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Teenagers and Therapy: How to Make it Work

child therapist teen therapyI recently have had an influx of adolescents in my office and I have learned some valuable lessons about how to approach them in the most effective ways. Teenagers have very distinct needs and do not really fit into either the almost-adult or still-a-child category. This can sometimes create difficulties when parents feel that therapy is necessary.

Many parents would like to see their adolescent children well-adjusted, happy, successful and social. That is a tall order for teens who are dealing with peer pressure, hormonal changes, academic expectations, parental ideals and their own self-discovery process, all simultaneously. When parents are interested in therapy for their teens to provide a neutral, objective party to help, it can be difficult to decide who can best deal with teen issues. Many children’s therapists will not treat adolescents (they are too old and unmoldable) and many adult therapists will not either (they are too young and volatile). What does that mean for a parent trying to find a good-fit therapist for their teenager?

I work with teenagers up to age 16 at my office and have noticed some interesting trends in their needs and wants. I have had to modify my treatment to best serve them, but with positive outcomes.

Teens want to talk about themselves. Human beings love to be the center of attention. If given the right environment and a trustworthy recipient, teens enjoy discussing their lives. As an addendum, teens like talking about what THEY like. Talking about their family arguments or school problems does not interest them. Their friends, their dreams and goals, their feelings, and their frustrations are the favorite topics for discussion.

Teens also like more structured activities. They do not feel comfortable with open-ended questions or nebulous hypotheticals (“What do you think about that”?) Teens do well with specific directives where they are able to complete a given task and then discuss it. I often use worksheets and creative projects to deal with emotions, family, friends and more.

children therapy play therapistTeens are very easily embarassed. Even more so that adults. They are at a sensitive age where their self-esteem and confidence is developing or sometimes non-existent. Any questions or activities that put them in a threatened position will yield defensive postures and difficult progress. They need to feel respected and valued for it to work.

The confidentiality of therapy is integral to success with teenagers. Many teens who have refused to continue therapy with other counselors felt that the therapist and parents were on a “team”, inevitably competing against them. Parents and counselors should NEVER discuss the teen in front of him or her, and it should be clear that the allegiance is between the teen and therapist, no where else.

There are many more issues when working with teenagers, but those are the most important ones through my experience. Generally, if the teen feels important and it is clear that the therapist does not have an ulterior motive for meeting with him or her (I am going to “fix” you), it will be helpful and well-received.

Remember, teens cannot be forced to get into a car and go to therapy. So, if they agree to go on the first visit, begrudgingly or not, consider it a success. If they go back again, it was widely successful. “This is a waste of time” or “I think this is stupid” is perfectly fine, as long as they continue to go. Adolescent rebellion and indifference is a part of life, but their actions will always speak louder than their words.

About

Previous to becoming a full-time Mom, Brenna ran a highly successful Child Therapy Private Practice. Brenna has been blogging and writing articles on Parenting since 2006, and is currently getting her PhD from the University of South Florida.

Related posts:

  1. Play Therapy Toys
  2. How to Make and Use a Feelings Chart
  3. Make Playtime a Priority!
 

24 Comments

  • Kevin Deibler

    This short read was very helpful and inspiring. I am a new play therapist and already started working with a 16 year old male. I would love to read more on effective techniques with this age group.

    Thanks.

  • david peace

    I find that in order to keep from giving the “us against you” impression to teens, I make sure to have the parent or guardian tell about and explore their own feelings.

  • Elizabeth Hood

    Thanks for your tips. Do you have any suggestions on specific worksheets that you find helpful and where those can be accessed?

  • Nida aamir

    I’m a parent facing scholastic ennui from an otherwise intelligent and cooperative sixteen year old. Your blog was definitely helpful but I need more help on how to help him on my own.There is only one child therapist where I live , and she is overbooked and too expensive for regular sessions. I checked the AD/HD checklist and he doesn’t fit that group. If I’m being read by a number of therapists Id appreciate any advice that may help.

  • Olga

    I think for the parents it is difficult sometimes to influence their teenager to go to therapist. Why not hire “secret” therapist? A therapist can be presented as family friend, become friends with teenager and start gradually influencing his or her thinking, ways of life, etc. in a positive way, but without the uncomfortable feeling of being on therapy.

    • Nataly Owen

      That would ruin the therapeutic alliance and what would happen once the child found out? They would feel deceived, at best. Not to mention that this would be unethical…

  • P Gray

    What are some of the worksheets you use? and creative projects?

