Teenagers and Therapy: How to Make it Work

by brenna on March 14, 2008

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.

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{ 16 comments… read them below or add one }

Kevin Deibler July 31, 2009 at 6:43 am

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.

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david peace January 4, 2010 at 2:58 pm

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.

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Elizabeth Hood February 18, 2010 at 12:13 am

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

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Nida aamir January 28, 2011 at 8:24 pm

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.

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Olga June 11, 2011 at 10:01 am

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.

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Nataly Owen August 12, 2011 at 12:12 am

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…

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P Gray July 18, 2011 at 5:25 pm

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

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brenna July 18, 2011 at 6:08 pm

Some I created on my own, others I got from colleagues or workshops. If you would like me to send you a few of them, email me.

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Dena Kuntz July 18, 2011 at 7:19 pm

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.

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Dabney Byrd July 27, 2011 at 8:10 pm

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

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Reshmi K. October 28, 2011 at 6:59 pm

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.

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brenna October 29, 2011 at 6:29 pm

Please email me directly at brenna@thekidcounselor.com and I can send you what I used. Thanks!

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Stephanie Robbins November 8, 2011 at 3:24 pm

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

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Amy Kessinger December 20, 2011 at 2:49 pm

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.

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K.M. LPC February 3, 2012 at 11:27 pm

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!

Reply

brenna February 4, 2012 at 1:55 pm

I will be in touch via email.

Reply

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