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14 March 2008

Teenagers and Therapy: How to Make it Work

Teenagers and Therapy: How to Make it Work

I recently have had an influx of adolescents in my office and I have learned some valuable lessons about how to approach them in the most effective ways. Teenagers have very distinct needs and do not really fit into either the almost-adult or still-a-child category. This can sometimes create difficulties when parents feel that therapy is necessary.

Many parents would like to see their adolescent children well-adjusted, happy, successful and social. That is a tall order for teens who are dealing with peer pressure, hormonal changes, academic expectations, parental ideals and their own self-discovery process, all simultaneously. When parents are interested in therapy for their teens to provide a neutral, objective party to help, it can be difficult to decide who can best deal with teen issues. Many children’s therapists will not treat adolescents (they are too old and unmoldable) and many adult therapists will not either (they are too young and volatile). What does that mean for a parent trying to find a good-fit therapist for their teenager?

I work with teenagers up to age 16 at my office and have noticed some interesting trends in their needs and wants. I have had to modify my treatment to best serve them, but with positive outcomes.

Teens want to talk about themselves. Human beings love to be the center of attention. If given the right environment and a trustworthy recipient, teens enjoy discussing their lives. As an addendum, teens like talking about what THEY like. Talking about their family arguments or school problems does not interest them. Their friends, their dreams and goals, their feelings, and their frustrations are the favorite topics for discussion.

Teens also like more structured activities. They do not feel comfortable with open-ended questions or nebulous hypotheticals (“What do you think about that”?) Teens do well with specific directives where they are able to complete a given task and then discuss it. I often use worksheets and creative projects to deal with emotions, family, friends and more.

children therapy play therapistTeens are very easily embarassed. Even more so that adults. They are at a sensitive age where their self-esteem and confidence is developing or sometimes non-existent. Any questions or activities that put them in a threatened position will yield defensive postures and difficult progress. They need to feel respected and valued for it to work.

The confidentiality of therapy is integral to success with teenagers. Many teens who have refused to continue therapy with other counselors felt that the therapist and parents were on a “team”, inevitably competing against them. Parents and counselors should NEVER discuss the teen in front of him or her, and it should be clear that the allegiance is between the teen and therapist, no where else.

There are many more issues when working with teenagers, but those are the most important ones through my experience. Generally, if the teen feels important and it is clear that the therapist does not have an ulterior motive for meeting with him or her (I am going to “fix” you), it will be helpful and well-received.

Remember, teens cannot be forced to get into a car and go to therapy. So, if they agree to go on the first visit, begrudgingly or not, consider it a success. If they go back again, it was widely successful. “This is a waste of time” or “I think this is stupid” is perfectly fine, as long as they continue to go. Adolescent rebellion and indifference is a part of life, but their actions will always speak louder than their words.

  • Kevin Deibler

    This short read was very helpful and inspiring. I am a new play therapist and already started working with a 16 year old male. I would love to read more on effective techniques with this age group.

    Thanks.

  • david peace

    I find that in order to keep from giving the “us against you” impression to teens, I make sure to have the parent or guardian tell about and explore their own feelings.

  • Elizabeth Hood

    Thanks for your tips. Do you have any suggestions on specific worksheets that you find helpful and where those can be accessed?

  • Nida aamir

    I’m a parent facing scholastic ennui from an otherwise intelligent and cooperative sixteen year old. Your blog was definitely helpful but I need more help on how to help him on my own.There is only one child therapist where I live , and she is overbooked and too expensive for regular sessions. I checked the AD/HD checklist and he doesn’t fit that group. If I’m being read by a number of therapists Id appreciate any advice that may help.

  • Olga

    I think for the parents it is difficult sometimes to influence their teenager to go to therapist. Why not hire “secret” therapist? A therapist can be presented as family friend, become friends with teenager and start gradually influencing his or her thinking, ways of life, etc. in a positive way, but without the uncomfortable feeling of being on therapy.

    • Nataly Owen

      That would ruin the therapeutic alliance and what would happen once the child found out? They would feel deceived, at best. Not to mention that this would be unethical…

  • P Gray

    What are some of the worksheets you use? and creative projects?

