Teen Therapy 13 and up, Confidentiality in Washington State: What Parents Need to Know

When parents bring their teen to therapy, one of the biggest questions they have is, “What will I be told?” It’s completely understandable—parents want to be involved and make sure their child is safe. But at the same time, therapy only works if a teen feels like they have a space to talk openly, without fear that every word will make its way back to their parents.

In Washington State, confidentiality laws are designed to balance both of these needs. Let’s talk about what stays private in therapy, what parents can expect to hear, and why confidentiality is so important for a teen’s mental health.

What’s Confidential for Teens 13 and Up?

In Washington State, once a teen turns 13, they have legal rights to confidentiality in therapy. This means that a therapist cannot share what a teen talks about in therapy with their parents without the teen’s permission—except in specific circumstances (which we’ll cover in a moment).

This law is in place to encourage teens to open up. If they know that everything they say will be reported back to their parents, they may censor themselves—or avoid therapy altogether. When a therapist can offer a truly private space, teens are more likely to talk about what’s really going on, whether that’s anxiety, depression, school stress, friendships, relationships, or even struggles with self-harm or suicidal thoughts.

What Can Parents Be Told?

While confidentiality is key, parents aren’t completely out of the loop. Therapists can and do communicate with parents, but the focus is on general concerns rather than private session details. Here’s what parents can typically expect:

Guidance on how to support your teen – Many therapists help parents understand what their child needs and how they can help at home.
Concerns about safety – If there’s an immediate risk of harm, parents will be brought in.

When Will Parents Be Notified?

While teens have privacy, there are certain situations where a therapist must break confidentiality and inform parents (or authorities, if needed):

If a teen is at risk of serious harm to themselves or others
- If a teen talks about suicidal intent (having a plan and means), the therapist must act to keep them safe, which often includes informing parents.
- If a teen expresses intent to harm someone else, parents (and possibly authorities) will be notified.
If a teen is experiencing abuse or neglect
- If a therapist has reason to believe a teen is being abused (physically, sexually, or emotionally) or neglected, they are legally required to report this to child protective services.
Self-harm (like cutting or burning) – It depends
- This is where things can get tricky. Many teens who self-harm do not have suicidal intent, meaning they aren’t trying to end their life. In these cases, therapists often do not tell parents unless the self-harm is severe, meaning needing medical attention, escalating, or life-threatening.
- Instead, the therapist will work with the teen to develop safer coping strategies and may encourage the teen to involve their parents when they’re ready.
- If the self-harm is putting their life at risk (deep cuts, risk of infection, burns, or unsafe practices), parents will be informed.
Medical emergencies
- If a teen is experiencing a medical or psychiatric crisis that requires intervention, parents will be contacted.

Why Does Confidentiality Matter for Teens?

Some parents may feel frustrated—“Why can’t I know everything? I’m just trying to help!” But confidentiality is actually one of the most powerful tools in therapy. Here’s why:

It builds trust. If a teen knows their therapist won’t immediately report everything back to their parents, they’re much more likely to open up.
It gives them a sense of control. Teens are in a developmental stage where they crave independence. When they have a space that’s truly theirs, they feel more empowered to work through their struggles.
It makes therapy effective. Therapy only works if a teen feels safe. If they’re constantly worried about their words getting back to their parents, they may withhold important information.

How Can Parents Support Their Teen in Therapy?

Even though parents may not get a play-by-play of every session, there are still ways to stay involved and support your teen’s mental health:

Let them know you’re there for them—without pressure. A simple, “I’m here if you ever want to talk” can go a long way.
Respect their privacy. Avoid pressuring them to share what they talked about in therapy.
Trust the process. Therapists work hard to ensure teens are safe while giving them the space to work through their emotions.
Ask how you can support them. Instead of asking what they talked about, try asking, “Is there anything I can do to help you outside of therapy?”

Final Thoughts

Teen therapy is most effective when young people feel they have a private, safe space to talk. While Washington State law protects that privacy, it also ensures that parents are informed in situations where safety is at risk.

If your teen is in therapy, the best thing you can do is trust the process, respect their space, and offer your support. Over time, many teens feel more comfortable opening up—not just in therapy, but with their parents too.

If you have any questions about confidentiality, don’t hesitate to talk to your teen’s therapist. They can help you understand how to support your child while respecting their need for privacy.