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One of the characteristics of psychotherapeutic work with children and adolescents is parental presence, which introduces additional parameters into the setting and function of the therapist. Parental presence makes the existence of the external world constantly present, increasing the risk of bias in interpreting and understanding the intrapsychic world. Interference is common in the therapeutic setting, and mostly challenges the therapist's tolerance. Meetings with parents may trigger fantasies in the therapist's mind, which interfere with the game of identifications with the child and the fantasized parents. The common bond with the child creates conscious and unconscious reactions, and there is always the risk of the therapist being overwhelmed and losing his or her capacity to understand object relations and transference phenomena. The therapist's function may be influenced either through weakening of the symbolizing capability or through hampering the capability to understand the child's function of fantasy. Parents are always present, while the therapist's countertransference movements evolve. Given that the technique of interpretation is not always available, the main goal is to use countertransference challenges in the service of the child's psychotherapy, by understanding the child's internal reality, resistance, and experience, as well as the intensity and nature of external experiences within the family.