Adolescent Therapy

Regardless of whether your concern is about your teen’s school performance, refusing to communicate with you, depressed mood, anxiety, irritability or angry outbursts, being teased or bullied by peers, or difficulty dealing with major stressful life events, such as changing schools, abuse, divorce, moving, or family loss...Nothing is more painful than watching your child struggle without knowing how to make it better.

Let's start with some basic information about these Amazing beings called teenagers...

Social Development

Developmentally, the adolescent years are a period of identity exploration and seeking independence in preparation for adulthood. They are trying to figure out who, what, and how they want to be.

In their process of identity exploration, it is normal for teens to push boundaries, become more opinionated, and prioritize the company and advice of peers more than that of their parents. Being socially accepted by peers is often of utmost importance. Problems can arise if teens encounter significant teasing, cyber bullying, or negative peer influences.

Remember, teens want to establish independence, but they don’t know how to do this yet. They also do not fully understand how consequences work and have difficulty understanding that some behaviors have lifelong impacts.

Cognitve Development

Teens’ thinking process and actions are often focused on short-term goals. Thus, they can be more impulsive and make decisions based on a sporadic or whimsical thought, instead of thinking things through. They are still fine-tuning their abstract reasoning, problem-solving, and delayed gratification skills.

While you’ve been helping your child to prepare for adult independence and responsibility all along, it’s important to realize that your teen’s plans and desires may be different from what you want for them.

Listen to your teen’s thoughts about the future. Support and respect their decisions and offer ideas about what you think he or she might be good at. Encourage your teen to get involved in the community and help her connect with other caring adults who can positively influence his or her development.

Emotional Development

Teens are maturing and learning to process and understand their feelings. They may experience occasional mood swings, be increasingly sensitive, and want to keep their distance from parents. Having limited ability to understand and cope with their newly discovered and confusing emotions may lead to risky behaviors, such as: self-injury, aggressive outbursts, drug and alcohol use, or sexual activity.

Although some behaviors your teen may exhibit are normal, it can also cause confusion of what is truly typical. If your teen is exhibiting increased irritability, poor decision making, poor emotional stability, and poor coping skills persistently for more than a couple of weeks, it is probably time to contact a mental health professional.

Try to gauge whether your teen’s moods and behaviors interfere with their daily functioning or feel beyond something you can understand or manage. A classic sign of trouble is when your teen simply refuses to talk to you anymore and/or does not want to listen to anything you have to say.

Yes, teens are supposed to reject their parents to some degree to form their own identities, but there is a limit to how much of this is healthy. When pressed, most teens would probably, although grudgingly, admit that they still need and want their parents’ support, guidance and reassurance. This is true whether your teen admits to this or not! But sometimes, the support of parents simply isn’t enough.

The good news is that even very troubled teenagers can develop into healthier and happier beings with a solid support system.

Here are a few common symptoms that indicate the need for professional help:

Your teen appears sad, tired, restless or irritable most of the time. One of the confusing things about teen depression is that it often manifests as crankiness and hostility. I don’t mean the occasional outburst, but more a persistent pattern of irritability.
Your teen has trouble falling asleep or staying asleep. Optimally, adolescents should obtain between 8-10 hours of sleep per night. If your child sleeps much more or less than that, it could be a sign of trouble.
Frequent nightmares or difficulty shutting their brains down at bedtime.
Any dramatic changes in eating habits, weight gain, or weight loss.
Social isolation, or difficulty making and keeping friends. Your child remains closed off in his/her room all day to play video games or watch TV and does not seem to have any close friends s/he socializes with outside of school.
A decline in grades or school motivation. Your teen used to be a solid A or B student and now can barely keep a C average. Resist the urge to chalk this change up to laziness or bad teachers. Depression, anxiety, hyperactivity, sleeping problems, eating disorders, or drug use can all have a powerful negative impact on a person’s ability to concentrate and learn.
And most importantly, if your teen asks to speak with a professional... Listen and make an appointment. Try not to get caught up in bombarding them with questions or trying to get them to explain why they don’t want to talk to you right now. This is probably their way of letting you know they are dealing with something significant, and they have the amazing insight to seek help in a healthy, appropriate manner. If they are questioned too much, or if they are not given the opportunity to meet with a psychologist or therapist, then they may resort to unhealthy and potentially dangerous alternatives.

What if my teen doesn't want therapy?

“I’m fine!” Sound familiar? With teens, this frequent claim often masks struggle with social isolation, school anxiety and schoolwork avoidance, excessive screen and video game time, experimentation with substances, hopelessness, helplessness, and thoughts of self-harm. And most of them don’t even know yet just how common such struggles are. Seeking to camouflage their pain, often teens simply try to “push through” to no avail, and simply give up.

Many teens are resistant to starting therapy, because they think of the therapist as an ally to their parents and not for them. This is a common misconception that is often alleviated after their first meeting with me. The therapeutic alliance is the primary factor in determining whether your teenager will be helped through therapy.

If your teen is reluctant to start therapy, I usually have two suggestions:

First, acknowledge that talking to a stranger about personal issues may seem scary and counter-intuitive. Suggest that they meet with a therapist once without any obligation and emphasize that you would not force them to continue.
I will sometimes meet with teens in the home or another preferred familiar environment. (There is a small additional fee for off-site services.)

My work with teens starts simply and slowly—I listen. A therapist is not “just another adult” telling your teen what to do. Instead, a therapist's role is to foster rapport and trust to create a space for your teen to process their emotions. Judgement is left at the door, as teens feel more than enough of that from themselves, their peers, and others. With time and trust, therapy helps teens move toward understanding their own behaviors and those of the other people in their lives. With understanding in place, we empower teens to embrace hopeful, courageous change, sorting the real from the imagined, and the helpful from the unhelpful.

Once your teenager realizes that the therapist is their ally and not yours, they will be more likely to engage in treatment. A therapist often can serve as a positive adult role model who isn’t the teen’s parent, which increases the likelihood that your teen won’t dismiss the guidance presented through therapy.

What can I do to support my teen’s therapy at home?

This is a great question that shows you are probably already supporting your teen. You certainly have the best possible attitude! As a parent, you are one of the most important people in your teenager’s life. Parent participation is an important part of adolescent therapy.

Teens are likely to be more willing to make positive changes if they see you modeling the ability to seek help appropriately and follow through efforts to improve. After first discussing this with your teen, I periodically invite parents to meet separately with me to discuss parenting concerns, your child’s progress, and to provide additional tools and tips for how to support your teen outside of therapy.

As treatment progresses, your teen will probably begin telling you more about what s/he needs. The best thing is to listen and see if you can give the type of support they ask for (within reason of course!).

“The most precious gift we can offer anyone is our attention. When mindfulness embraces those we love, they will bloom like flowers.”

-Thich Nhat Hanh

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