This study aimed to conceptually explore how adolescents’ relational expectations formed through parasocial interaction (PSI) may be reenacted within therapeutic relationships and how such dynamics may influence therapists’ responses. To achieve this, previous studies related to PSI, therapeutic relationships, and therapist responses were integratively reviewed, and PSI types identified in prior research were used as an analytical framework to examine possible relational expectations and therapist responses. The findings suggest that adolescents’ PSI experiences may shape specific relational expectations, which can be reproduced in diverse ways within therapeutic relationships. Depending on PSI types, clients may expect different relational patterns and interaction styles toward therapists, potentially influencing therapists’ emotional responses and intervention approaches. In addition, therapists’ responses need to be understood not merely as individual reactions but as relational phenomena emerging through the interaction between clients’ relational expectations and therapists’ professional roles. In conclusion, this study explored PSI experiences within the context of therapeutic relationships and organized possible relational expectations and therapist responses according to PSI types. Furthermore, by proposing an exploratory reflective framework for therapists’ self-reflection, this study provides foundational implications for understanding adolescents’ media-based relational experiences within therapeutic relationships.