  • Dena Kuntz

    I work as a program therapist at as an intensive outpatient therapist. I am interested in gaining new material for working with teenagers in small groups. Any books, worksheets, or suggestions that you may have would be greatly appreciated. Thank you for you time in advance.

  • Dabney Byrd

    I am working with some teens who are detached emotionally from others and some who are ODD – any help would be appreciated

  • Reshmi K.

    Hello. I am a therapist at a hospital in Atlanta, GA and I work primarily with adolescents. I was wondering if there were any websites or worksheets that you find work best with adolescents? Thank you for any help.

  • Stephanie Robbins

    Hi Brenna. I am interested in any worksheets you would consider valuable. I am currently working with ages from 7-15. Thanks!

  • Pingback: August 2011: Teens and Therapy | G2B | Getting to Better

  • Amy Kessinger

    Hello! I am interested in worksheets and resources you find helpful in working with adolescents. I am a psychologist working in an outpatient mental health office with a variety of adolescent clients.
    Thanks!
    Amy Kessinger, Psy.D.

  • K.M. LPC

    How to effectively work with a teenage girl who just opened up about sex and alcohol? I have since made a behavioral contract about reducing her alcohol usage (in specifics). Any more ideas/suggestions?
    Thanks!

  • Andrey Moiseev

    This article was helpful enough to get an idea, what to expect in teen counseling. I just started to work with 14 year old femail teen and this information whould help greatly in my work. The part where teen manage to come for first session very true. Here you feel a bit success when you knew that she wasn’t so eager to come to see shrink.

  • kris hilton

    Hi Brenna,
    I’m a therapist who ran across this site. I have not worked with a lot of kids but am about to due to a job change. Would you be kind enough to send me any of the worksheets/creative projects you mentioned? I need some quick and easy ideas to get started as I build my repetoire.
    Also, do you know or have any knowledge about something called “soul cards?” I googled them but am wondering if they’re really that effective and thought it would help me make a decision if there was some endorsement. Thanks!

  • Natalie Townsend

    Hi Brenna,
    I am still a rookie therapist and would love to see some worksheets/activities you like to use with teens. I see clients from ages 9-adult, the majority are teens. I am feeling a bit insecure about how to work with the parents, especially when they are unhealthy. I feel like I need to advocate for the teens, but I have had some parents say they feel like I “side” with their teen….any thoughts? Thanks so much for your time. Natalie

    • brenna

      I will email you the materials for working with teens. About the parents – you need to make it very clear that you will not engage in a dual relationship. It is always best to be honest and direct upfront about who your allegiance is with. If you are seeing the teen, your confidentiality and obligation is to him or her. If you are working with the parent, then it is with them. It is better to tell them expectations up front than to leave it open and let them assume or interpret down the road. If parents accuse you of siding with their child, make it very clear that you side with no one. Your responsibility is to work with them to help them make their family the best it can be. Whatever needs to be addressed with whomever the issues originate, that is your focus. It sounds a little counterintuitive, but I assure you it helps alleviate the frustration and confusion.

  • Linda

    Hey brenna,

    I am a counselor at a middle school and I have notice the self mutilation is one of the biggest things affecting teens and I have no experience with this issue at all!!! So I was browsing the internet looking for information and I stumbled upon this website. Would you happen to have any information, worksheets, anything at all on this topic? Please feel free to email me with information. Thank you in advance

  • E.F.

    Hello Brenna,
    I am a new Therapist, who worked primarily with adults, but got a new job where I now work, primarily with children and teens, totally out of my comfort zone. My issue is I have a 16 year old male, who I see in the Foster Parents home, and he doesn’t want to have therapy, he been through a lot – parents have drug dependencies. I’ve talked to him about what he wants out of life (solution-focus therapy), he did talk to me a little. I’ve talked to him about ‘Positive Goals and Affirmations’ – he listened but really didn’t respond. Basically he is not responding to therapy. When I discussed with him why I’m there and how Therapy can help him, he let me know that he thinks it’s stupid and he feels he controls his feelings by keeping everything in, and not letting it all out – by discussing it with me, someone he really doesn’t know or trust. I told him that was fair and I understand why he would feel that way, but I do care and that I went to school to be able to help people, not hurt them. My question to you at this point, what types of things can I do with him to create a trust with him, so I can begin a successful therapy with him. Will the worksheets everyone is speaking of help? Any suggestions you have will be greatly appreciated.

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