Senior members of families from collective cultures expect to be consulted about any health problems that their child/adolescent has and to accompany the young person to health appointments. The tendency to focus on the young person as the client must be supplemented by close attention to the family system and social network, which can include crucial members in other countries. It is important to acknowledge and welcome family members who accompany the child or adolescent client. Rather than excluding them because of privacy, meeting family members together before meeting alone with the client can be an important step to building trust and a source of valuable information.
Rules of confidentiality and disclosure should be applied in a way that respects cultural context. For CALD families, the cultural legitimacy of parental authority over adolescents should be taken into account. For counseling and treating youth, interventions should be framed in ways that avoid alienating family members or aggravating intergenerational conflicts. Similarly, disclosure of diagnostic issues and family “secrets” (eg, about traumatic events) should be approached carefully, with an understanding of what is at stake for the family. When ambivalence towards treatment or non adherence is an issue, involvement of such mediators as a key family member or trusted family ally in discussions of the different treatment alternatives can strengthen the therapeutic alliance, empower the family and provide necessary support to the client (Kirmayer, 2011).