Capacity and Competence in Child and Adolescent Psychiatry
Abstract
Capacity and competence in the field of child and adolescent psychiatry are complex issues, because of the many different influences that are involved in how children and adolescents make treatment decisions within the setting of mental health. This article will examine some of the influences which must be considered, namely: developmental aspects, the paradoxical relationship between the need for autonomy and participation and the capacity of children, family psychiatry, and the duty of care towards children and adolescents. The legal frameworks relevant to consideration of consent and competence will be briefly considered, as well as some studies of children's consent, participation and competence. A case vignette will be used as a focus to consider the complexity of the issue of competence in child and adolescent psychiatry, in the particular mental disorder of anorexia nervosa.
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New cognitive skills are acquired in adolescence, referred to by Piaget as hypothetico-deductive reasoning: the ability to think of hypothetical solutions and to formulate a systematic plan for deducing which of these solutions is correct.
“New cognitive skills are acquired, referred to by Piaget as hypothetico-deductive reasoning: the ability to think of hypothetical solutions and to formulate a systematic plan for deducing which of these solutions is correct [12, 13].”
From Why is it hard to make progress in assessing children's decision-making competence? (2015) · cites this paper as [13]
In adolescence, biological, cognitive, and social development progress and the brain undergoes substantial change with an increase in efficiency of brain functioning.
“In adolescence, biological, cognitive, and social development progress and the brain undergoes substantial change with an increase in efficiency of brain functioning.”
From Why is it hard to make progress in assessing children's decision-making competence? (2015) · cites this paper as [13]
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“In addition, there are aspects of confidentiality that may conflict with the protection of the child, that is, in the context of child abuse or if the child has asked the therapist not to share certain information with the parents (Koelch & Fegert, 2010; Tan & Fegert, 2004).”
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- Authors
- Tan, J. O. A., & Fegert, J. M.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Tan, Jacinta O. A.
- ORCID
- Tan, Jacinta O. A.
- Venue
- Health Care Analysis
- Published
- 2004-12
- Volume
- 12
- Issue
- 4
- Pages
- 285-294
- ISSN
- 1065-3058 (ISSN-L)
- 1573-3394
- OpenAlex
- W2051412017
- Cited by
- 45
- References
- 51
- Citations by year
- 2025: 2 · 2024: 2 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 5 · 2015: 5 · 2013: 1
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Health Care Analysis (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Sociology and Political Science › Children's Rights and Participation
- Keywords
- decision-making capacity, competence, child and adolescent psychiatry, child consent, children's participation, autonomy, family psychiatry, duty of care, anorexia nervosa, developmental factors
- MeSH terms
- Adolescent, Anorexia Nervosa, Feeding and Eating Disorders, Child, Child Care, Female, Humans, Male, Morals, Patient Participation, Mental Competency
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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