    • http://www.thekidcounselor.com brenna

      Some I created on my own, others I got from colleagues or workshops. If you would like me to send you a few of them, email me.

      • Cesar

        Hi!
        I read your article on dealing with teens, and found it extremely interesting. Could you send me some worksheets too? I have a 12 year old girl who appears indifferent to all types of activities…
        Thanks

        • http://thekidcounselor.com brenna

          I will send them via email.

          • Lauren

            Just beginning practice with teenagers, I would also be interested in receiving any worksheets/suggestions if possible. Thank you!

          • http://thekidcounselor.com brenna

            I will send them to your email address.

      • Kayce Riggle LCSW

        Hello- I found your blog on therapy with teenagers. I am beginning to see an increase in teenagers in my area and was curious to know if you had any specific techniques/worksheets you use with teens. Any help would be greatly appreciated!
        Thanks,
        Kayce Riggle LCSW
        Missouri

        • http://thekidcounselor.com brenna

          Look for them in your email.

  • Dena Kuntz

    I work as a program therapist at as an intensive outpatient therapist. I am interested in gaining new material for working with teenagers in small groups. Any books, worksheets, or suggestions that you may have would be greatly appreciated. Thank you for you time in advance.

  • Dabney Byrd

    I am working with some teens who are detached emotionally from others and some who are ODD – any help would be appreciated

  • Reshmi K.

    Hello. I am a therapist at a hospital in Atlanta, GA and I work primarily with adolescents. I was wondering if there were any websites or worksheets that you find work best with adolescents? Thank you for any help.

    • http://www.thekidcounselor.com brenna

      Please email me directly at brenna@thekidcounselor.com and I can send you what I used. Thanks!

  • Stephanie Robbins

    Hi Brenna. I am interested in any worksheets you would consider valuable. I am currently working with ages from 7-15. Thanks!

  • Pingback: August 2011: Teens and Therapy | G2B | Getting to Better()

  • Amy Kessinger

    Hello! I am interested in worksheets and resources you find helpful in working with adolescents. I am a psychologist working in an outpatient mental health office with a variety of adolescent clients.
    Thanks!
    Amy Kessinger, Psy.D.

  • K.M. LPC

    How to effectively work with a teenage girl who just opened up about sex and alcohol? I have since made a behavioral contract about reducing her alcohol usage (in specifics). Any more ideas/suggestions?
    Thanks!

    • http://www.thekidcounselor.com brenna

      I will be in touch via email.

  • Andrey Moiseev

    This article was helpful enough to get an idea, what to expect in teen counseling. I just started to work with 14 year old femail teen and this information whould help greatly in my work. The part where teen manage to come for first session very true. Here you feel a bit success when you knew that she wasn’t so eager to come to see shrink.

  • kris hilton

    Hi Brenna,
    I’m a therapist who ran across this site. I have not worked with a lot of kids but am about to due to a job change. Would you be kind enough to send me any of the worksheets/creative projects you mentioned? I need some quick and easy ideas to get started as I build my repetoire.
    Also, do you know or have any knowledge about something called “soul cards?” I googled them but am wondering if they’re really that effective and thought it would help me make a decision if there was some endorsement. Thanks!

  • Natalie Townsend

    Hi Brenna,
    I am still a rookie therapist and would love to see some worksheets/activities you like to use with teens. I see clients from ages 9-adult, the majority are teens. I am feeling a bit insecure about how to work with the parents, especially when they are unhealthy. I feel like I need to advocate for the teens, but I have had some parents say they feel like I “side” with their teen….any thoughts? Thanks so much for your time. Natalie

    • http://www.thekidcounselor.com brenna

      I will email you the materials for working with teens. About the parents – you need to make it very clear that you will not engage in a dual relationship. It is always best to be honest and direct upfront about who your allegiance is with. If you are seeing the teen, your confidentiality and obligation is to him or her. If you are working with the parent, then it is with them. It is better to tell them expectations up front than to leave it open and let them assume or interpret down the road. If parents accuse you of siding with their child, make it very clear that you side with no one. Your responsibility is to work with them to help them make their family the best it can be. Whatever needs to be addressed with whomever the issues originate, that is your focus. It sounds a little counterintuitive, but I assure you it helps alleviate the frustration and confusion.

