Therapy with Teens
It is very typical for teenagers to want to handle problems in their life on their own and in their own way. They might seek out friends, social media, the internet, and occasionally even parents for information or guidance. Their fundamental need to be independent is very strong at this point in development. The problem is that sometimes that all-encompassing drive exists even though they are still developing the skills, experience, and self-confidence to be able to accomplish it on their own.
A teenager’s identity is an ongoing work-in-progress for many years. Through observation and plenty of trial-and-error, they discover who they are as an individual, how they relate to others, and how to get by in the world. Their desperate need to fit in while simultaneously standing out can create its own source of conflict.
That’s why when a teenager feels that he or she stands out in an unwanted way they can feel overwhelmed. Even things like experiencing anxiety, depression, problems with friends, struggles at school, or conflicts at home can seem like something that others might notice. Whether or not that is the case it can cause serious stress for teens.
When a teenager is having difficulties, they may display it by being emotional, acting out behaviorally, or through changes in their academic performance. No matter how they deal with their issues it’s likely that they will have trouble talking about what’s going on. They may be unable to find the words to express themselves, be too embarrassed to acknowledge it, or even reluctant to put their need for independence aside and rely on someone else for help.
Well-meaning parents may encounter unexpected resistance from their teenager. Arguing, frustration, and tension in the home add another level of problems onto whatever was overwhelming to start. Even teens who have previously had great relationships with their families might struggle with asking for help or taking it when it's offered.
In many cases, teenagers will agree to start therapy when they realize that everything they’ve tried on their own hasn’t worked in dealing with their problems. They may also want to talk about their difficulties with someone who is safe but not a part of their family or friend group. If they see the value in leaning on someone else they might realize they can get the help they need.
Many teenagers will even say they experience a sense of relief in going to a place where they know they will not be judged. It can be validating and comforting for them to learn that everyone struggles with difficult emotions, thoughts, behaviors, and situations at times.
But, perhaps most importantly, therapy allows teenagers to learn skills and strategies they can use for the rest of their life.
THE FIRST SESSION
If your teenager is younger than 18 years of age, the initial paperwork is completed by the parent or legal guardian. If they are 18 or older, your teen will need to sign the necessary form providing consent to treatment. You are provided with a full explanation of client confidentiality and how it applies to your teenager’s specific situation at the very beginning of treatment. It is a priority to make sure everyone understands confidentiality and how that works with the parent-child relationship.
During the first session with your teenager, the objective is to discuss what difficulties they are experiencing. It’s important to gauge what they feel is troubling them most and what might have contributed to these concerns along the way. Additionally we will start to set their desired goals to direct treatment.
Your teenager is given the choice of whether he or she wants to talk about their problems alone or with a parent(s) in the room to provide additional explanation or detail. If he or she wants to start out on their own (which is encouraged, but not required), the parents’ perspective and information can be shared afterwards or via telephone at a later time.
Once the period of intake is complete, the next steps of the process can begin. We will start by discussing the treatment goals and approaches will be reviewed in detail for everyone involved.
THE THERAPEUTIC APPROACH
One of the most commonly used techniques is Cognitive Behavioral Therapy (CBT). This type of therapy is used to help teens develop effective ways of coping with the problems they are encountering. Some of the skills most frequently requested and developed include:
- Techniques for dealing with the thoughts, emotions, and physical sensations associated with anxiety and worry.
- Strategies for improving study habits, time management, planning, organization, and completing large assignments by breaking them down into smaller components.
- Methods for enhancing self-esteem and self-confidence.
- Coping with depression, sadness, and grief.
- Problem-solving to build towards desired outcomes in life.
- Recognition of unhealthy relationships and how to deal with them.
- Connecting with peers and maintaining healthy social relationships.
- Identifying possible distractions and sources of procrastination.
- Managing anger in a productive and non-aggressive way.
To help teenagers develop the mindset and skills needed to approach difficulties in their lives in healthier and more effective ways we use several resources. Some of these include apps, online videos, workbooks, and other materials that can be used outside of sessions. Most teenagers come to use these resources in their own way, which is normal and expected. Even though they may not use them as suggested, important improvements are still being made.
In most instances there will be differences between your teenager’s desired outcomes for therapy and what you want for them. This is perfectly normal and something that will continue to be discussed throughout the therapeutic process.
At the beginning of the process we will discuss potential time frames required to address chosen goals. During the course of their therapy, teenagers will be challenged to identify their personal values and goals for the future. The main objective of the treatment process is to help your teenager grow into a healthy and independent adult who is capable of seeing the “big picture.”
IF YOUR TEENAGER IS NOT QUITE READY
Teenagers may be reluctant to come in to discuss their personal issues initially. This may be for a number of reasons. Please be understanding and patient with your teen. Validate their feelings that opening up about a problem is not easy for anyone.
But if the situation can’t wait, and the problems experienced by your teenager are significantly affecting the whole family, there are several steps that parents can take right away to help:
- Learn skills and strategies to model the behavior you want your teenager to exhibit.
- Improving communication, particularly when it comes to setting expectations.
- Establish rewards and consequences for behavior that are effective for changing the dynamic at home.
- Creating appropriate boundaries and responses when lines are crossed.
- Developing the techniques of collaborative problem-solving.
- Start the process of therapy for any problem where the family’s involvement in treatment is important for achieving good outcomes (e.g. Oppositional Defiant Disorder, eating disorders).
WORKING IN CONJUNCTION WITH SCHOOLS
When issues affect your teenager’s ability to succeed in middle or high school, it is important to have frequent communication and collaboration with school personnel. This can include regular check-ins with support staff (School Psychologists, Guidance Counselors, Resource Room teachers) and attendance at Annual Reviews, 504 Plan meetings, and Committee on Special Education meetings (by request).
Many parents of teenagers in need of school services struggle to navigate the complex system, and as a result, their children may be left without the accommodations and modifications they need. Parents will be given information on how the process works and how advocacy to the school district functions.
If your teenager is about to go off to or is currently attending college, the goals are a little different. We work towards developing their awareness of the on-campus support services and the self-advocacy skills to access them. Recommendations for available technology and accommodations that may be helpful to the pursuit of higher education are provided as well.
FINAL THOUGHTS
When your teenager struggles, it can be hard to know what steps to take to help them. This can be particularly difficult when your teenager doesn’t seem to want to get help. This is where working with a therapist can significantly improve outcomes.