Therapy with teenagers may look different from therapy with adults or young children. The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Most teen clients are brought to the office by a parent/guardian, meaning time must be spent building trust and security. I encourage teen clients to be active participants in sessions to promote feelings of autonomy and control early in treatment. It is important that the teen has a safe, private space to work on his or her goals. For therapy to be successful, the teen must be able to talk freely, without feeling like what is shared must be censored for fear of disclosure to parents. Therefore, we will not disclose information to the parents without the teen's consent unless we believe that the teen is a danger to himself or others. Some disclosure by the teen can be extremely helpful in facilitating a trusting relationship between the teen and the parents and we will work with the teen to encourage this type of disclosure. With the teen's consent, we will also give the parents periodic updates on the teen's therapeutic progress. We encourage the parents to call us with any questions or concerns throughout the course of therapy.
Exceptions to confidentiality include:
Suspected child abuse or dependant adult or elder abuse, for which the therapist is required by law to report to the appropriate authorities immediately.
If a client is threatening serious bodily harm to another person, the therapist must notify the police and inform the intended victim.
If a client intends to harm himself or herself, the therapist will make every effort to enlist his or her cooperation in ensuring his or her safety. If a client is unable to remain safe, the therapist will take further measures to ensure the client's safety.
Legal differences are particularly important, especially for laws about confidentiality and family involvement in treatment. Under California state law, children who are 12 years of age and older may consent to their own treatment (Family Code § 6924). However, parents can be involved in the treatment at some point (with a few exceptions). This means that teens can come to therapy and have an additional layer of privacy, allowing them to share more openly with the therapist. If there is a risk of harm to self or others (such as suicidality or self-harm), this information would be shared with the parent to ensure the client’s safety.