  • Linda

    Hey brenna,

    I am a counselor at a middle school and I have notice the self mutilation is one of the biggest things affecting teens and I have no experience with this issue at all!!! So I was browsing the internet looking for information and I stumbled upon this website. Would you happen to have any information, worksheets, anything at all on this topic? Please feel free to email me with information. Thank you in advance

  • http://thekidcounselor.com E.F.

    Hello Brenna,
    I am a new Therapist, who worked primarily with adults, but got a new job where I now work, primarily with children and teens, totally out of my comfort zone. My issue is I have a 16 year old male, who I see in the Foster Parents home, and he doesn’t want to have therapy, he been through a lot – parents have drug dependencies. I’ve talked to him about what he wants out of life (solution-focus therapy), he did talk to me a little. I’ve talked to him about ‘Positive Goals and Affirmations’ – he listened but really didn’t respond. Basically he is not responding to therapy. When I discussed with him why I’m there and how Therapy can help him, he let me know that he thinks it’s stupid and he feels he controls his feelings by keeping everything in, and not letting it all out – by discussing it with me, someone he really doesn’t know or trust. I told him that was fair and I understand why he would feel that way, but I do care and that I went to school to be able to help people, not hurt them. My question to you at this point, what types of things can I do with him to create a trust with him, so I can begin a successful therapy with him. Will the worksheets everyone is speaking of help? Any suggestions you have will be greatly appreciated.

    • http://www.thekidcounselor.com brenna

      I will send them to you via email.

  • cheri

    If you have any worksheets or games you can share that are good for teenage demographic in individual or group psychotherapy, I would appreciate it. Thanks
    Cheri Yadon LPCI

    • http://thekidcounselor.com brenna

      I will email them to you.

  • Anne

    Hi Brenna, I have read many of your posts and I would really appreciate some of your worksheets. I work with kids from 3-17 (mostly 3-8) and I feel I have become stuck with several of them.

    Thanks!

    • http://thekidcounselor.com brenna

      I will email them to you. I hope you find them helpful.

  • Amanda

    Brenna, like the many others who have posted before me, I am a new therapist working with a lot of teenagers (both girls and boys). I am interested in the worksheets that you have used and found helpful. (I have very little knowledge about how to work with teens successfully).

    Thank you, so much, for the information in this article. Very helpful.

    • http://thekidcounselor.com brenna

      I will email you the activities.

  • Sarah Gbadebo

    Hi Brenna, I found your article on teens to be extremely helpful! Could you please send me the worksheets and creative projects you used with the teens on deling with emotions, friends, family, etc. I would really appreciate it!

    Thanks

    • http://thekidcounselor.com brenna

      I will send them to you through email.

  • Sandy

    I also would be interested in obtaining copies of the worksheets you use with your teenage population. I am presently working with a 17 yr. old who has issues with trust and difficulty expressing his true feelings. I am feeling a little stuck and would greatly appreciate some guidance.

    • http://thekidcounselor.com brenna

      I will send the activities to you through email.

      • Orit K

        Could you please send it to me as well

        thanks (orit.hopehouse@gmail.com)

  • Kate

    Hello Brenna,
    I have worked with teens for many years and still need help. : -) After reading your articles i would like to like to see your worksheets and projects. Thanks much!

    • http://thekidcounselor.com brenna

      I will email you with the activities.

  • Michele

    I am a therapist working with children 3-16 and would love to see some worksheets/activities you like to use, especially with teens. I work with many children in foster care or at risk children including past abuse, substance abuse, anger, ODD, ADHD, attachment disorders etc. We provide extensive outpatient mental health services. I find that creative direct/specific/art interventions, besides just talking, assists more in getting the children to address their feelings/behaviors/trauma. I would love to hear your ideas please.

    • http://thekidcounselor.com brenna

      Please look in your email for the activities.

  • Faith

    I work with teens who often don’t want to say a single word, or who use manipulation to talk only about what they want to talk about and take the focus away from a specific issue that they dont want to face. I, like all the other comments above, would love resources of structured activities for working with teens, thanks for your support.

