Therapy with Adolescents

Despite every best effort, there are situations where a teenager may need help above and beyond what a caring parent is able to achieve. Key developmental issues common to adolescents include separation from parents, challenging authority, dating and relationships, initial experience with death or loss, identity development, launching to college, and dealing with peer pressures. Sometimes teens don’t want to talk to their parents about these issues. Often they are more receptive to talking to an outside third party, such as a counselor or psychologist.

According to recent data from the Journal of the American Academy of Child and Adolescent Psychiatry, up to half of U.S. children and adolescents meet diagnostic criteria for at least one mental disorders by age 18. This research came from the first nationally representative, face-to- face survey on the topic. The data, released in October 2011 by researchers at the National Institutes of Health, also showed that many of these disorders emerge early — with an average age-of-onset of 6 for anxiety disorders,  age 11 for behavior disorders, age 13 for mood disorders, and age 15 for substance use disorders. The percent of youth who meet criteria for mental illness is as follows: 31% Anxiety disorders, 19% Behavior Disorders, and 14% Mood disorders. Unfortunately, many of these disorders are left untreated because the symptoms and early warning signs are not recognized.  Research also supports the idea of early intervention; the sooner you treat an emerging disorder, the better the outcome.

When To Seek Help For Your Teen

Many teens are familiar with therapy and will ask you to see a therapist. Other times, you may notice changes in your teen that signal to you it’s time for some outside help. Some of the behaviors or symptoms that may signal your teen needs help include, but are not limited to:
  • Changes in mood (ie. crying often, irritability, angry outbursts)
  • Declining grades and academic achievement and/or missing school
  • Anxiety or fear regarding activities or certain events or situations
  • Loss of interest in activities they once enjoyed
  • Isolation, withdrawal or lack of social contact
  • Extreme bullying at school or cyber-bulling
  • Refusing to go to school or fearful of going to school
  • Physical or verbal confrontations, aggressive behavior
  • Changes in appetite, either eating more or eating less, or noticeable fluctuation in weight
  • Significant changes or events in your househould (divorce, death, loss of a loved one, 
moving to a new area)
  • Compulsive thoughts or behaviors
  • Dangerous or reckless behaviors (use of drugs or drinking, reckless driving, sneaking out at night)

If your family is experiencing a great deal of high level conflict, it may be beneficial to seek help for family counseling in order to support your entire family.

I view my role as multifaceted. First and foremost, I work to build trust with the teen, and seek to understand their point of view as fully as possible. For families who want help in addressing communication barriers in the family, we will include family sessions aimed at fostering healthy communication. During family therapy, communication is facilitated in a safe, structured format that works towards accomplishing shared goals. For more on communication with your teen, read my article about How to Get Along With Your Teen: Talking, Rules and Conflict.

Lastly, I help teens to be aware of their thoughts, feelings, and behaviors. We discuss specific problem areas, but also focus on strengths and increasing autonomy. Being aware of what motivates them, and how their feelings relate to their actions, helps teens feel in control of the decisions they make. I help teens think about their future aspirations. They may have mixed feelings about leaving home and launching to college. Some common questions for teens to start thinking about as they begin therapy include:
  • What process do I use to make decisions or choices?
  • What type of peer relationships do I have? Am I satisfied with these relationships?
  • What do I hope for myself? For my future?
  • When do I feel happiest? When am I feeling my worst?
  • What are my triggers, and how can I create coping skills to help?
  • What are some important events that have happened recently in my life?
  • What are my fears, my concerns?
  • What is my communication style — how do I let people know what’s on my mind?
  • If I could change things, what would I change?
Therapy is a collaborative effort. It can be hard a times and can bring up painful feelings. It involves the person being willing to discuss difficult issues. The benefits of therapy often include a new understanding of your relationship with others, clarifying your feelings and thoughts, being able to better manage difficult situations, and feeling hopeful and confident about the future.