In Ontario there is no fixed age at which a teenager can agree to therapy. What counts is whether the teen understands what therapy involves and what follows from saying yes or no. If they do, the decision is theirs, and what they say in sessions is generally not passed on to a parent without their consent. The law sets a few clear limits on that privacy, and this article goes through them one statute at a time, so you know what to expect before the first appointment.
Three separate questions, often mixed up
Most of the confusion comes from treating these as one question. They are answered by different laws:
- Who can agree to the therapy itself? That is the Health Care Consent Act.
- Who decides what is shared about the sessions, and with whom? That is the Personal Health Information Protection Act, usually shortened to PHIPA.
- When can or must a therapist share information without anyone's agreement? That is partly PHIPA and partly the Child, Youth and Family Services Act.
Agreeing to start: capacity, not a birthday
Psychotherapy is a treatment under the Health Care Consent Act, 1996, which defines treatment as anything done for a therapeutic, preventive or other health-related purpose. Section 4 says a person is capable of consenting if they can understand the information relevant to the decision and can appreciate the reasonably foreseeable consequences of deciding, or not deciding. Every person is presumed capable, and a practitioner can rely on that unless they have reasonable grounds to think otherwise. The Act gives no minimum age.
The College of Registered Psychotherapists of Ontario puts it the same way in its guidance to psychotherapists on consent with minors: there is no age of consent for personal health care decisions, and a minor's capacity is assessed case by case. A young person can be capable for some parts of care and not for others.
When a therapist decides that a child is not capable, therapy goes ahead only with the consent of a substitute decision-maker, which is usually a parent. If the parents are separated, the CRPO page points out that a custody order or parenting agreement may give health care decisions to one parent only, even under joint custody. Have that document to hand when you first call.
What a parent can expect to hear, by situation
PHIPA deals with information. Under section 23 of PHIPA, a parent of a child under 16 can consent on the child's behalf to sharing their health information, with an important exception: information about a treatment the child decided on by themselves. And where a child under 16 is capable of making the decision about their information, the child's decision wins if it conflicts with the parent's. The CRPO guidance says the same in practical terms: when a minor is capable, the therapist needs that minor's informed consent before sharing their health information with a parent.
| Situation | Who agrees to the therapy | What a parent can expect to hear |
|---|---|---|
| Under 16, capable of the decision | The teen | What the teen agrees to share. Content of sessions stays private unless a legal limit applies |
| Under 16, not capable of the decision | A substitute decision-maker, usually a parent | The parent is involved in decisions about treatment and information, since they are the one consenting |
| 16 or 17 | The teen, if capable. Capacity is presumed at any age | What the teen agrees to share. The child protection reporting duty described below no longer applies in the same way |
The table is a summary of the statutes, and the line between "capable" and "not capable" is drawn by the therapist for each young person and each decision. It is general information, not legal advice for a particular family.
Where privacy has limits
A significant risk of serious harm
PHIPA section 40 allows a health professional to disclose information without consent if they believe on reasonable grounds that it is necessary to eliminate or reduce a significant risk of serious bodily harm to a person or a group. The wording is "may", so it is a professional judgement, and in practice it is the situation most parents have in mind when they ask about limits.
If you are worried about your teen's safety right now, do not wait for a session. In an emergency, call 9-8-8 (Suicide Crisis Helpline, 24/7), call 911 or go to the nearest emergency department.
Suspected abuse or neglect
Section 125 of the Child, Youth and Family Services Act, 2017 requires anyone, including professionals who work with children, to report to a children's aid society right away when they have reasonable grounds to suspect a child is in need of protection. Subsection 125(4) says that duty does not apply to a young person who is 16 or 17, although a report may still be made for them. This is the reason the age of 16 comes up so often in conversations about teen therapy, even though it is not the age of consent.
A court can also order records to be produced. That is rare in ordinary therapy, but it is one more reason a therapist explains the limits at the start rather than promising that nothing ever leaves the room.
Why the default leans towards the teen's privacy
Teenagers say less when they think their words travel. In a randomized trial published in JAMA in 1997, 562 high-school students listened to a recorded doctor's visit. When the doctor assured them of confidentiality, the share willing to talk about sexuality, substance use and mental health rose from 39% to 46.5%, and the share willing to come back for future care rose from 53% to 67%. The study was done in California with a recorded scenario and measured what students said they would do, not what they did, and it involved a physician, not a therapist. Its authors ended by asking how to explain the legal limits honestly without putting young people off care, which is close to the conversation this article suggests below.
Things to settle in the first session
Some therapists who see teens meet the parent and the teen together for part of the first session. Whether or not that happens, these are worth agreeing on out loud, with your teen present:
- what you, as a parent, can expect to hear: general progress, attendance, only what your teen chooses, or something else;
- how you would hear it, and whether your teen is told first;
- what the therapist does if they become worried about safety, and who they would contact;
- who books, pays and receives receipts, since those can show that sessions happen;
- if you are separated, what the parenting order says about health care decisions and who is told what.
Some teens hesitate because they assume everything goes straight home. A short sentence from you can help, for example:
I want you to have someone to talk to who isn't me. I won't ask what you talk about. If you want me to know something, you can tell me or ask your therapist to.
Then keep to it. Asking "what did you talk about?" after each session works against what you just said. A lighter question, such as "was it okay?", leaves room for your teen to say more when they want to.
How BridgeMinds works with teens and parents
Carolina Vintu, PhD, Registered Psychotherapist, works with adolescents as well as adults. As the teen therapy page describes it, she collaborates with parents in a structured and respectful way, balancing a teen's need for privacy with clear communication about goals and progress. Sessions are by video across Ontario, in English, Russian or Romanian. If your family lives between two cultures and the question of privacy feels different at home, the article on parenting across two cultures may be useful too. You are welcome to book a free 15-minute consultation to ask how confidentiality and parent contact would look for your teen.
