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Ask a Professional: Therapy and confidentiality

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Ask a Professional: Therapy and confidentiality

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Ask a Professional: Therapy and confidentiality

Does anybody have this experience? You take your child to a psychologist via GP referral for all the typical 14-16 meltdown bad behavior related issues.

Then the psychologist says he can't talk to you about your child's condition unless the child agrees? What you do when the child in anger does not agree?

Worst the child uses the psychologist comments like " oh you are 15 now and will have opinions... and tells you off! The GP is supportive.

So my question is what can we do as parents.

Hi @mmjmmj,

It can be such a frustrating and worrying experience when you don’t know what is happening for your child!

While I can’t speak to the individual circumstances of what is happening for your teen, I thought it might be helpful to talk a bit about how confidentiality usually works with psychologists and therapists, and some ways in which parents can be involved.

One of the most important factors in therapy working helpful, is the person being willing to talk to the psychologist about what is happening, and being actively involved in working on goals. With teens this can be particularly tricky, because it often isn’t their idea to attend therapy. So, it can take more time and effort to develop trust.

If the teen knows that information they tell the therapist is going to be shared with the parents, then they will generally be reluctant to share, and will view the therapist as someone working for the parents, rather than working with the young person. This can make it hard to develop trust and can get in the way of working on goals in therapy.

There are some times where information should be shared - for instance, when there is a risk of harm to the young person. These limitations of confidentiality should be discussed at the beginning of therapy.

Of course, this doesn’t mean that the young person cannot choose to share information. Sometimes this is something which the teen might be more comfortable with a bit later on in therapy, when they have had time to work with the psychologist on ways to approach challenges like effective communication. Teens are also more likely to agree if there is a specific purpose in mind, rather than a general sharing of information. For instance, they might be more likely to agree to a conversation with the psychologist about how the parent can support their progress in therapy.

You could introduce this idea by letting your teen know that you want to support them, and that having a conversation with the psychologist, yourself and the teen sometime might help you know how best to do that. Even if they don’t take you up on it for now, this might be something that they are willing to do later.

You mention that your child has been quick to share their opinion, and it sounds like this has been challenging because they are using this as an opportunity to criticise you. I can understand this would be really challenging to listen to, and you could be feeling quite hurt.

Teens definitely do have opinions, and developing their own beliefs and ideas is really important, but it doesn’t mean that their opinions are more valid than yours. When you’re being criticised or yelled at it can be tempting to argue and defend your own perspective. This is understandable, but it can also increase the chances that neither of you are really listening to the other person.

Your teen might be expressing themselves in a way which focuses on their perspective, and which is unfair to you, but it could give you some insight into how they are thinking about things.

Taking a moment to really listen to their perspective and acknowledge the emotion behind it, can help open up a genuine conversation between you, and mean your teen is more open to hearing your perspective on things.

If your teen has only just started seeing the psychologist, then it is likely that so far they have focused on understanding and validating the teen’s experiences. As therapy continues, the focus can shift more to skills, and you might notice differences in your teens behaviour. For instance, if your teen has meltdowns because they feel overwhelmed and stressed, as they learn skills to manage their emotions, they are more likely to be able to respond flexibly and feel less overwhelmed. However, learning these things does take time.

In the meantime, it can be helpful to keep an eye out for any small moments where things seem a little better, and to acknowledge these in a positive way - when you’re going through a tough time with your teen it’s easy for the moments of conflict to take the focus, so looking for opportunities for positive interactions is important.

It’s also important to look after yourself - I’d encourage you to consider what support you currently have in place, and what you might find helpful right now - whether it’s chatting with a friend, taking time to do something you enjoy, or talking to a professional yourself.

Best wishes,

Linda is a psychologist experienced in working with people across the lifespan, including teenagers and their families, in a variety of settings, and is ReachOut's Clinical Lead.