2025 guidance doesn’t offer formulas. It reinforces process. When you’re making a difficult call — about disclosure, about risk, about parental involvement — what matters is that you can explain your reasoning.
- How did you assess capacity?
- What were the competing interests?
- What conversations did you have?
- Why did you decide what you decided?
Documentation becomes less about defensiveness and more about clarity.
Young people today are often highly informed. They are exposed to conversations about mental health, rights, identity, and autonomy earlier than previous generations.
They may ask directly:
- “Will you tell my mum?”
- “Do I have to come?”
- “What happens if I don’t want to talk about that?”
If consent is treated as static, those questions feel disruptive.
If consent is treated as evolving, those questions become part of the work.
The real shift in the 2025 guidance isn’t new rules. It’s a reframing.
Consent with children and young people is not a legal shield at intake.
It is an ongoing ethical relationship.
When we revisit consent over time, we don’t weaken parental authority.
We strengthen trust.
And when tensions arise — as they inevitably do — we are standing on a clear, thoughtful process rather than a form signed months ago.