  • letitia carter

    Hi Brenna,
    I just stumbled upon your blog and have been enjoying the posts. If it is OK, I’d like to re-post a couple of your blog articles on my website http://www.creativetherapynz.com
    I am an LCSW from WA recently relocated to New Zealand, and am finding my cultural way as a child therapist here.
    So far, I have found that children and teens struggle with the same problems and worries here that they do in the US, but have fewer resources, and find the “helping profession” culture is still emerging. It makes the need for “creative” therapy even greater!
    I am intrigued by the many requests from peers regarding your teen activities worksheets. I have found written self-disclosure worksheets generally work well with teens and their families.
    But now I am interested to see what you are using!
    Best of luck to you, and great website
    :)

  • chuck

    i just read your article and i found it to be very interesting, i am a CDP just getting started in working with teens, sure could use all the help i can get, can you send me some worksheets to get me started please…..

    thank you,
    chuck

  • Susan

    Hi, I hope this finds you doing well. I, too, work with some adolescent clients and would love to get some of the worksheet/activities that you’ve found helpful!

  • Elise

    Hi Brenna,
    I’d love a copy of some of these worksheets as well. I have just begun seeing adolescent clients as a fresh MFT and can use anything you have found helpful. Thank you for your blog!

  • Katie

    I am very much interested in any work sheets you have. I have just started counselling teens and would appreciate any tools. My email address is katiedbartlett@hotmail.com

  • Key

    This article is right on time for the teenage clients I work with. Can you send the activities and worksheets you discussed in your article?

  • http://www.facebook.com/satara.carr Satara Carr

    Would you pleasw be kind enough to share with me the resources you mentioned in your article as I am a mental health therapist working newly with adolescents and I am looking for great resources as how I can better my work with these teenagers I have found that this article has been right on point with the hardships I have currently as I spoke up before I am new working with adolescents and they don’t quite work the same way as my um younger clients do would you please email me any advice or resource is that you could.

    • thekidcounselor

      Please check your email for my activities.

  • Sabrina Fair

    Excellent information!

  • Valencia Bratton

    New LPC here.. I need some ideas and interventions for the preteen and teenage age group. Please help!

  • http://www.facebook.com/brittany.brumit Brittany Brumit

    I am also a new LPC and would love to be able to use some of the interventions and worksheets that you use for preteens and teenagers. Do you mind emailing these to me at bks05b@acu.edu?

  • http://www.facebook.com/brittany.brumit Brittany Brumit

    I am also a new LPC and would love to be able to use some of the interventions and worksheets that you use for preteens and teenagers. Do you mind emailing these to me at bks05b@acu.edu?

  • christina

    I would love to have some worksheets and resources to use with this population as I have found them to be the hardest to engage in tx. c.acree@espsmd.com
    Thanks in advance!

  • christina

    I would love to have some worksheets and resources to use with this population as I have found them to be the hardest to engage in tx. c.acree@espsmd.com
    Thanks in advance!

  • Kerri Chard

    Hi Brenna, I have just come across your wonderful blog, I work with at risk teenagers and would love to see your resources, I am always on the lookout for new ways to engage my clients

  • Lori West

    Could you email me your worksheets and resources? Thank you so much! loridwest@gmail.com

  • callye

    I’m working with teens and would love those resources as well.

  • kellie turchetta

    I am also a LCSW , working in a new private practice. Most of my clients are teens and children. I would love your resources and worksheets. Thanks
    Kellielcsw@gmail.com

  • Scrumptious

    I’ve just started an MFT internship at a high school, and I would love to take a look at your resources and worksheets. Thanks for a helpful article!

  • Autumn W

    Hi Brenna, I am an MFTI working with mandated youth in SF. I would also like the worksheets you use with your teens if you’re still sharing, thanks!
    autumnbayes@gmail.com

  • Tee

    Hi, if you’re still sending out your resources and worksheets, I would love to receive a copy. My email address is sweet.tee.426@gmail.com.

    Thanks!

