Between Privacy and Secrecy: Reconsidering Parental Involvement in Psychodynamic Psychotherapy with Adolescents

Psychoanalytic and psychodynamic traditions have historically prioritized the adolescent’s internal world, often at the expense of engaging parents in therapy. This paper revisits prevailing assumptions regarding adolescent autonomy, therapeutic confidentiality, and the exclusion of parents from the psychotherapeutic process. It questions the psychodynamic distinctions between privacy, secrecy, and separateness and explores how these constructs shape both the therapeutic frame and the adolescent’s developmental path. Through a detailed clinical case study of a 16-year-old adolescent, the paper examines the therapeutic and ethical complexities of parental exclusion. Supervision processes and countertransference reactions are incorporated to illuminate the therapist’s evolving stance. The case illustrates how uncritical adherence to confidentiality, interpreted as absolute privacy, may collude with developmental defenses, reinforce familial ruptures, and limit therapeutic efficacy. The paper advocates for a more flexible, dynamically attuned approach to confidentiality in adolescent treatment. It proposes that therapists differentiate between protective privacy and defensive secrecy and actively negotiate the boundaries of parental involvement. Within this framework, confidentiality is understood not as a fixed rule but as a therapeutic position open to reflection and relational recalibration. This stance allows for the adolescent’s psychological growth while potentially facilitating a reparative parent–child connection.