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When A Teen Is Struggling, The Family Is Struggling

Any time we work with teens at Tribeca Therapy, there is always some involvement with the family. In our practice, we relate to people as part of a system, with the family being the most important system in which teens spend time. If understood without context, the troubles of teenagers are easy to see as individuated problems. They’re brooding, unmotivated, and prone to overusing drugs, alcohol and video games. While these statements can be accurate, we work hard to understand these as part of a system. Teens' behavior is not just a reflection of hormones or internal dynamics, but our culture, their schools, and of course, their families.

In family therapy with teens, we work to understand what’s happening with a teen in the context of the family. When a teen is struggling, the family is struggling. There are times when approaching issues as a family issue from the start is best, whether the struggle is in the family system rather than with the teen him- or herself, a notable breakdown in a family’s communication, issues with discipline and limit setting, or the family experiencing a loss with everyone struggling with grief. When a family approaches us and articulates their need for help as family therapy, we assume at least some members of the family other than the teen are presenting themselves as ready to do hard emotional work.

With Teens, The Entire Family Goes Through Adolescence

What makes adolescence challenging, more than anything, is its in-between-ness. Teens are able to understand and act in all sorts of nearly grownup ways. They are physically strong, can travel (somewhat) independently, access information, and communicate with just about anyone. At the same time, their life experience is small, and their judgment is often poor or middling. This produces all sorts of conflict.

Understanding this as something that is happening in and to the family rather than just the teen helps take the focus away from “my kid is possessed” to “our family is changing.” In the latter formulation, everyone needs to learn how to do new things, and needs to grow. In particular, parents are still an authority, but a new kind of authority with some (but not all) authority relinquished. This means parents need to add liberties that can be earned with benchmarks, including building trust, as well as enforce rules and expectations with different explanations and perhaps updated consequences.

Teens And Parents Often Feel Equally Dismissed: Communication In Family Therapy With Teens

How can parents listen to their teen when it sounds like they’re crazy? And conversely, how can a teen listen to their parents when he or she knows they won’t listen? We can’t say enough how much we hear versions of these questions, and nearly always the two go together. The teen feels as if their parents aren’t hearing them, and vice versa.

How can family therapy help? At times, it looks like being a moderator or facilitator. If the communication has broken down significantly, either in the form of silence or shouting, we function as negotiators of sorts: hearing everyone out, and creating terms on which everyone can come together and be heard. Teens and parents often feel quite equally dismissed. We often challenge and then, teach each party how to hear one another so everyone can feel taken seriously.

Drug And Alcohol Abuse In Teens Exists As A Part Of A Bigger Context, Including The Family

Substance use can be scary for parents, and often they need the help of a skilled substance abuse specialist to assess just how concerned they should be. Substance abuse in teens always exists as a part of a bigger context–both emotional and social issues in a teen’s life, as well as within the family. One line of investigation is to examine how siblings’ or parents’ substance use, abuse, or history of use or abuse is relevant to a teen’s choices with drugs and alcohol.

However, often the question of how the family system is related to a teen’s drug or alcohol use is less obvious. Drugs and alcohol are tools for managing emotions. They’re often poor and misused tools, but if we respond to a teen’s drug or alcohol use in merely punitive ways (and sometimes punitive interventions are necessary), we can miss out on working to understand the teen’s emotional role in the family.

Exploring A Teen’s Acting Out Behavior And Legal Involvement In Family Therapy

Doing therapy with teens in the context of family work can often feel like a scavenger hunt or solving a mystery. There are lots of reasons young people act out, and they often have something to do with what’s happening in their families. In family therapy, we have the opportunity to explore that with the relevant players in the room.

Acting out behaviors are complicated, and those that involve the legal system are also more severe. We work to help families find a balance between restrictions and freedom. When adolescents get in trouble with the legal system, something in that balance has broken down. While many assume a therapist is inclined to support freedom, there are times when a restrictive posture needs to be favored, and times when strict rules and a punitive response to their being broken is required. When necessary, we support parents to clearly and firmly set these limits.

Adolescence Is When Teens Explore Who They Are: Families Are Both Audience And Ally

Adolescence exists in our culture as a kind of balance between freedom and restriction. Teens are stuck between a need to make and own the consequences of choices with a need for guidance and structure. Young people need space to explore who they are: the kinds of friends they choose, their politics, and their feelings about money and sex. Teen’s exploration of who they are and their place in the world can also be complicated when facing conflicts of culture in their family.

Teens also may be exploring their gender and sexual identity. How teens present themselves in the world, and what they feel safe to express doesn’t happen in a vacuum. Families are both audience and ally. They are the people a teen seeks the approval of, has wants and wishes for, and lean on for support and protection in navigating a world which, while changing, can still be hostile to those who make unconventional choices.

Meet our founder and clinical director, Matt Lundquist, LCSW, MSEd

A Columbia University-trained psychotherapist with more than two decades of clinical experience, I've built a practice where my team and I help individuals, couples and families get help to work through difficult experiences create their lives.

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Family Therapy With Teens