When a Child Needs Therapy: Who Gets to Know What?

Hi, I’m Heather Steele, owner of Morrisville Counseling and Consulting, and an experienced therapist serving the Raleigh-Durham area.

One of the most common concerns I hear from parents is:

“What will my child talk about in therapy?

And will I get to know everything?”

I completely understand where this question comes from. As a parent, you want to make sure your child is safe, supported, and getting the help they need.

You may feel anxious about what’s being shared behind closed doors. But here’s the challenge—therapy is built on trust.

I like to use this analogy with parents: Imagine your child keeps a diary. Would you feel comfortable reading every single page without their permission?

Most parents say no because they know that privacy is important for their child’s growth and independence.

Therapy works in a similar way. A therapist will absolutely share important information with you, especially if it involves safety concerns.

But they also need to respect your child’s privacy with non-harmful thoughts and emotions.

Let’s break it down.

Why Privacy in Therapy Matters for Kids and Teens

For therapy to be effective, children need to feel safe expressing their feelings.

If they worry that everything they say will be reported back to their parents, they may hold back—or worse, shut down completely.

Confidentiality allows kids to:

✔ Be honest about their emotions without fear of punishment or judgment.

✔ Talk about struggles they might not know how to share with their parents yet.

✔ Learn to process their feelings in a healthy, independent way.

If a child feels like therapy is just another way for their parents to monitor them, they may lose trust in the process.

What Parents DO Get to Know

While therapy is private, it’s not a secret. Parents often worry that they’ll be left completely in the dark about their child’s progress, but that’s not the case.

Therapists aim to balance confidentiality with parental involvement in a way that supports both the child and the family. Here’s what you can expect:

🔹 General Progress Updates

A therapist won’t share word-for-word what your child says, but they will keep you informed about their overall well-being and progress. This could include:

• Themes and goals – For example, if your child is working on anxiety, the therapist might say, “We’re focusing on building coping skills for overwhelming situations.”

• How your child is engaging – Are they opening up? Do they seem hesitant? This insight can help you understand their comfort level.

• Ways to support them at home – A therapist might suggest specific strategies, like giving your child more independence, improving communication, or setting up a consistent routine.

📌 Example: A parent of a 10-year-old struggling with school anxiety might hear:"Your child has been practicing relaxation techniques when they feel overwhelmed at school.

You can support them by encouraging these techniques at home before tests or stressful situations."

🔹 Serious Concerns

Confidentiality does not mean secrecy in dangerous situations. If a child reveals any risk of harm, therapists are required to involve parents and, if necessary, other authorities. This includes:

• Self-harm or suicidal thoughts – If a child expresses thoughts of hurting themselves, parents will be informed immediately, along with a plan for safety.

• Threats of harm to others – If a child makes serious threats toward others, appropriate steps will be taken to protect those involved.

• Abuse or neglect – If a child discloses abuse, therapists must report it to the proper child protection services.

📌 Example: If a 13-year-old shares thoughts of self-harm, the therapist would immediately contact the parents, discuss safety precautions, and potentially refer them for a more intensive level of care if needed.

🔹 Guidance for Parenting

Therapists understand that parents play a huge role in a child’s emotional well-being. That’s why they work closely with families to provide tools and guidance that reinforce therapy at home. This might include:

• Helping parents respond effectively to big emotions – For example, instead of saying, “Stop crying,” a therapist might encourage parents to say, “I see that you’re upset. Let’s talk about it.”

• Improving family communication – Teaching parents and kids how to express their feelings in a way that fosters understanding rather than conflict.

• Encouraging healthy boundaries – If a child struggles with social anxiety, a therapist might coach parents on how to gradually expose them to new situations without overwhelming them.

📌 Example: A parent of a 16-year-old experiencing social anxiety might be advised:"Instead of pushing them to attend every social event, try starting small—maybe a one-on-one outing with a friend they feel comfortable with."

❌ What You WON’T Get

While parents get important updates, they won’t get:

🚫 A word-for-word breakdown of therapy sessions.

🚫 Every little detail about what their child is feeling.

🚫 Their child’s private thoughts unless they are relevant to safety.

This is because therapy is a safe space for kids to open up. If they feel like every conversation will be reported back to their parents, they may withhold important thoughts and emotions, making therapy less effective.

What If I Really Want to Know More?

This is a tough spot for many parents. It’s natural to want to be involved in your child’s healing, but it’s also important to respect their process.

Here’s how you can stay connected without overstepping:

🗣 Ask open-ended questions. Instead of “What did you talk about in therapy today?” try “How are you feeling about your therapy sessions?”

🤝 Show support, not pressure. Let your child know they don’t have to share everything, but that you’re always there to listen when they’re ready.

📞 Talk to the therapist. If you’re feeling in the dark, ask your child’s therapist for general feedback. They can share themes and progress without breaking confidentiality.

📝 Trust the process. Even if your child isn’t opening up to you yet, therapy is still helping them work through emotions in a healthy way.

Finding the Right Balance

As parents, it’s easy to feel like you should know everything about your child’s life. But part of growing up is learning how to manage emotions independently.

At Morrisville Counseling and Consulting, we help parents navigate this delicate balance—ensuring children feel safe and supported both in therapy and at home. If you have concerns about your child’s mental health, we’re here to guide you through the process.

💬 Curious about how child therapy works? 

Let’s talk. Schedule a free consultation here and let’s find the best way to support your child together.

Your child’s healing matters—and you don’t have to figure it out alone.