At The Therapy Hub we pride ourselves on our family centred practice; all our therapists aim to strengthen the relationships of the families we work with. We know that bringing a young person to therapy can be nerve wracking for parents* too, and wanted to demystify how we involve parents in therapy. 

*when we use “parents” we are including carers and guardians

Why we involve parents in therapy

As their primary caregiver/s, you are the most important person in your young person’s life. As therapists, we want to equip you with the understanding and strategies to support your young person and foster a strong, positive relationship. You spend more time with your young person and will be in their life much longer than any therapist, so we make it a priority to include you in therapy as much as possible.

Research in neurobiology and attachment has shown the importance of the parenting relationship for helping young people build great relationships and emotional regulation skills. Research also shows that parent involvement in therapy has long term benefits for young people, and improves therapy outcomes.

The first session

If your young person is under 18, we strongly recommend parent/s attend the first appointment. The set up of the session will be tailored to you and your young person to be responsive to your needs and comfort. 

When the therapist greets you in the waiting room at the time of the session, they will offer options for how the session can be structured. For example, some young people want a parent in for the whole first session, others for the first 15 minutes, and others for the last 10-15 minutes. 

Parents are often keen to speak to the therapist before their young person, and there are cases where the therapist will opt to speak to your young person first if this is their preference. Rest assured your young person’s therapist values your input and will make time to speak with you. Remember, your young person’s therapist is working on building a relationship with them from the very first session, and research shows that the therapeutic relationship is the most important factor in how useful therapy is. 

Throughout therapy

At the start of each session, the therapist will check in with you and your young person to discuss who will be joining the session and for how long. Often the therapist will recommend that parent/s join for some of the session, either at the beginning or end (or sometimes both!). This is when the therapist will update you on how therapy is progressing, provide suggestions/strategies, and give you the opportunity to provide information and feedback, and ask questions.

As therapy progresses, it is common for there to be sessions in which your young person is seen alone. This can be for a variety of reasons, for example the session has been focussed on teaching your young person a new skill/strategy. If you’re ever unsure about the frequency of sessions/your involvement, let the therapist know – we want to make sure you feel supported and engaged in your young person’s care!

Parent-only sessions

You can request to schedule a parent-only session with your young person’s therapist at any time, and this may also be suggested by your young person’s therapist. Although they aren’t present during parent only sessions, your young person is still the client and as such the therapist is obligated to inform your young person of any contact (i.e. phone calls, sessions, emails) they have with you. The therapist will also give your young person a summary of what was discussed, for example “your parents talked to me about how it’s been hard for you to get to school, and mentioned you’ve had some issues with friends recently. They also asked for some advice about how they can support you, and I asked them some questions about your development”.  The therapist will also discuss how you could approach speaking with your young person about parent sessions (if you haven’t already).

At the beginning of therapy

There are a number of reasons why parents may opt to have a parent-only session before bringing their young person to therapy. Having a parent-only session first gives you the opportunity to discuss your thoughts/concerns with the therapist in detail, provide a thorough developmental history, and receive support and guidance regarding how you might speak to your young person about coming to therapy, other support services they may be eligible for, and general parenting strategies. 

If your young person engages in therapy after the parent session, their therapist will be open in telling them that a parent session took place, and will give them a summary of what was discussed (as noted above).

Throughout therapy

There will likely be times when a parent only session is necessary or beneficial, including but not limited to:

• Supporting separated parents – e.g. discussing coparenting and managing transitions/changes between households
• Specific and recurring conflict/challenge/s experienced by young person – discussing in detail and offering strategies/tools/resources 
• Discussing recommendations for further assessment or supports – e.g. assessment for Autism, ADHD
• General parenting support – e.g. setting and maintaining developmentally appropriate boundaries, managing conflict, how to respond/support if young person is distressed

Confidentiality

In the first session, your young person’s therapist will explain confidentiality in therapy to you and your young person. 

Your young person’s therapist must keep what your young person says to them private, and not share this information with any other people, including you (parents), unless the therapist has your young person’s permission.  This privacy, also called confidentiality, is very important because it helps your young person feel more comfortable and have more trust in their therapist. 