  • Anna

    Hi Brenna! I am a graduate student working with at risk teens and I was hoping you could email me the worksheets you use! It seems like they would be very helpful. Thank you so much! abf719@yahoo.com – Anna

  • Alexa

    Hi Brenna! Great article and great tips! I am a provisional psychologist that is currently starting work with adolescents and would really appreciate any resources you may have available to share. Thanks a lot! Warmly, Alexa.
    alexa_vartosu@hotmail.com

  • Andy

    Hi Brenna. I counsel young people and would love to see your worksheets and resources andycrosier@aol.com Many Thanks

  • Mariana

    Hi Brenna, I am working with young people in a boarding school and would really appreciate if you could share with me any resources you may have that could help me in dealing with teenagers. Thanks

  • Wendy

    Hi Brenna, I would love to see any resources and worksheets you have for counseling children and teens. Thanks

  • Vanessa Vaziri

    Hello Brenna, I just started working with a teen in therapy and I’d love to get some of your resources that others on this page are asking for :-) My email address is vaziri@wisc.edu

    Thanks so much!

  • RITA GANDHI

    Hi Brenna,i m going to start working with girls in schools.if you could help with your worksheets and any resources that could help me in dealing with girls.

  • Randal McClintock

    I loved your article, I too work with teenagers and often find it difficult to find things that aren’t too grown up and that are also not boring and childish for them. Would you mind sending me worksheets and resources as well?

    Thanks! rjmcclintock08@gmail.com

  • Donna Bates

    Your article was very interesting. Can you please send me worksheets and resource materials? My email address is donnabates75@yahoo.com

  • Brittany D

    Hi! I loved this article and find it so relevant to the work I do as I’m a school counselor! I would love to be able to look at your resources and worksheets. My email is bdenhar1@gmail.com
    Thank you so much!

  • Trisha

    I would also love a copy of the worksheets and activities. Please email me at trisha81g@hotmail.com

  • viviana

    Would love if you could send me your resources and activities doing my intership at a group home for teen girls. Thank you
    vmoralesof214@gmail.com

  • Rebecca Chesney

    Hi,
    I am an LPC-Intern and work often with teens. Would you pleeeaaase send me a list of your favorite activities/worksheets/resources? I’d really appreciate it!! rchesney@me.com

  • Dawn Reagor-White

    Hello, I am a substance abuse counselor and a Grad student in professional counseling. Could you send me some insightful activities and worksheets for teenagers? It would be greatly appreciated, dreagor@greatlakesrecovery.org
    Dawn

  • Kimberly Peck

    Hello! I work with teens who are adopted and often the underlying issues are grief and loss. I would love some of your activities and worksheets to use with teens. Thank you for your work! My email is klpmsw@gmail.com.

  • rcatbarr

    If you are still sharing activities and worksheets, I’d love to take advantage of your wonderful experience in my work with teens. thank you! i’m rbarrngrille@hotmail.com

  • kristin

    Hi Brenna, Thank you for the great article. If possible, please send me any resources/worksheets you are willing to share. I am currently an LPC-Intern working with teens at a non-profit organization. Thanks so much! kjb0830@yahoo.com

  • Trisha Evans Ryder

    Ditto to what everyone else stated. Anything you are willing to share is very much appreciated. My email address is trisharyder7@gmail.com

  • Jelysa

    Hello! I hope I am not too late in my reply, but I am an MSW intern and would absolutely appreciate resources as well! I am interning at a high school substance abuse prevention program affiliated with NCADD. My email is jelysah@rutgers.edu. I hope you are still able to share this information with me. Thank you in advanced!

  • Rebecca Lynn

    I am a school counselor and also LPC. I enjoyed your article and agree that teens can be challenging. I would love to see some of your worksheets or resources. Thanks.
    Rebecca Lohr LPC
    rlohr@jebc5.k12.mo.us

  • Eddie Gibbons

    I am an MSW working with some teens and would appreciate any resources you can share that I could review and maybe use, egibbonsmsw@yahoo..com Thanks

  • Kendra

    Hi, I am a LPC- Intern and have recently started working with the teen population. So far I’ve been doing most of which you have mentioned in your article….allowing them to focus on themselves and topics of their interest. I would just like some more ideas of structured activities. If you are open to sharing any helpful resources or worksheets it would be greatly appreciated!!!!! All credit to you! Thanks!
    If so, my email is kwms05@aol.com