Undoubtedly, the most important aspect of working with adolescents and teens is trust and authenticity. Beyond my clinical expertise and typical therapeutic style, these two words are my guide when it comes to working with adolescent clients. Experience has taught me that this means being honest, open, genuine and transparent. As such, it is my policy to spend the first session with the parents/caregivers and teen together so that we can discuss the balance of confidentiality in our therapeutic relationship. This balance consists of the legal, ethical, and emotional rights of the parents to know what is going on with their child and the teen’s need to be open and honest in the therapeutic relationship. Part of this discussion includes helping the teen understand that because he or she is a minor, ultimately, his or her parent has the legal right to know everything that is discussed in therapy. This also includes a discussion of the “deal breakers,” meaning the type of information that the therapist will always tell the parent (i.e., abuse, dangerous and/or illegal behaviors and situations). It is my opinion that therapy with teens works best when the teen is confident that the therapist is a trusted person with whom he or she can share painful, embarrassing, or otherwise difficult information in a confidential manner. At the same time, the parents must be comfortable with how much they know about what is going on in the life of their child, including the therapeutic relationship. Thus, the first session is an open discussion of these needs and striking an initial agreement between parents, teen, and therapist that optimizes everyone’s needs as much as possible. This discussion can and will be repeated as needed in order to maintain the optimal balance for the family.