9 Reasons To Protect Your Child’s Confidentiality with their Teen Therapist
If you are the parent of a teen in therapy, you may have questions about confidentiality with your teen’s therapist. You’ve probably had the urge to reach out to your child’s therapist at some point. Do any of these thoughts sound familiar?
I wish I knew what was going on in my teen’s therapy.
I’d feel better if I could just talk to my teen’s therapist.
If I don’t talk to my teen’s therapist, they won’t know what’s really going on.
My kid probably isn’t bringing up the things they need to work on.
I just need to talk about scheduling or logistics. It’s not a big deal.
I knew I should ask first and my kid told me it was ok.
As a parent, it makes sense that you would want to be involved in your child’s therapy and help them feel better. And, in many cases, collaboration with parents is a vital part of teen therapy. But, it needs to be done very carefully. In almost every situation, including your child in that conversation is best.
Including your child in ANY conversation with your teen therapist is important to protect confidentiality because it:
- Protects the therapeutic relationship between your child and their therapist, so therapy actually works
- Prevents replicating an unhealthy family dynamic in therapy
- Reduces the risk of your teen blaming you for violating their privacy and distracting from more important issues
- Teaches your teenager how to be their own self-advocate and schedule-manager
- Prevents the therapist from burning out so they can continue to be effective in doing the job you hired them for.
Here are the 9 most common reasons why parents want to reach out to your kid’s therapist, why it doesn’t work, and the better ways to handle each situation. Which, in reality almost always means including your teen in conversations with their therapist. Implementing these tips will help protect confidentiality with your teen’s therapist.
And, after you’ve read this whole thing, check out part 2: the conditions when it IS appropriate to talk to your child’s therapist without them present.
*This is a long one so bear with me! It’s all very useful!*
**Don’t miss a note for adolescent therapists at the end of this article**
Reason 1: You want to tell your teen’s therapist what you think they need to work on.
Why It Won’t Work
A teenager must feel that their therapist is on their team. Having another adult telling them what to do is a recipe for teen therapy disaster. This means the therapist should be treating the teenager as their primary client and not the parents.
If parents are a “bug in the ear of the therapist”, telling them what to work on, the parents become the client instead of the teenager. The teenager certainly won’t feel like THEIR goals are what is driving therapy.
This is tricky “dialectic” (two opposites that are true at the same time) because parents are the paying customers. While it seems fair that the paying customers get direct access to the services, in this case, parent’s access to the therapist without the adolescent present actually ruins the services being paid for.
I can’t tell you how many times I have worked with teens who complain about the way their parents have communicated with their previous therapist (or even myself if/when it happens). They are justified in feeling violated even when parents’ intentions are coming from a good place. If this happens, we will spend a lot of time validating their feelings, and this means we won’t have time to work on the actual issues they are having.
What To Do Instead
Let’s avoid this situation in the first place! If your child feels they can trust their therapist then they will build a rapport with them faster. This means we can get to work on the reasons you want them in therapy in the first place, and you’ll experience less resistance! Please, try not to guide your child’s therapy if possible.
When it is absolutely necessary, be transparent. Any time you communicate with your teen’s therapist, they should know about it and witness it. Then, they don’t have to wonder whose agenda is on the table. Keep them in the room when you’re making the phone call, cc them on the email you are sending, and make sure they are present if you’re meeting with their therapist.
Reason 2: You want to tell their therapist what you’ve noticed so they will have objective data to work with during teen therapy.
Why It Won’t Work
There is no such thing as absolute truth. Your perspective is always subjective because your emotions, values, and life experiences are the way you view the world. There’s nothing wrong with that, you’re human! But, your kid has a different way of seeing the situation. So, when the therapist brings the parents perspective to the session, it can quickly turn into a he-said-she-said battle. This is a distraction and time-waster distracting from the actual issues in therapy.
What To Do Instead
Make sure your child is included in any conversation with the therapist. Having your teenager present in the conversation allows them the opportunity to agree/disagree/modify/advocate right then in the moment. This protects the therapeutic relationship as described above. And, it saves A LOT of time and detective work when the therapist does not have to go back and forth between sources trying to gather data.
