Back Off,Forge Ahead,or Play the Long Game: The Ethics of Working With Adolescents Who “Aren’t Ready”

Pediatric psychologists often receive referrals to work with adolescent patients who are not necessarily interested in changing their behavior (e.g., adhering to medication). In these situations, psychologists make decisions about their clinical course of action. Although often not made explicit, these decisions involve important ethical implications. This article presents an example of an ethical decision-making framework and highlights the relevant factors when working with youth who are not interested in changing the behavior for which they have been referred. This article also considers the implications of various courses of action including residual distress for relevant stakeholders. We provide recommendations for making decision-making processes explicit and identify factors that may affect decision-making.