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  • Janie Feldman

Teens in Therapy – A Primer for Everyone

Updated: Jan 21, 2021


The very word evokes an immediate, strong reaction. What comes to mind when you read the emotion-laden word? Is it your own recollection of your coming of age? Or is it your perception of a young person of your acquaintance? Whether your thoughts shift to yourself,  your child, or someone you know, you will certainly react with personal connections to a period of development that, while the teenage years are a part of the normative transition from  childhood to adulthood, it’s difficult for any of us to apply the term ‘normal’ to teenagers.

Yet that turbulent period from puberty to adulthood is indeed notorious for wild shifts in emotion, radical changes in body, mind, and personality, and an overabundance in emotional reactivity. How can any of this be normal? It is precisely the loss of childhood and fledging independence that rocks a child first into adolescence then into adulthood. Developmentally, the progression from childhood dependence on parents and family must shift toward reliance on self and increasing awareness and association with peers. Cultural influence has a huge impact on youth and impacts this transition through contemporary music, movies, and social trends.

So, what is a young person to do? The vast and vacant area of adolescence is akin to a vast body of water, and teens set afloat on small rafts that bounce them between the shores of childhood and adulthood. If you have ever really watched teenagers closely, you will see them ricochet from being dependent, childlike and clingy, to being fiercely (and often blindly) independent.

And, they go back and forth between these states with frenzied reactivity and raging emotionality. If you think it is difficult to be near some of these emotionally volatile teens, think again how hard it must be to be a teenager. And, if given the chance, few of us would opt to return to this tumultuous phase of development.

Enter therapy. No, not you – get therapy for your teenager, for therapy can play a crucial role in adolescent development. Teens not only need the emotional support that therapy offers, many of them actually welcome the opportunity to chat candidly in a private setting with a compassionate, sympathetic, yet objective, adult. A professional psychologist who actually “gets” teens is in high demand. Truth be told, some of my favorite clients have been teenagers who hunger for the respect, attention, and peace that therapy offers them. It can be incredibly rewarding for both client and therapist alike.

So, what is therapy like for teenagers? What actually brings a teen into therapy? Teens often enter therapy because they want to be in therapy. They want support, they welcome change, they recognize their emotional needs, if only because they are confused, and typical teenagers want to talk. A lot. About all the many people in their lives, about their relationships, about their own hopes and desires, about the confusing social messages confronting them, society’s trappings, parents’ expectations; today’s teens are feeling alone, feeling different, feeling misunderstood, and are also dealing with siblings, school pressure, peer pressure that doesn’t look or feel  anything like what schools tell them, pressures to conform, desires to rebel, and even more than all this. In actuality, this is often just the beginning of what we discuss in teen therapy; if there   are issues within the family such as divorce, relocation, rivalry, learning challenges, social isolation or harassment, then there is even more to explore process. Lots of teens also struggle with their identities, anxiety, depression, relationships, body image and substance use/abuse.

With so many challenges befalling most teenagers today, it is difficult to consider how teens survive adolescence without the support they receive from good psychotherapy!

Therapy begins when either the teen or the parent initiates the therapy. Unless the teenager is eighteen or older, the teenager does not enter therapy alone. Parents have a presence in their teen’s therapy, and for good reason. Many parents seek help in dealing with their teens, just as much as their teenaged children need therapy time themselves. And rightly so: as parents remain primary caregivers for their maturing children, they assuredly need the help in comprehending why teenagers act and emote as strangely as they do. Their evolving role as parent is almost as difficult to maneuver as navigating through adolescence is for teenagers.

Yet teens need and deserve privacy in therapy. Ethical practice dictates that therapy must be confidential, and that parents will be told of life threatening situations involving their children. Involved and caring parents will often seek more information from their teenagers’ psychologists. It is challenging for many psychologists to balance sharing helpful information while maintaining privacy and confidentiality of the teen. In my practice, I offer parents snippets akin to headlines in a newspaper, sharing just enough general information to satisfy curious and concerned parents while maintaining the trust of the young people I see by keeping personal details out of the dialogue. Rather than serve as a communication conduit between teenagers and parents, I strive to empower teens to first identify which material would be helpful to share with their parents, then I facilitate the teens conducting that communication independently of me through role plays and other therapeutic techniques.

Trust is crucial in the therapeutic process, and even more pivotal in the special alliance psychologists establish with teenage clients. Teenagers must feel their psychologists can keep their secrets in order to share their innermost thoughts and personal experiences. How can psychologists help adolescents steer through all the critical decisions and avoiding countless   risks facing today’s teens, when teens feel their therapist betrays their confidences? Revealing such secrets is tantamount to therapeutic failure, and effective teen psychologists are wise to alert parents to these confidentiality issues. So, it is imperative for parents to understand the boundaries of privacy that protect teens and insure they will remain comfortable enough in therapy to continue to share their most personal thoughts, feelings, and experiences.

So, how can parents help their teenaged children get the most out of therapy? Here are some

Do’s and Don’ts for parents bringing their teenagers to therapy:

  • DO seek referrals from friends, guidance counselors, and pediatricians for psychologists who relate well with teenagers

  • DO interview prospective psychologists to find one who demonstrates experience, success, and comfort in working with teens

  • DO establish a convenient time for therapy that suits your teen’s schedule

  • DO request a meeting with your teen AND his/her psychologist to explore together their goals in treatment, as well as progress

  • DO alert your teen, if and when you need to make contact with his/her psychologist, and have your teen present if possible and appropriate

  • DO encourage your teenager to share important events and issues by him/herself There are other helpful suggestions for things to avoid, and these are the don’ts.

  • DON’T enter the therapy office unless invited, and if invited, keep your stay as brief as possible

  • DON’T “tell on” your teenager; urge your sons or daughters to communicate directly as much as they are willing

  • DON’T ask for extensive details from the psychologist, as this is intrusive to the teen’s therapy and reduces his/her ability to trust

  • DON’T react too quickly if your teenager shows some resistance to attending therapy; instead, suggest your teen discuss his/her concerns directly with the psychologist

  • DON’T ask to see the psychologist, or have the psychologist treat a sibling, as both arrangements represent a conflict of interest for the psychologist

  • DON’T reschedule an existing appointment if your teen is “not in the mood;” instead, bring the teenager anyway and alert the psychologist so he/she can help the young adult address any concerns

Therapy for teenagers can provide a unique and valuable opportunity for young people to explore their identities, emotions, relationships, goals, and obstacles in a safe and nurturing environment. In therapy, teens can develop greater independence as they prepare to leave childhood behind. Empowered by an experienced psychologist, teens can survive adolescence and emerge with greater insight and personal competence, ready to meet the challenges of adulthood. Parents can play a supportive role in their teenagers’ therapy, but this role diminishes as the adolescent approaches adulthood and assumes greater independence.

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