Teens and Therapy

Chances are, if there is a teenager in your life right now, your level of concern about their well-being and mental health has drastically increased in the past couple of years. The season of COVID has placed unprecedented challenges on all of us. Many professionals, including myself, would argue that teens have been impacted the most. In addition to the normal challenges and dynamics of adolescence, teens have been forced to continually adapt, change routines, adjust to new learning modalities, endure social isolation, and experience radical cultural tension and political division. Most likely, this tension in one form or another has found its way into your own home.

While I write this from my perspective as a therapist, I am a parent first. I have three children and three step-children; a real-life “Brady Bunch.” I have experienced a variety of the “teen spectrum” firsthand, as no two children are alike. Knowing when to seek therapy for a mental health concern is just as important for parents as knowing how to handle any other childhood concern, i.e. when to call the pediatrician when to head to Urgent Care, when to call 9-1-1, or when Tylenol and chicken soup will do the trick.

Normal or Concerning?
When families with teenagers experience challenging times, it is often the teen in the family that gets encouraged to attend therapy. Parents become worried about things they notice in their teen and wonder if it is normal or if it could be a sign of something more serious. If you are the parent of a teen you might be noticing fluctuating moods; withdrawal and isolation; shifting of friendships; questionable social influence from peers or social media; choices and interests that raise eyebrows; and defiant or challenging behaviors. Should you be worried? Will this pass?

Therapy can be helpful to rule-out and identify higher level of concerns. There are times when a withdrawn teen is really experiencing clinical depression. When your teen’s absent-mindedness and forgetfulness is really ADHD. When high-risk behaviors are better explained by bipolar disorder. It is important to know the difference between feeling nervous and having a full-blown panic attack or when a feeling of disconnection leads to thoughts of suicide. Attending therapy can help the teen and the parents identify when a more concerning diagnosis is present and whether further focused treatment or even medical attention is warranted.

Start with a Family Conversation
Try talking honestly about your concerns to your teen. Strive to keep communication open by listening to your teen’s perspective and validating your teen’s experience. Effective communication requires listening and speaking. It is typically easier for the parent to begin being the listener; providing nonjudgmental validation to your teen. Once the teen feels heard and validated, the teen is more apt to listen to the parents’ perspective with a little more openness. If you try this approach and still feel stuck, it is probably a good indication that talking with a therapist can help. Therapy can help sort through the concerns and initiate important dialogue between parents and teens.

When to Seek Therapy
Trust your instincts as a parent. If you have a concerned feeling in your gut, act on it. As parents, it is absolutely okay to seek outside support, such as therapy for yourself, and to offer the same to your teen. If serious concerns are evident, therapy is essential. If everything is deemed “normal,” then the reassurance and validation from a third-party can help build your parenting confidence.

Teen’s Hesitancy to Attend Therapy
Sometimes teens will resist going to therapy for a variety of reasons. The teen might not believe therapy is truly confidential and they might worry that the therapist will relay their private information to their parents. Therapists have a legal and ethical duty to discuss the parameters of confidentially with parents and teens at the onset of therapy. It is important that the parents and teens understand exactly what, if any, information will be conveyed to the parents, with the teen’s awareness and agreement.

Another source of hesitancy in teens to attend therapy is that the teen may believe that some other family member is the actual problem and that the other family member needs therapy more than they do. And, truth be told, sometimes the teen is correct! However, even if this is the case, therapy can help the teen feel validated and learn new communication skills and coping strategies for stress within the family.

Family or Individual Therapy?
Family therapy is a great way to strengthen the family system by including all members of the family in learning how to regulate emotions, improve problem-solving, or role-playing new communication skills. A therapist can help facilitate conversations between parents and teens. Emotions can run hot between parents and teens so having a neutral third-party, such as a therapist, to help navigate conversations can really take the pressure off the parent and the teen. The therapist will ensure that everyone has an opportunity not just to speak, but to feel heard and understood.