Reason 3: You don’t want to upset your teenager, embarrass them, or speak negatively in front of them.
If you just read reasons 1& 2 and are thinking “but I don’t want to take away from the positive progress,” or “I don’t want my kid to think I am speaking badly about them,” this one is for you!
Why It Won’t Work
In order for your child’s therapist to use the information you gave them, it needs to show up in the room. Your kid is going to wonder where their therapist got the information if they haven’t brought it up themselves. And in my experience, they figure it out pretty quickly.
A consequence of this indirect form of communication is that it threatens the trust between your child and their therapist. It also promotes suspicion, not only between your teen and their therapist but also between you and your teen. On the other hand, if you weren’t intending for the therapist to bring it up in session, I would err on the side of not sharing in the first place. This way you are not asking your kid’s therapists to hold your secrets.
As a family therapist at heart, my goal is to promote healthy and honest, albeit sometimes difficult, communication within families. So using the therapy as a space to practice this is an amazing way to model the importance of transparency, authenticity, and vulnerability. Secrets keep us sick. Let’s use therapy to get better.
What To Do Instead
If you have concerns about how your child is doing, consider talking with them about it directly first. Your teenager is not too fragile to hear your concerns. Nor should they be treated as such by either you or their therapist.
After trying this several times, if you still feel it needs to be addressed directly with the therapist, tell your child of your intention. Try saying something like “we’ve talked about this ourselves many times already, I think it’s important that Laura knows. So, I am going to:
- email her. I will cc you to it so you can see it so you know exactly what I said” or
- ask for a meeting with all of us present”
With everyone present, everyone has the chance to discuss their discomfort, get validation and acknowledgment, and be held accountable for their behavior.
Reason 4: You are worried and anxious about your child and you want to discuss it with their teen therapist
Why It Won’t Work
Relying on outside information to soothe your inside emotions doesn’t usually work. Reassurance seeking doesn’t help you kid’s anxiety, nor will it work for yours. It’s a nice bandaid: works in the short term by giving you something to soothe the worry thoughts. But, not in the long term. Because as soon as it wears off, those worry thoughts will come back and you’ll need more and more reassurance to soothe your brain.
Each time this happens is another potential threat to your child’s relationship with their therapist (see above).
Plus, think about how anxious you are about not being a part of your child’s therapy. Then, think about how anxious your child will feel if they are not a part of their OWN therapy. Especially, if your kid is in therapy for anxiety in the first place, the last thing you want to do is use their therapist to soothe your emotions while worsening theirs.
What To Do Instead
Learn how to tolerate the uncertainty of the unknown. Try some self-soothing techniques any time the urge comes up. These techniques include deep breathing, mindfulness, healthy distractions, etc. If after the initial wave of anxiety eases you are still worried, ask yourself what is actually happening vs what you fear is happening. Check in about the likelihood of the threat.
If these techniques aren’t working, consider some brief individual therapy to strengthen your own distress tolerance skills. Nothing will make your child more willing to work on themselves than seeing you doing the same thing! Plus, then you can model positive mental health, which is the very thing you want them to learn in therapy, right?!
Reason 5: You want advice from a teen therapist on what to do for a particular situation
Why It Won’t Work
If your child has crossed limits, broken house rules, or is unsafe, the advice will likely be to use behavior changing strategies. For example, this may mean implementing consequences or increased structure. If your kid thinks this came from their therapist, they may want to start avoiding their therapist.
This complicates the situation even further because one of the roles of a teen therapist is to help them learn to gracefully accept consequences. If you put your child’s therapist in a pseudo-parent role, asking for parenting advice may jeopardize their role as your child’s therapist.
There is also a risk that your needs may not be met in this conversation. You may wind up feeling frustrated with your child’s therapist if they don’t give you the advice you wanted. All of this frustration and rapport damage isn’t worth it. As you can see, asking your child’s individual therapist for parenting advice is a lose-lose-lose situation for everyone.
What To Do Instead
Consider taking a parent coaching e-course like this one to gain skills you need for all of this complicate work: Translating Teens: A Parent’s Guide to Adolescent Emotins and Behaviors.
