When working with children and adolescents I frequently conduct a combination of individual and family therapy. With children under 14, I also see the parents without the child to help with parenting issues such as setting appropriate boundaries, consequences, reward and support systems. Some meetings may be mostly educational about a particular disorder or learning general parenting skills.

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Adolescents (age 14 and older) are legally entitled to receive confidential medical and therapeutic services. Thus, before discussing any information with parents I obtain the teen's agreement and consent. Typically, I will not see the parents without their teen being present, unless they consent to that. If parents call I will listen to the information they are presenting me with but will not disclose information that the teen has shared with me in confidence.

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The exception is when an adolescent has disclosed to me any child abuse, a preoccupation/and/or plan for suicide or homicide, or preoccupation with hurting themselves or someone else.

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Drug/alcohol use may at times be subject to confidentiality, but most often it becomes a family issue and is discussed with parents. The teen is usually aware of parental knowledge unless there are unusual circumstances. Running away threats are handled with great sensitivity to balance safety and therapeutic alliance. The teen will be aware of any need to deviate from standard confidentiality.

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In divorce situations, both parents usually need to agree on the child's need for therapy (under 14 only).