Reasons To Protect Your Teen’s Confidentiality with their
Therapist
If you are the parent of a teen in therapy, you may have questions about confidentiality with your teen’s therapist. You’ve may have the urge to reach out to your teen’s therapist.
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 teen probably isn’t bringing up the things they need to work on.
I knew I should ask first and my teen told me it was ok.
It makes sense for a parent to be involved in their teen’s therapy. Collaboration with parents is a vital part of teen therapy. Done carefully, including your teen in that conversation. Including your teen in any conversation with their therapist is important to protect confidentiality because it: Protects the therapeutic relationship between your teen and their therapist, so therapy actually works, it prevents replicating an unhealthy family dynamic in therapy, it reduces the risk of your teen blaming you for violating their privacy and distracting from more important issues it teaches your teenager how to self-advocate
Here are some reasons why parents want to reach out to their teen’s therapist, why it is unlikely to work, and alternatives. Implementing these tips will help protect confidentiality with your teen’s therapist.
1. You want to tell your teen’s therapist what you think they need to work on. A teenager must feel that their therapist is on their side. 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 counsellee 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 counsellee instead of the teenager. The teenager certainly won’t feel like THEIR goals are what is driving therapy. This is a tricky dialectic, because parents are the paying consumer. While it seems fair that the paying consumer 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. Let’s avoid this situation in the first place. If your teen 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. 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.
2. You want to tell their therapist what you’ve noticed so they will have objective data to work with during teen therapy. 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. Your teen has a different way of seeing the same 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. Having your teenager present in the conversation allows them the opportunity to agree/disagree/modify/advocate right in the moment. This protects the therapeutic relationship as described above.
3. You don’t want to upset your teenager, embarrass them, or speak negatively in front of them. 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 teen 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 teen's therapists to hold your secrets. 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 stuck. If you have concerns about how your teen is doing, consider talking with them about it directly. 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 Andrew knows. So, I am going to: email him. I will cc you to it so you can see it so you know exactly what I said” or ask for a session 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 behaviour.
4: You are worried and anxious about your child and you want to discuss it with their teen therapist Relying on outside information to soothe your inside emotions doesn’t usually work. Reassurance seeking doesn’t help you teen’s anxiety, nor will it work for yours. It works in the short term by giving you something to soothe the worries. 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 teen’s relationship with their therapist. Plus, think about how anxious you are about not being a part of your teen’s therapy. Then, think about how anxious your teen will feel if they are not part of their own therapy. Especially, if your teen 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. Learn how to tolerate the uncertainty of the unknown. Try some self-soothing techniques when the urge arises. These techniques include deep breathing and mindfulness. 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 therapy to strengthen your own distress tolerance. Modelling therapy, is likely to inspire work on themselves
5: You want advice from a teen therapist on what to do for a particular situation If your child has crossed limits, broken house rules, or is unsafe, the advice will likely be to use behaviour changing strategies. For example, this may mean implementing consequences or increased structure. If your teen 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, then asking for parenting advice may jeopardise their role as therapist. There is also a risk that your needs may not be met in this conversation. You may wind up feeling frustrated with your teen’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.
6: Your teen says things like “well my therapist said…” as a challenge to your parenting. This is splitting, a defence mechanism used in moments of intense pressure, stress, anxiety, and anger. Splitting is an attempt to take the attention off one’s self 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. It is an unconscious defence mechanism. 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 may remind parents that “I do not believe every single thing your teen 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.
7: Your child has told you that they don’t like their therapist 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 one’s relationships outside of therapy. In doing so, one learns it is possible to address concerns directly without conflict and while still maintaining a positive relationship. Your teen needs to experience it 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 altered. 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.
8: You asked your kid if you could talk to their therapist and they said yes! When teens say yes, it is usually for a combination of reasons. There’s a power dynamic between parent and child making 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, than to worry about their therapeutic relationship with someone they see one hour a week and gives them unconditional positive regard.
I’m sometimes asked by parents how they can convince their teen to go to therapy. Parents may say something like this: “My son thinks I’m the crazy one, and that I should go instead..” or “My daughter doesn’t want to tell a stranger her personal problems…” or “Our daughter thinks you’ll tell me everything she says after the session is over…” or “Our son came to our family session, and he thinks therapy is boring.”