And/or consult with a parent coach. They can collaborate with your child’s individual therapist to make sure they are leading you down the right path for your child’s specific needs. This protects the confidentiality with your teen’s therapist, and most importantly, gets everyone the help they need!
Reason 6: Your child says things like “well my teen therapist said…” as a challenge to your parenting.
Why It Won’t Work
This is splitting, a defense mechanism used by teens (and sometimes adults) in moments of intense pressure, stress, anxiety, and anger. Splitting is an attempt to take the attention off of oneself by creating friction between two other parties.
If parents and therapist are working towards change that feels overwhelming, the teenager may shift the attention to turning those parties against each other.
This is often NOT a conscious, intentional, or manipulative process. It is an unconscious defense mechanism!
What To Do Instead
Take what your child tells you about their therapist’s beliefs with a grain of salt. Keep in mind that they are remembering the pieces of the conversation that resonates most with their pain. They often are not reporting on the other half of the conversation that resonates with their guilt.
I often remind parents of my teen clients that “I do not believe every single thing your kid tells me about you; it might help in these moments for you to extend the same courtesy to me.”
Trust that your teen’s therapist has everyone’s best interest at heart and is not throwing you under the bus. If you have persistent concerns that you and your child’s therapist are not on the same page, ask to talk about this during a session with your child there to protect the confidentiality with your teen’s therapist.
Reason 7: Your child has told you that they don’t like their therapist
Why It Won’t Work
If there is really a problem in the therapeutic relationship, it is a very healing, albeit foreign, experience to navigate that directly. Working through relationship issues in therapy is one of the best ways to improve your relationships outside of therapy. In doing so you learn it is possible to address concerns directly without conflict and while still maintaining a positive relationship. Your child needs to experience this for themselves to have healthy relationships in their future. You can’t do it for them.
Alternatively, it is also possible that this may be splitting too. They may be uncomfortable with the change and accountability that the therapist represents. Trying to protect them from their own growing pains might be an enabling pattern that needs to be changed.
What To Do Instead
Validate their discomfort. Whether it is real or perceived is not yours to decide. Encourage them to work on their relationship directly. Help your teenager come up with language for them to address their concerns and ask for their needs to be met. If this does not work, suggest a meeting all together, never alone!
Reason 8: You have a scheduling question to ask their teen therapist
Why It Won’t Work
Ok, this one will work for the scheduling issue itself! But, it’s a missed opportunity to teach developmentally appropriate independence. The older your teenager gets, the more responsibility they can take for managing their schedule. If you are doing it for them, you may be fostering dependence on tasks that are well within their ability to complete at their age. Let’s not miss an opportunity to practice life skills!
What To Do Instead
In the beginning, include them in scheduling conversations and emails. Over time, slowly turn this responsibility over to your teen. Maybe start by having them cc you on scheduling emails. Your teen will learn how to become an effective consumer of mental health treatment (or any health care for that matter).
Logistically you are showing them how to manage these types of communications. Knowing how to schedule or change an appointment is an essential skill for adulthood. Seeing you do it will prepare them to do it themselves.
Clinically, you allow for autonomy in their own treatment. Autonomy is a developmentally appropriate need that teens have. And, inviting them to be a part of their own therapy will keep their willingness high!
Reason 9: You asked your kid if you could talk to their therapist and they said yes!
Why It Won’t Work
Here’s the thing. I just gave you 8 sound reasons why it’s not a good idea! Do you think they are thinking about any of those?! Absolutely not! It is our job as adults/caregivers to make wise and difficult decisions for young people when they don’t have the pros and cons themselves.
When kids say yes it is usually a combination of reasons. First of all the power dynamic between parent and child makes saying “no” very uncomfortable. Teens are likely to say yes to parents if they carry underlying guilt and shame for “needing” therapy in the first place or for “parents spending money on them for their problems”.
And it is even harder to say “no” if there is an underlying dynamic of not feeling free to speak genuinely or advocate for one’s needs. It makes sense that a teen is more likely to fear the risks of saying no to parents, who they have to live with every day, then worry about their therapeutic relationship with someone they see one hour a week and gives them unconditional positive regard.
The other reason why they may say yes is that it is very uncomfortable to be in the room when parents are expressing their concerns. Naturally, a teenager would give the go-ahead to skip out on this unpleasant situation, especially if they know the report won’t be a glowing one.
