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Ethical Considerations for Mental Health Clinicians Working with Adolescents in the Digital Age


Purpose of Review

Adolescents’ use of digital technologies is constantly changing and significantly influences and reflects their mental health and development. Technology has entered the clinical space and raises new ethical dilemmas for mental health clinicians. After an update on this shifting landscape, including a brief review of important literature since 2014, this article will demonstrate how core ethical principles may be applied to clinical situations with patients, using vignettes for illustration.

Recent Findings

The vast majority of adolescents (95%) across all demographic groups can access smartphones (Anderson et al. 2018•). Technology use in mental health is also expanding, including a proliferation of “apps.” While qualitative data from technology experts reports overall positive effects of technology (Anderson and Rainie 2018), concern about its potential negative impact on youth mental health remains high, and an association between technology use and depression is strong. Internet addiction, online sexual exploitation, and accessing illicit substances through the “dark net” pose additional clinical and legal concerns. In this context, clinicians have an ethical responsibility to engage in education and advocacy, to explore technology use with teen patients and to be sensitive to ethical issues that may arise clinically, including confidentiality, autonomy, beneficence/nonmaleficence, and legal considerations such as mandated reporting.


New media and digital technologies pose unique ethical challenges to mental health clinicians working with adolescents. Clinicians need to stay abreast of current trends and controversies about technology and their potential impact on youth and engage in advocacy and psychoeducation appropriately. With individual patients, clinicians should watch for potential ethical dilemmas stemming from technology use and think them through, with consultation as needed, by applying longstanding core ethical principles.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Sandra M. DeJong.

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Conflict of Interest

Nicole Sussman is employed by Cambridge Health Alliance.

Sandra M. DeJong is a board member of the Psychiatry Residency in Training Examination of the American College of Psychiatrists, a committee member of the American Academy of Child and Adolescent Psychiatry, employed by Cambridge Health Alliance and receives royalties from Elsevier for a book on e-Professionalism.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Psychiatry in the Digital Age

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Sussman, N., DeJong, S.M. Ethical Considerations for Mental Health Clinicians Working with Adolescents in the Digital Age. Curr Psychiatry Rep 20, 113 (2018).

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  • Digital ethics
  • Adolescent psychiatry
  • Social media
  • Technology
  • Mental health
  • Internet