Confidentiality in therapy

At a glance

Confidentiality means that what a young person says in therapy is usually kept private.
For teenagers, this privacy means they often speak more openly, which makes therapy more useful.
It doesn’t mean secrecy at all costs. If there’s a serious safety concern, a therapist will share limited information.
It helps when everyone understands from the start how confidentiality will work.
Parents can still play an important role, even when sessions’ content isn’t shared with them.

illustration-of-3d-locks relating to Confidentiality in therapy

Why confidentiality matters to young people

For many teenagers, being able to talk without everything coming back to a parent, school or another adult is a big part of what makes therapy work.

Adolescence is a time when young people are working out who they are, what they think and how much of themselves they want other people to see. They may be dealing with family tensions, friendships, identity, embarrassment, anger, shame, sexuality, low self-worth or worries they’ve never said aloud before.

If they think their therapist will report back, many will hold important thoughts, feelings and experiences back, or stop talking altogether.
That’s why confidentiality matters. It’s not about shutting parents out. It helps make therapy a place where a young person can actually say what’s going on.

How confidentiality builds trust

Many young people carry fears such as “If I say that, I’ll get in trouble”, “If my parent hears this, it will turn into a row” or “If school finds out, everyone will see me differently”.
A teenager is more likely to talk openly when they know what they say won’t be used against them. This trust can make it easier for them to:

admit things they’re embarrassed by
talk about confusing or uncomfortable thoughts
bring up worries about home
explore something before they fully understand it
say what’s true rather than what’s acceptable

What confidentiality means in practice

Therapists rarely tell parents exactly what was said in sessions. Instead, the focus is on making sure the young person can speak openly. In practice, that usually means:

no blow-by-blow account of each session
no passing on of what’s been said in confidence
no personal details are shared with a school or anyone else without the young person’s permission

This can be difficult for parents and carers, especially when they’re worried and want to understand what’s going on.
However, you can still expect feedback that helps you better support your child – without crossing the young person’s boundaries. This might include:

a brief update on general progress, without sharing private session content
practical guidance on what might help at home
occasional joint sessions, if appropriate

How confidentiality works in the UK

In the UK, confidentiality in therapy is based on professional ethics, privacy law, consent and safeguarding. It’s not about excluding parents. It’s about recognising a young person’s growing independence and their right to access help.

This includes Gillick competence, a UK legal principle used to decide whether a child under 16 can agree to their own therapy or medical care. This depends on whether they understand what therapy involves, what confidentiality means, and when something may need to be shared.
For 16-17 year-olds, confidentiality is generally treated in a similar way to adults, while still holding safeguarding responsibilities.

How confidentiality works for pre-teens

Pre-teens are still developing their understanding of emotions, relationships and consequences. They might not be ready for the same level of privacy as a teenager.

Usually, pre-teen therapy takes a shared approach based on the child’s age, understanding and needs.
Parents and carers are more regularly involved in the process
Therapists might share general themes or observations with you
You might be involved in joint sessions
You could be given practical guidance to use at home

At the same time, it’s still important that the young person has some sense of privacy. They need to know they can speak without everything being repeated or analysed.

How we keep notes at TMH

Confidentiality is also about how information is recorded, stored and protected.

At TMH, therapists keep handwritten notes rather than detailed digital transcripts of sessions. These are short notes that help the therapist keep track of what matters, rather than writing everything down.

Young people also often speak in fragments, metaphors or imagined scenarios when they work something through. Recording every word can risk taking things out of context.

Notes are stored securely, with restricted access, in line with UK data protection and safeguarding standards.
In rare cases where we’re asked by law to share notes, we only provide what’s directly relevant to the situation.

Limits to confidentiality

Confidentiality is important, but there are limits.

A therapist may need to share some information if they’re concerned that a young person, or someone else, is at immediate risk of significant harm. In this case, the aim is safety not punishment.

We explain what needs to be shared and why, involve the young person where possible, and share only what’s necessary.

What to do

Talk about confidentiality early on

Confidentiality works best when everything’s clear from the start. Make sure everyone understands what stays private, what the limits are and what might need to be shared if there’s a safety concern.
Try not to question your child too closely after sessions

Repeatedly asking what was said can make a young person more guarded and less likely to speak openly.
Ask how you'll be updated

This might include brief check-ins or general updates.
Use check-ins well

Keep them focused on what’s helpful and relevant, rather than trying to gather private details.
Be honest about your worries

It’s understandable to find confidentiality difficult, especially when you’re concerned about your child. Try to stay focused on how confidentiality helps therapy work.
Respect privacy where you can

For many teenagers, having one space where they’re not closely questioned can make it easier to talk more openly over time.

When to look for further help

You may need further advice on confidentiality if:

your child doesn’t want to go to therapy because they think everything will be shared
there’s confusion about what the therapist can and cannot share
you’re increasingly worried about safety or there are signs of immediate risk
it’s leading to tension or arguments at home
your child is asking for more privacy, and you’re not sure what’s appropriate

What to remember

For teenagers, privacy can be the difference between saying something real and saying nothing at all. For parents and carers, that can take trust and patience. But privacy in therapy doesn’t mean being left in the dark. You should still expect general updates and practical guidance – and clear communication if there’s ever a serious concern.