However, there are some important exceptions to this rule. If your young person is involved in a court case and a formal request (a subpoena) is made which requires the therapist to share information then the therapist may have to, even without your young person’s consent.  Also, if the therapist believes that your young person is at serious risk of harming themself or another person, or if someone else is harming your young person, then the therapist must take steps to protect them. This means that the therapist may have to share what your young person has told them with other people, such as you (their parent), or the relevant authorities (eg., police, child protection), with or without your young person’s consent. If any of these situations do come up and the therapist must share your young person’s information, they will do their best to first talk to the young person about who they need to share the information with, what they need to tell them, and why. 

It is common for parents to worry that confidentiality will mean that they will be excluded from their young person’s therapy, and wonder “how are we supposed to help if we don’t know what they’re talking about in therapy?”. Right from the beginning of therapy, the therapist will work with your young person to understand the challenges/difficulties that have brought them to therapy, and explore ways to involve you as parents. While many young people are reluctant to share certain information or worries with their parents, one of our most important roles as therapists is to encourage and support young people to express how they’re feeling and ask for what they need from you as parents. 

All of the therapists at The Therapy Hub are experienced in working with young people and their families to find creative, accessible, and sustainable ways to communicate and strengthen their relationships. 

Can I communicate with my young person’s therapist without my young person knowing?

Sometimes parents want to give their young person’s therapist information, but don’t want their young person to know the information has been shared. This often comes up when parents aren’t sure how to talk to their young person about something or are worried it will lead to an argument.

While this is understandable, receiving information in this way prevents the therapist from being able to act on or use this information in therapy with your young person. It can also undermine the trust between you and your young person, and your young person and their therapist.

Your young person’s therapist can help you to discuss the issue/information openly with your young person in a therapy session. The therapist can scaffold the discussion to support you and your young person, and offer ideas and suggestions for how you might resolve the issue or move forwards. 

While it may sound daunting, this can give you and your young person a more positive experience of having a tough conversation; bringing these discussions to therapy can actually strengthen your relationship.

I’m worried my young person isn’t telling their therapist everything that’s going on – what do I do?

There may be things going on for your young person that are really difficult to talk about, even with their therapist. Your young person may also be worried that if they do talk about these things in therapy, it will become the only focus and they won’t get to talk about other things that are important. If you’re not sure if your young person has raised an issue in therapy, we recommend starting by (gently) asking them, e.g. “I know you really don’t like talking about X with me, and I was wondering if it’s something you have felt able to tell your therapist?”. If your young person says no, it’s important to stay calm and not push them. For example, you might respond “Ok thanks for letting me know. I’m not trying to pressure you, and I wanted to check if there’s anything I can do to help if you do decide to talk to your therapist about it? I really care about you and you deserve to have someone to talk to”. Sometimes even just agreeing to let your young person’s therapist know there is something they’re not ready to talk about can be helpful, as the therapist can also validate this and demonstrate that they will go at your young person’s pace.

Fees and Medicare rebates

In order for a 50 minute session to be eligible for a medicare rebate, the young person (i.e. the client) must be present for at least 35 minutes, with the exception of family and carer sessions (see below). As providers, therapists can be audited to ensure that they are compliant with these requirements, and can face legal action and even jail time for non-compliance.

As of the 1st of March, family and carer sessions are being incorporated into treatment under the Better Access initiative. 

Key information:

• This is an extension of Better Access, so your young person must have a Mental Health care Plan/referral.
• A maximum of two family and carer sessions can be used in a calendar year.
• These items replace sessions where your young person would see their therapist, and will come off the young person’s 10 available sessions for the calendar year.
• The therapist will need to obtain the informed consent of your young person (the client) to use these items, and record this in their records. There is a notation in the legislation that says the practitioner providing the service must explain the service to the client, obtain the client’s consent for the service and make a written record of the consent.
• The young person needs to understand that they can withdraw consent at any time.
• The young person cannot be in attendance during the session.

Any additional parent-only sessions will be billed privately and cannot be claimed through medicare. You may be able to claim some of the cost of parent sessions via private health insurance, though this will depend on your insurance provider and coverage.

Feedback/Further Information

When you come to The Therapy Hub, we encourage you to ask questions and share your feedback. If you have any questions about how we structure sessions for young people and families, please phone (03) 9958 8772.

Written by Clinical Psychologist Hilary Morgendorffer