Therapy for teens - does it really work?

Many parents want their teen to see a therapist. The reasons vary: sometimes parents see their teen is struggling and know they will not confide in them; other times, parents are struggling to manage the relationship with the teen, and think it will make life easier if the teen “works things out”, and then may become easier to manage and be around; and other times still, parents feel that there’s something wrong with their teen and want a professional and skilled person to assess the issues and help solve them.
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The problem is that when one side, in any relationship, is pointing an accusing finger at the other side, stating - directly or indirectly - “you have a problem, so go fix it”, rarely does it elicit a collaborative reaction in the form of “of course!! You are right! It’s all my fault, so let me just go ahead and take care of it”. Let alone if the former is a parent and the latter is a teen - where power (i.e. hierarchy) is naturally skewed in the parent’s favor, and the teen - by virtue of the developmental task (see my previous post "The formula to having a happy teen is...") - is separating themselves from adults to venture on a journey of self-reliance, self-discovery and independence, making this charged relationship difficult to navigate around issues of accountability and collaboration.

Therefore, the question that is begging to be asked is, can adolescents benefit from therapy?
I have heard, numerous times, from members of the therapeutic community, that adolescents cannot be worked with in therapy - a statement that is as infuriating as it is careless and ignorant.

There has been much research done on efficacy of therapy for mandated clients - that is, clients who are forced to take therapy. Most of it was conducted in prisons or other settings in which clients are usually mandated to therapy through the judicial system. The conclusion of all of them, is that mandated individuals can actually benefit greatly from therapy, as long as they can find a single, simple, personal motivator to participate. Imagine that! The only difference between effective and ineffective therapeutic processes is the client’s motivation to participate! Who could have predicted that?

Sarcasm aside, this is the classic “you can lead a horse to water, but you can’t make it drink”. Teens, much like any other human being, can benefit greatly from therapy, if they have some motivation to get support, or are interested in gaining insight to what is going on with them.

So should you force your teen to see a therapist?
For the reason described above, my default answer would be NO, with a few exceptions (suicidality, self harm, harming others and/or other risky behaviors that demand intervention).

So is it a lost battle? Am I supporting some of my colleagues’ perspective, that I had just criticized at the beginning of this post? How does one go about, when they truly believe their teen needs to see a therapist, yet their teen refuses?
Well, I recommend leading by example…

1. Tell your teen you need support, and would like to have their input in session, or, depending on the level of communication you have with your teen, channel Jerry Maguire, and ask them to help you help them.
2. Set up a meeting with a therapist for both of you (or all of you, or some of you - depending on the issues at hand and the availability of your partner\other family members), and emphasize the fact you all need support and are going to get it.
3. Talk to the therapist ahead of time and explain your situation, stressing your teens’ reluctance to participate. Your therapist will assess your teen, as well as the family dynamics, and may recommend more joint sessions.  Most likely that both teen and therapist will have a better sense of whether or not they can\want to keep working together - without you.

If they are still adamant to attend therapy and you believe therapy is absolutely necessary for your teen:

1. Allow them the choice between at least two therapists. If they have a preference you are aware of (gender, age, ethnicity, style of work\approach etc.) try to find appropriate candidates.
2. Communicate clearly (and mean it) that you will NOT interfere in their process (and mean it), nor will you have any access to what they will be discussing with their therapist.
3. If all else fails, and your teen remains reluctant - find a therapist for yourself, and use that support to help you manage your relationship with your teen. It’s probably beneficial to have your teen be aware of it, as long as you are not “guilt tripping” them (“look at what you’re making me do!!”). After all, you are always modeling behaviors, values and choices to your kids, by your actions, and not by your words. This is an amazing opportunity to model self-care, and to show them how everyone, including their own parent, may reach out for support when they need it.

What about when teens actually ask to see a therapist?
There are many such teens who ask their parents to meet with a therapist, and make great use of of therapy, by gaining insight about what they need as they form their identities and sense of self.

Paradoxically, it is not uncommon for parents to sabotage this process, by either asking to be involved in the process, or by pulling their teens out of therapy too early for various reasons (short funds, not seeing “results”  and so on). To these parents I would like to stress out that building a therapeutic alliance takes time, and is a delicate process, that cannot and should not be rushed. The benefits of therapy, much like any other deep processes, show up slowly sometimes, and in various ways.

Do not demand to be involved in the process, as confidentiality, and your teens’ trust in this confidentiality, are crucial for creating therapeutic efficacy. There are clear legal and ethical rules that therapists abide by, that make sure parents are informed on critical issues. You may also meet with your teen’s therapist, if you have questions or concerns, but it is important to respect confidentiality.

Therefore, I encourage parents to find ways to soothe their anxiety (seek therapy, consult with other parents, read relevant blogs\books, meditate, exercise etc), and enjoy the fact they are now sharing the responsibility for their child with a professional adult.

Adolescence is a tough and challenging stage for the teen and their family, and finding the right form of support can be crucial. Be mindful of your teen's need for respect and communication, and trust your own judgment in choosing the right avenue in offering this support to your teen.

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