However, the very nature of our work is shifting from short term strategies to long term ones. So while speaking without them may prevent temporary discomfort, it will only make the problems in the long-term worse (see all of the above).
What To Do Instead
DON’T ASK YOUR KID TO TALK TO THEIR THERAPIST WITHOUT THEM! Try any and all of the above strategies to avoid either putting your child in this uncomfortable position and/or letting them off the hook. If you must engage with your child’s therapist, have your teenager present during this conversation. It is a perfect opportunity for them to practice all they are learning in therapy to cope skillfully in an uncomfortable situation!
If All of These Suggestions Sounds Too Difficult, Consider A Better Solution: Family Therapy
The role of a teen therapist is neither to be your family therapist or coach for these conversations. They are there to help your teenager. So if all of the solutions to protect confidentiality with your teen’s therapist feels too difficult to do effectively on your own, then it is time to try a parenting course, parent coaching or family therapy.
Working with a family therapist can help you navigate these conversations on an ongoing basis. Validation and accountability are both needed for your teenager to truly heal. And one conversation with their therapist will not give anyone in your family enough of that.
All of these family dynamics may contribute to some of the underlying reasons why your teenager is in therapy in the first place. Don’t wait to address them. Sustainable change happens by addressing the whole family system!
If you are a teen therapist with parents who struggle respecting confidentiality with you as their teen’s therapist:
I strongly encourage you to share this article with them. I ask my teenage clients’ parents to read this for homework with every intake! The better we protect confidentiality between teens and their therapist from the start, the smoother therapy will go and the less burnt out we will feel!
At Montgomery County Counseling Center, we are always happy to partner with you by working with parents or families to supplement your work with your teenage clients! Lastly, Laura Goldstein offers consultations on how to conceptualize your case within these family dynamic concerns in mind. And she can help you work on protecting your limits while also doing clinically necessary work!
About The Author
Laura Goldstein, LCMFT is a Licensed Clinical Marriage and Family Therapist in Rockville Maryland and Founder of Montgomery County Counseling Center, LLC. Laura obtained her Bachelor’s degree in Neuroscience from Franklin and Marshall College in Lancaster, PA. She then went on to earn her Master’s degree in Family Therapy from Thomas Jefferson University in Philadelphia. Laura became intensively trained in Dialectical Behavioral Therapy (DBT) through Behavioral Tech Linehan Institute in 2015. She is also Level 1 Trained in Gottman Couples Therapy. After working in both substance use and failure to launch IOP programs, Laura now works in her private practice alongside her excellent associates! Montgomery County Counseling Center serves individuals, families, parents, and couples who are struggling with intense emotions, fraught relationships, and maladaptive coping behaviors.
Wow – great insight and guidance. Very helpful in regard to why establishing and maintaining boundaries is so important and beneficial.Hopeful that more therapists will share this guidance with their patient and their parents. Parent – Child (espeically teens) dynamic can be very challenging – this is so helpful in understanding how to best charter the course.
Thanks so much! I am always thrilled to helpful other providers help others. It’s like 6 degrees of magnifying the rewarding nature of this work 🙂
Just not anything other than self serving advice. Doctors, lawyers, police and priest all have successfully incorporated parents with confidential work in the best interest of their child. While generally the relationship staying therapist/client is ideal, it is neither absolute or always the best approach. Most things dealing with human nature and frailty are never etched in stone. Very surprised at everything except…..pay another therapist.
I very much appreciate your thoughts. I definitely agree there is some gray area to this, which as I reread, does not come through enough in the original text. I may take your feedback and create some edits to infuse a greater sense of flexibility.
At the same time, I do believe that the role and relationship with a therapist is unique and different in comparison to the other professionals you mentioned and therefore requires a different set of expectations and boundaries. Ultimately, it is clinically effective and ethical to minimize dual relationships in any context, be that within a family system or within a treatment system.
Kindly,
Laura
The vital subject of confidentiality between adolescent patients and their therapists is skillfully highlighted in this blog. It is crucial to respect and sustain this trust in order to encourage honest communication and promote their emotional development.