Problems typical of adolescence include school difficulties (poor grades, low motivation, AD(H)D), parent-teenager conflict (negotiating the teenager’s desire for more freedom and privileges, issues involving defiance, respect and compromise), drug use and abuse, depression and withdrawal, oppositionality and hostility, and sexual experimentation. There may be other difficulties that a teenager has struggled with for many years, such as sleeping or eating problems, issues related to self-esteem, Autistic Spectrum Disorders, attention disorders, and so on, that continue to plague a child as he enters adolescence, or actually worsen at this time. It is not uncommon for the relationship between a teenager and his or her parents to undergo considerable change during this phase which is difficult for the whole family to deal with. Teens often become more private and seek more physical and emotional distance from their parents. Some teenagers seem to desire more of everything, but especially freedom, control and power. These changes can be alarming and personally challenging for parents as they observe their child transforming in front of them, and teenagers do not usually evolve easily, but likewise feel challenged and disturbed by their transformation. I have found that therapeutic intervention can be useful for teens and parents alike to negotiate these changes while still remaining in touch with each other, as they attempt to carry over some of the positive aspects of the earlier relationship they shared when the child was younger into the new relationship that must be negotiated between a teenager and his or her parents.
Bringing children and their parents closer together is often an important goal of therapy, as the majority of a child’s difficulties seems to affect and include the parents, even when this is not obviously so (i.e. when the issues are school-related). And most parents want to be involved in their child’s therapy in some way, whether is it through consultations with the therapist as their child’s therapy progresses, or through parent-child therapy or family therapy. But, I have found that some teenagers are so angry with their parents that they do not want to include the parents in the therapy. Other teens can accept or even desire to have their parents involved in their treatment, and family therapy may occur where the teen and the parents discuss the issues under the guidance of the therapist. Some teenagers agree to try out therapy, relieved that their need for assistance has been recognized, while other teenagers hate the idea, feel the parent is crazy for suggesting it, and refuse. Therapy can last for one session or several years, and some teens find once a week to be adequate, while other teens may need more frequent sessions in order to overcome their difficulties. Therapy with teenagers is as individual and challenging as the teens themselves, but over time I have developed a way of being with teenagers and young adults of both sexes that often produces positive changes.
Early Adolescents
Early adolescents (11-14) may find it too difficult and beyond their capacities to “just talk” to the therapist, and may require some play, usually games, in order to feel comfortable enough to talk about what is worrying them. If the therapy is successful, playing and talking can happen alongside each other, and some days play is not necessary (the play happens in the language). This process of developing comfort, ease and trust in the therapy of younger teenagers can take longer to develop than with older children, but many children in this range are the teens who struggle the most with the adolescent changes that are occurring within them. Unfortunately, children in this age range are the ones most likely to reject the idea of therapy, and consulting me about how to approach your teenager about therapy may be useful if you are struggling with this challenge.
Mid-to-Late Adolescents
Therapy with middle adolescents (15-17) and late adolescents (18-21) usually involves less play and more talk, as the child has become more comfortable with language and the expression of their thoughts and feelings, and may be more capable of establishing an alliance with the therapist. Therapy in these phases is not unlike therapy with adults, especially late adolescents. The teen talks about his or her worries and the therapist listens as an attentive, empathic presence who responds to the child in a way that facilitates the child’s sense of being understood and known, and helps them further explore their own experience and how this experience intersects with the experience of important others, including the therapist.
Adolescence is usually considered the most challenging phase for parents and therapists alike to adapt to, cope with and treat effectively. While adolescent turmoil is not uncommon, handling this challenge well is just as important as the good decisions we made during the first days of our child's infancy. Therapy with parents and teenagers can address the problems and facilitate optimal psychological growth for the child as he or she continues to develop through this last phase of childhood.
