Q: When I work with teens, I worry their parents will be upset if I don’t strongly discourage potentially dangerous behavior (sex, drugs, tattoos, etc.). How can I address the consequences of their choices without judging or lecturing?

A: Ah, the challenges of working with teenagers! Officially, your client is the adolescent, but since so many people have a stake in the process, it can often feel like parents, school personnel, extended family, and even the larger community are peering into the room. In such cases, therapists are understandably concerned about their liability and the professional consequences of making a mistake. At the same time, it’s important not to let that get in the way of staying focused on your client and doing what’s effective.

Consider the example of 15-year-old Sasha, who has a history of mood dysregulation, impulsive behaviors, and a wary relationship with her parents. In session, she tells you she had a great time over the weekend with friends at a party, where there was drinking and drug use. She’s elated that some of the older high school boys had paid attention to her, and casually reveals that she had sex with one of them. Although her parents had found out she was there, she’d lied to them about the drinking and certainly never mentioned the sex.

Sasha is aware that her parents sent you an email to report their concerns and let you know that she’s now grounded for two weeks. But she…