Core ethical principles for the conduct of psychotherapy with children and adolescents transcend times, trends, and jurisdictions. Advances in technology, variations in state law, and the evolution of federal law should stimulate consideration of how these ethical principles apply to new situations; however, the guiding compass remains the psychotherapist’s obligation to create and protect the integrity of the psychotherapeutic space to provide the child or adolescent the freedom to identify, examine, explore, and hopefully resolve the issues that bring one to treatment. Boundaries, privacy, confidentiality, and the patient’s autonomy are components of this space. Together, they reflect a basic respect for the patient central to professional conduct and essential to any effective treatment process.