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As CPA expands child & adolescent services, we’re pleased to announce we’ll be periodically sharing short articles by CPA clinicians on issues addressing children, adolescents, and parents.
Adolescents and Psychotherapy
In my last piece I talked about what parents might expect from therapy for young children. As parents know, teenagers are a different breed. Adolescence is a time for major hormonal and sexual changes, as well as a shift in cognitive development leading to increased abstract reasoning capacities. It is a natural time for youngsters to be branching out from the family, maybe making new friends, and trying new activities. This is all in the service of developing their own identities: How am I similar to and different from my family? My peers? What am I good at? What do I believe? All times of great change are inherently unstable. For some teenagers, these changes can trigger confusing or conflicted feelings, sometimes depression or anxiety, and for a smaller subset, can contribute to eating disorders or substance abuse. School stress and anxiety about life after high school are additional factors that can lead some teenagers to experience mental health symptoms for the first time.
Therapy with adolescents needs to respect this new developmental stage, so it is appropriate for parents to play a lesser role than they would with younger children. Often, even when teenagers have a close, respectful relationship with their parents, they may have an increased need for privacy and independence. If there is friction between the child and parents (which so often happens in adolescence) the teenager may fiercely guard his or her privacy, and overstepping the bounds can lead to refusal to get support or help. Thus, as a parent, you need to step back unless your child invites you into the therapy. This is not to say that you don’t have input—the clinician should get background from you as well as from your child to get each of your perspectives on why counseling or therapy would be helpful at this time. However, the child is the client in the therapy relationship, not the parent. For example, while a parent’s main concern might be poor grades or fighting with a sibling, the child himself might bring in an issue that is completely different (and may in fact underlie some of the behaviors on which the parent is focused.)
Because the child is the patient, he or she needs to be able to trust the therapist and to speak as freely as possible without fear of parental repercussion or control. Of course, because the child is still a minor, his or her medical information is legally accessible to you as a parent. It is important for you, the clinician, and your child to discuss whether there are certain behaviors or information that you want or that the therapist needs to share with you. As with any counseling or therapy, it can take a few tries to find the right fit, especially if your child is reluctant to engage in the process in the first place. If your child will not engage in counseling or therapy, consulting with a psychologist and with school personnel yourself can be helpful in getting ideas to support your child in other ways.
Riikka Melartin, Psy.D. is a licensed psychologist who provides individual therapy, counseling, and consultation for clients who are diverse in age, ethnicity, and sexual orientation. Until recently, she also worked as a school psychologist.
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