Child and adolescent psychotherapists and psychoanalysts are continuously confronted with grappling with their young patients’ right to privacy and upholding confidentiality, while simultaneously working closely with parents who often divulge secrets that have become the child’s unconscious burden to bear. A child’s conception of privacy is reliant on his or hers chronological age and developmental phase. For example, when working with the very young child (infancy through three years old), the therapist is almost always working with the parent and child dyad and the child’s privacy often carries little meaning in this setting. However, privacy becomes increasingly necessary and powerful in school-age children, and particularly formidable during pre-adolescence and adolescence. In addition, the concept of privacy is influenced by family values. It has been my experience that many families often confuse secrecy with privacy, which may result in intense feelings of guilt, betrayal, and conflicts of loyalty.