The teenage years can be tumultuous, even in the best of circumstances. These years are rife with possibility and a time to learn about oneself and the world. Teens also struggle with multiple outside pressures and developmental changes, tasks and expectations. Oftentimes, teens haven’t had a chance to see what lies beneath the glossy exterior of their peers; judging their ‘insides’ by other people’s ‘outsides’ can compound a teen’s sense of isolation and being different. Without the logistical benefit of hindsight, it is impossible to see how these differences might one day manifest as great gifts. Even with the most supportive and understanding families, there are some things that are just awkward and uncomfortable for kids to discuss with their parents. As a neutral, outside party I can compassionately listen to their concerns without the attendant anxiety and investment that is part and parcel of their relationships with family and friends.
I meet with parents or guardians before I meet with the adolescent. This initial session involves a holistic history of the child’s development: medical issues, developmental issues, learning concerns, peer and sibling relationships, relationship with parents, significant losses or changes in the teen’s life, an assessment of their strengths and struggles; behavioral issues, anxiety and depression issues; concerns over any dangerous or self-harming behavior; and why they are seeking help for their child at this time and what would they like their child to get from therapy. At this session, I explain how I work and what the parameters are in working with teens and their families. If the teen has significant depression or anxiety, that requires a more structured and intensive help than I can provide in a once-a-week outpatient setting, I will inform the parents and provide resources and referrals. Occasionally, the parents aren’t aware of the extent of their child’s problems and I explain that assessment is an ongoing part of the work with teens. If the problems are more severe than originally assumed, I will help the family with resources and referrals at that point. With the parents and with the teen, I review confidentiality and what parents have the right and need to know about their child.
A big part of therapy is helping a teenager to understand and explore their developmental tasks of: autonomy, individuation and separation, identity development and formulation, the importance of peer groups, and the concurrent need for parental support, help, and feeling of belonging and being accepted. I can help teens with the roller coaster ride of discovering their burgeoning sense of selves while helping them set parameters and make decisions that are respectful of themselves and of others. Whether ‘checking in’ or working directly with parents, I can help them view their child’s maturation and development from their teens’ vantage point, while respecting the family structure and values.
