A ten-year-old sits across from a psychologist, sent by a family court judge to be evaluated as part of a custody dispute she didn’t ask to be part of. She hasn’t consented to anything—legally, she can’t. So who’s actually protecting her here?
Questions like this sit at the heart of one of the least glamorous but most important ideas in psychology: informed consent. It sounds like mere paperwork—a form to sign before the real work begins. In forensic settings, where clients are often children, court-ordered, incarcerated, or otherwise unable to fully speak for themselves, it’s anything but routine.
Psychologists in the United States don’t take anything like the medical field’s Hippocratic Oath, but the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct holds every member to a similar spirit: to “benefit those with whom they work and take care to do no harm” (American Psychological Association, 2017). That code—first adopted in 2002 and amended since, most recently in 2017—lays out informed consent as one of the clearest ways psychologists put that principle into practice.
In plain terms, informed consent means that before anything else happens, a client has to clearly understand certain specifics: what their rights are, and any limits on those rights; what services they’ll actually receive, and who is providing them (including whether trainees will be involved); whether anything will be recorded or videotaped; and what it will cost, financially or otherwise. In couples or family therapy, it also has to be clear who the actual “client” is and how each person in the room relates to the therapist. And critically, the person has to have a real chance to ask questions before agreeing to any of it.
Most of the time this happens on paper, through a consent form drawn up for that purpose. It can also be given verbally, but if a psychologist skips the paperwork, careful documentation of that conversation becomes essential—there’s no written record to fall back on otherwise.
When Consent Isn’t Really an Option
There’s a major exception to the consent requirement: services that are legally mandated. If a court orders someone into treatment, or a job requires a psychological evaluation as a condition of employment, consent is effectively implied. It’s a routine, known condition of participating. Information still has to be shared about what to expect, but the person doesn’t get to opt out.
Then there’s a more difficult category: people who legally cannot give informed consent at all—children, people with severe cognitive impairment, and unwilling incarcerated individuals, among others. These clients can’t provide consent in the full legal sense, but that doesn’t mean their voice disappears from the process. Psychologists are still expected to explain things as clearly as the person can understand, protect their rights and well-being, and seek their assent. It ends up being a kind of informal, developmentally appropriate agreement, even when formal consent isn’t legally possible.
Forensic settings bring these hard cases together constantly, and the people involved are often unusually vulnerable to being exploited by the very systems meant to help them. A few of the tensions come up repeatedly.
For instance, with children, modifying an explanation of rights enough for a young person to understand it can mean oversimplifying it so much that any “consent” they give barely qualifies as informed at all. And if a parent or guardian isn’t available or capable of consenting on the child’s behalf, that responsibility can fall to courts or child welfare institutions—bodies that are, by design, more distant from the child than a parent would be. If this happens, there’s no guarantee the child’s interests can truly be protected.
Confidentiality raises its own dilemma. How much should a psychologist share with a parent or guardian, and how much is the child entitled to keep private? There’s no single right answer, and reasonable professionals can land in different places depending on the situation.
Similar tensions show up with cognitively impaired or court-ordered adult clients. In these cases, a psychologist’s clinical findings can directly shape whether a jury believes someone is dangerous, competent, or credible—which means the stakes of getting the evaluation and the consent process right go well beyond the therapy room.
What the Professional Guidelines Actually Require
The field has tried to answer some of this directly. In 2013, the American Psychological Association formally adopted the Specialty Guidelines for Forensic Psychology, replacing the older 1991 guidelines that governed this area for two decades. Among other things, the current guidelines direct forensic practitioners to clearly explain to several points to examinees from the very beginning: the purpose and nature of an evaluation, who will have access to the results, the limits on confidentiality and privilege that apply, whether participation is voluntary, and what the consequences of participating—or not—might be. Where someone isn’t required by a court to participate, practitioners are expected to obtain that person’s actual informed consent rather than assuming it.
Where it comes to confidentiality, the guidelines steer psychologists toward disclosing only what’s directly relevant to the legal question at hand, and toward giving clients or their legal representatives real access to their own records along with a clear explanation of what’s in them. This is a significant update from the 1991 version; a direct answer to the confidentiality worries forensic psychologists have raised for decades.
The bottom line is that informed consent can look like a formality—a box to check before the actual work starts. But in forensic settings, where clients are so often children, court-ordered, or otherwise unable to fully consent on their own behalf, it’s closer to the opposite: it’s the one moment, before anything else happens, where a person’s rights get spelled out and named out loud. Get it wrong, and everything that follows is built on a foundation nobody actually agreed to.
Key References
American Psychological Association, “Ethical principles of psychologists and code of conduct” (2002, amended effective June 1, 2010, and January 1, 2017).
American Psychological Association. (2013). “Specialty guidelines for forensic psychology,” American Psychologist, 68(1), 7–19 (2013)
O’Donohue, W. T., & Ferguson, K. E, Handbook of professional ethics for psychologists: Issues, questions, and controversies (2003).
