What will my teenager tell the therapist that they will not tell me? And if they tell the therapist something important, will I find out?
These two questions sit beneath almost every parental decision about adolescent therapy. They are reasonable questions. They are also the questions whose answers will determine whether therapy works.
Why Confidentiality Is the Mechanism, Not Just the Policy
Confidentiality in adolescent therapy is not a bureaucratic formality. It is the therapeutic mechanism itself. A teenager who believes that what they say in session will be reported to their parent will not say anything meaningful. They will perform the role of “teenager in therapy” without doing the work of therapy, answering questions with what they think the therapist wants to hear, or what they calculate is safe for their parent to know.
This is not hypothetical. It is the most common barrier to effective adolescent treatment. The teenager who sits in the chair at a Midtown Atlanta practice and says “I’m fine” for six sessions in a row is not necessarily resistant. They may be testing whether the therapist will keep their word. Trust is not given. It is earned through consistent proof that the space is genuinely theirs.
For parents accustomed to being their child’s primary advocate and information source, this requires a significant psychological adjustment. You are paying for the service. You are managing the logistics. You may be the one who identified the problem. And you are being asked to accept that you will not have full access to the content of what happens in that room.
That is not a flaw in the model. It is how the model works.
What Stays in the Room
In standard adolescent therapy practice, the content of sessions is confidential to the teenager. This includes what they discuss, the feelings they express, the details of their social life, their thoughts about family members, their experiments with identity, and their private experiences.
A therapist may share general themes with parents when clinically appropriate and with the teenager’s knowledge: “We’re working on anxiety management strategies” or “They’re processing some social stress.” But specific details, direct quotes, names of friends or romantic interests, and the teenager’s private reflections on family dynamics remain within the therapeutic relationship.
This boundary is not absolute. There are specific, clearly defined exceptions, and every competent adolescent therapist explains these exceptions to both parent and teenager in the first session, before any therapeutic content is shared.
The Limits of Confidentiality
Confidentiality in adolescent therapy has legal and ethical limits that are non-negotiable. These are not gray areas. They are clear lines that every licensed therapist is trained and legally required to observe.
Imminent danger to self: If the teenager discloses active suicidal intent with a plan and means, the therapist is obligated to act. This may involve contacting the parent, contacting emergency services, or both. The threshold is imminent risk, not general distress or passive thoughts about death (which are more common in adolescence than most parents realize and are addressed within the therapeutic frame).
Imminent danger to others: If the teenager discloses a credible plan to harm another person, the therapist has a duty to warn and protect that includes breaking confidentiality.
Abuse or neglect: If the therapist has reasonable cause to suspect that the teenager is being abused or neglected, Georgia law requires a mandatory report to the Division of Family and Children Services (DFCS). The therapist does not investigate. They report. This obligation exists regardless of the source of the information and regardless of the therapist’s relationship with the family.
Court orders: In rare circumstances, a court may compel disclosure of therapy records. This is uncommon in standard adolescent therapy but is relevant in custody disputes or legal proceedings involving the teenager.
These limits should be explained clearly at the outset. If your teenager’s therapist does not discuss confidentiality limits in the first session, ask. Clarity about boundaries is a sign of competence, not a red flag.
What Parents Can Expect to Know
You will not receive session transcripts. You will receive what is clinically useful for you to know in order to support your teenager’s progress.
In most adolescent therapy arrangements, this includes periodic parent check-ins (monthly or as needed) where the therapist shares general progress, areas of focus, and recommendations for the home environment. These check-ins should happen with the teenager’s knowledge. A therapist who meets with parents secretly, without the teenager knowing, has compromised the therapeutic relationship in a way that is difficult to repair.
You can expect to know whether your teenager is engaging in the process. You can expect to know if the therapist recommends additional evaluation (for example, psychiatric assessment for medication consideration). You can expect to know if there is a safety concern that meets the reporting threshold described above.
Parents should not expect to know the content of your teenager’s private disclosures, the details of their romantic life, what they say about you when you are not present, or the specific events they are processing. That material belongs to the therapeutic relationship.
The Atlanta Community Context
In a metropolitan area where social networks overlap significantly, especially within Atlanta’s private school communities, Buckhead social circles, and the tighter neighborhoods of Decatur and Virginia-Highland, confidentiality carries additional weight. Your teenager may be concerned not only about what you will know but about what your friend, who is the parent of their classmate, might find out. Or what their school counselor might hear. Or what might appear in a record that could affect a college application.
These concerns are specific, practical, and legitimate. A competent adolescent therapist in the Atlanta metro area understands these dynamics and addresses them proactively: how records are stored, who has access, what happens if a parent requests records for college disability accommodation, and what protections exist against informal information sharing.
If your teenager attends a school where the therapist has other clients, the therapist is ethically prohibited from acknowledging the other therapeutic relationships. Your teenager will not find out who else is in therapy at the same practice. This may seem obvious, but for teenagers navigating tight social environments, this assurance matters.
Building Trust Before the First Session
Before your teenager’s first appointment, you can lay groundwork that supports the therapeutic process.
Explain to your teenager why you are suggesting therapy in honest, non-pathologizing language. “I think you could use someone to talk to who is not your parent and who is professionally trained to help” is more effective than “there’s something wrong and we’re getting you help.”
Clarify that you will not ask them to report on every session. If they want to share, they can. If they do not, that is acceptable. Your access to information will come through the therapist’s parent check-ins, not through interrogation after each appointment.
Acknowledge that therapy is for them, not for you. Even if you initiated it, even if you are managing the schedule and the insurance, the therapeutic space belongs to your teenager. Respecting that boundary before the first session teaches them that you mean it.
And address the most common adolescent fear directly: therapy is not a sign that something is wrong with them. It is a resource that high-performing, intelligent, capable people use. In a city where executive coaching, personal training, and career consulting are normalized, framing psychological support as another form of professional development is both accurate and destigmatizing.
This content is for educational purposes and does not replace professional legal or psychological advice. Confidentiality laws and ethics vary by jurisdiction and specific clinical circumstances. The information provided here reflects general practice in the state of Georgia as of 2025. Consult your teenager’s therapist directly for practice-specific policies.