Patient warnings in court-ordered evaluations of children and families

The rules covering disclosure of information generated by court-ordered clinical evaluations in Massachusetts require that patients be warned that the patient-psychotherapist privilege does not apply to the evaluation interview. The nature of the warning required ("the Lamb warning") is not perfectly clear and is especially uncertain when those being warned are children and families. Comparing the Lamb warning to the Miranda warning offers some insight but is not conclusive. To reach conclusions regarding the type and degree of procedural protections for children required by the Lamb warning, it is necessary to analyze the stakes, interests, and capacities involved for children in juvenile court. This analysis suggests that in most situations a relatively informal procedure is sufficient to provide the required warning. However, there are some exceptional circumstances in which more formal and thorough warnings should be required. These include juvenile transfer hearings and some situations involving child abuse and neglect.