Therapy with a teenager is a delicate balance between making the teens confidentiality the priority, while at the same time acknowledging the limits of their confidentiality as a minor. It is also a balance of respecting a teen’s independence while respecting the large role a family system has on their lives.
This balance is not easy, but it is necessary to provide ethical and effective treatment to your teen. If you enter into a therapy process without hearing the therapist's effort to manage this balance, I advise you to find another therapist.
There are times when a teen absolutely does not want their parents involved. This boundary can be respected by allowing the teen to meet the therapist first. If the teen likes the therapist then a separate meeting with the parents can be provided to review the legal and ethical limits of confidentiality and the treatment plan.
When a teen seeks therapy it can be as mild as needing to just talk somethings out with a neutral party, to as severe as a mental health crisis that needs more support than once a week therapy. A relationship with the teen’s family to address changing recommendations helps provide the fastest most informed support.
As a parent, here are the basic steps you should expect from a therapist:
An invitation to meet the therapist in person on the first session or speak with them on the phone.
Time to express your concerns about your teen’s mental health and your hopes for their treatment as well as any relevant family history.
Learn how the therapist manages the legal and ethical limits of a therapist's confidentiality. Ideally, this happens with your teen present, and you are both allowed time to ask questions and express concerns.
Be provided a way to express your concerns to the therapist over the duration of treatment.
A therapist can receive your emails and voicemails and can respond to them as long as the teen is made aware of the communication and consents to some form of response.
5. Be provided a treatment plan that spells out how the therapy time will be used, as well as a time frame for when the treatment plan will be reviewed again.
Too many times I have heard stories of parents reporting that they never met their teen’s therapist or the therapist never responded back to their questions. When a therapist ignores the parents of a teen they are ignoring the fact that your teen is a part of a larger family system that will have a greater impact on the teen’s lives than an hour of therapy once a week will. At minimum, they are limiting their ability to be effective in your teen’s therapy by not understanding your family system, history, culture, and values. At worst, they are limiting their ability to support your teen if a crisis arises.