These are just a few reasons among many as to why teens may reject the idea of therapy. Here are seven ways to navigate these complaints and encourage your teen to attend therapy:
1. Introduce Your Teen to a therapist before problems arise. Teenagers may feel intimidated at the prospect of sharing personal information with a therapist, and for good reason. Before a first meeting, therapists start as strangers. Therapists are also adults trained in clinical psychology who can read teenagers’ minds! No wonder teens can resist therapy. (Just kidding about the mind-reading!) Why wait until your teenager is in crisis before encouraging a first visit with a therapist? Scheduling a one-time “get-to-know-you” session with a teen-focused therapist is a great way to dispel misconceptions about therapy and build an initial connection. This one-time visit also gives the teen an opportunity to interview the therapist and decide about the therapist. Teens are often surprised when they enjoy the initial session and may request follow-up sessions without your prompting.
2. Take the lead and go to therapy yourself . Nothing speaks louder to our children than our own actions. Your willingness as parents to attend therapy helps to normalize the therapy process for your kids. In fact, before starting therapy, begin to create a family culture where vulnerability is allowed and respected. Being vulnerable doesn’t mean that something is wrong with you, but shows you are courageous enough to grow. We’re comfortable taking our cars in for tune-ups, scanning our high-end computers for viruses. Why wouldn’t we take time to care for our minds?
3. Make therapy a family issue. Stay open to the idea that you as the parent may be contributing to the problem. Sometimes it’s hard to see your own role in a teen’s problem when your teen is the one acting-out, yelling, and defying your rules. Psychological issues don't occur in a vacuum. In fact, all psychological issues, even neurologically-based disorders, occur within an environment. The most basic environment for a teen is his or her home life, so of course the family will play a role in the teen’s psychological health. Your humility and willingness to acknowledge that you may play a role in the problem can help a teen acknowledge that he or she may also play a role in the problem.
4. Allow your teen ownership over the therapy process. Teens want to feel respected too. In therapy this respect begins with privacy. Allowing your teen to confide in some stranger can feel unnatural. You’ve invested your time and finances into raising this teenager and now some stranger has more information about your teen than you do. As tempting as it may be to ask your teen questions about her or his therapy, please know, your teen might resist therapy if what she or he said to the counsellor gets back to you—whether it’s coerced by a parent or leaked by the therapist. Confidentiality is a cornerstone for successful counselling. Some exceptions exist to confidentiality—ask your prospective therapist about these exceptions.
5. Explain that therapy for teens Is designed for teens. Skillful therapists for teens will approach therapy differently for teens than they would for adults or children. Connecting with a teen often involves attending to the things that interest teenagers—. music, relationships, freedoms, sports, events at school, etc. Tracking a teen’s interests not only makes the sessions fun for teenagers, but sends a message that what matters to them matters to the therapist. The therapist is also not the “third parent” for your teenager. While a therapist will often agree with a parent’s perspective, he or she will also advocate for the teen to the parents. A teen’s attempt to address a problem may look like acting-out instead of constructive dialogue. The therapist can help your teen express his or her concerns in a more literate manner.
6. You can gain some leverage with your teen through negotiation. Teenagers often believe they will not make the same mistake—or believe they will not get caught again—or are focused on what they want in the moment. As such, teens will often agree to a conditional postponement of therapy. Use a statement such as “We can take a pass on therapy for now if you agree that you will willingly go if your behaviour declines to such-and-such a point (create a measurable point).” Make sure to follow-through with counselling if your teen crosses that measurable point. Teens will find many reasons as to why crossing the measurable point didn’t count. Follow the letter-of-the-law on this one and schedule an initial session. Other teens, who fear they may cross that measurable point, will rise to the occasion and improve their behaviour—if for no other reason than to avoid therapy.
7. If your teen’s problems are out-of-control, or scary enough, then you may need to force the issue. Examples of such issues could include legal trouble, health risks, drug abuse, running away, etc. But even for such scary reasons, you will want to encourage voluntary attendance as opposed to forcing the issue when possible. Voluntary attendance correlates with better treatment outcomes. If a teenager is in danger and unwilling to voluntarily seek help, then you may need to contact the police or call a local psychiatric hospital.
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