Children's Understanding of Risks and Benefits of Psychotherapy

In recent years there has been increasing interest in allowing children to give independent consent to treatment. This study assessed children's ability to process information about the risks and benefits of psychological treatment. Seventy-five children aged 10-19 with varying treatment histories were asked to identify statements as either risks, benefits, or irrelevant to therapy. They were then presented with four treatment dilemmas and asked to make a decision about whether a minor should enter therapy and to explain their reasoning. Sixty-four percent of the children demonstrated the ability to accurately identify all but the irrelevant statements. One fourth demonstrated the ability to offer reasons to enter or' refuse therapy and took into account both the risks and benefits of hypothetical treatment dilemmas. No significant differences between children at different ages were found. Low scores on both instruments were consistently associated with below-average reading comprehension. Wide variability between minors at different ages, reading comprehension levels, and demographic characteristics suggests that determinations of competency to consent be based on the capacities of the individual child.