The silent agreement: how unspoken consent between therapists and parents leaves parents outside the child’s therapeutic process

Psychodynamic Practice

https://doi.org/10.1080/14753634.2025.2592240

Dror Oren

Private Practice, Empathy - Psychological Forum for Counseling, Guidance and
Parenting Therapy (R.A.), Israel
(Received 24 June 2025; Accepted 16 November 2025)

Child and adolescent psychotherapy often operates under ‘the agreed-upon lie
a silent understanding between parents and therapists: treatment focuses on the
child, while parents and their inner world remain outside the therapeutic process.
This implicit agreement shapes referrals, creating a default therapeutic frame that
reduces complexity and limits the therapist’s role. The unspoken assumption is
that the child should be the central focus, without considering the wider system of
influences or examining the parents’ potential role as therapeutic subjects and
agents of change. This practice does not optimally serve therapeutic goals.
Instead, it often serves emotional needs of parents, therapists, and the broader
system. In doing so, it may obscure the possibility of meaningful change and
reflect intrapsychic and systemic dynamics that encourage avoidance of work
with parents. To clarify, the paper examines psychological and systemic factors
from three perspectives: parents, therapists, and children. On the parents’ side,
avoidance – such as fear of judgement – may fuel the hope that change occurs in
the child alone. On the therapists’ side, pressures to please, prevent dropout,
a perceived lack of therapeutic mandate or legitimacy to engage parents, or
reliance on narrow role definitions reinforce the pattern. On the child’s side,
there may be an unconscious wish to preserve the therapeutic space for selfexpression
and play, while resisting conflicts with parents. Finally, the paper
proposes an integrative model to move beyond avoidance and the automatic
child-only focus. The model encourages a flexible systemic – dynamic process
that includes parents as subjects, supporting a deeper, more authentic therapeutic
alliance that holds the needs of both parents and children. It also preserves the
clinical option to focus on the child, the parents, parenthood, relationships, or the
family as needed.
 

Keywords: Parental psychotherapy; child psychotherapy; systemic
dynamics; psychodynamic parent therapy; integrative treatment models