Often teens may feel reluctant to talk about certain things with parents present and that is normal. At their emotional core, teens just want to be accepted and loved by their parents. It might feel risky to the teen to share everything with their parents. Individual therapy for the teen can provide an element of reassurance, thus encouraging confidence for the teen to communicate more openly with the parent.

Individual therapy can be extremely rewarding and effective for teens! There is a turning point I have seen over and over again with teens in therapy when, after a few guarded sessions, something shifts. The teen comes in, settles in on the sofa, and declares, “I like coming here.” They drop their emotional guard, trust the process, and start to really grow. That’s when the real therapy begins.

More than Just Talk
Therapy is full of opportunities for skill-building. None of us are born knowing how to communicate effectively, or manage our thoughts, or regulate our emotions, or how to build healthy relationships, or even repair relationships that are important to us. Therapy can help teens improve these skills by increasing their knowledge and understanding around questions such as “What’s really going on my brain?” and “Why do all these emotions feel so big?” and “I think in circles and never get anywhere. Can you help me organize my thoughts?” Talking is an essential part of therapy but skill-building tools are what the teen takes with them when therapy has ended.

When to Seek Immediate Medical Attention
You may already know with certainty that your teen is struggling with a high-risk issue. Perhaps your teen blurted out in frustration that they don’t see any point in living anymore. Maybe you recently noticed cut marks on your teen from self-harming behavior. Maybe you discovered drugs in their pockets when you were sorting laundry. Perhaps you’ve noticed your teen isn’t eating, or eating too much, sneaking food, or over-exercising. Suicidal ideation, self-injurious behavior, substance use, eating disorders, or any other high-risk behavior warrant immediate medical attention to get help for your teen right away! These areas of concern are critical. Parents can seek immediate help by calling one of the numbers below or reaching out to your primary care physician or pediatrician. Always call 9-1-1 in case of a life-threatening situation including suicidal behavior or drug overdose.

· National Suicide Prevention Lifeline 1-800-273-TALK (8255)
· SAMHSA Treatment Referral Helpline 1-877-726-4742
· Riverside County: 1-951-686-HELP (4357)
· Orange County: 1-714-NEW-HOPE (714-639-4673

Ready to Make an Appointment?
If any (or all) of this article has resonated with you, then perhaps it’s time to give therapy a try. I’d be honored to meet with you and/or your teen to learn more about your personal concerns. We can map out a plan together and customize therapy around your goals. And because I believe in the “right fit” so much, if I end up not being the right therapist for you or your teen I will work hard to help you find another therapist that feels like a better fit.

(Psst, hey teenager! This is just for you.) Did your parent give you this article to read hoping you’d agree to try therapy? Well, I hope you keep reading. A lot of the teens I have worked with tell me, “Kristin, you aren’t like other therapists.” (That’s been a good thing to them!) So maybe you have gone to therapy before. Maybe it helped, maybe it didn’t. Maybe you have never tried therapy. Maybe your parents want you to come (even forcing you to go) and you don’t want to. Or maybe you are the one who wants to go to therapy and your parents don’t think you need to go. Maybe you are feeling supported, maybe you aren’t. Maybe you’d like your parent to attend therapy with you, or maybe you want to come alone. Maybe you feel empowered and excited about coming to therapy, or maybe you are terrified. And maybe you are concerned about how confidentiality really works. No matter what you are feeling, it’s okay.

Most likely you have tons of questions about therapy and usually that is the best place to start. Make an appointment just to ask questions and get a feel for what therapy is like. Trust me, it’s not like the movies. I’d also add that the most important factor in therapy is what is called the “therapeutic relationship.” In other words, it’s about how much you like your therapist and how comfortable you are. Therapy works best when you are honest in therapy and it can feel difficult to be honest if you don’t like your therapist. It’s about trust and respect and feeling validated. Don’t get me wrong, it’s not about friendship. Therapy should feel a bit challenging. Oftentimes it takes time to find a therapist who feels like the right fit for you. I’m willing to try if you are. Let’s give it a go!

Kristin Cyprien, LMFT See profile here
Licensed Marriage and Family Therapist
CAV Family Therapy Inc.

(951) 712-2009