In-Person Therapy for Teens

In-person therapy offers teens a separate space from home or school to talk about what’s really going on

Home, school, home, school—this is often the setup for many teens, with the occasional addition of extracurricular activities. Coming to therapy in person gets teens out of the house and away from school and into a kind of third space where they can reflect on their lives elsewhere. Parents, friends, relatives, and teachers are all great resources, but one of the advantages of having a therapist for teens is that they exist outside of an adolescent’s daily life.

Therapists can be quite neutral, which means worries about coming off a certain way (so important to teens!) can be grappled with in isolation from more complicated home and social dynamics. Therapy is separate and private, which can be the very thing that allows teens the freedom to talk about what’s really going on. While this can happen remotely, being together in person rather than online reinforces this separateness, leading to more open discussions.

Teens missed key developmental moments during COVID: In-person therapy or remote therapy that moves to in-person work can ease this path

As the COVID quarantine era fades further into the rearview mirror, many have moved on. However, parents commonly see some of the lasting effects of this period on their teens. Symptoms like depression and anxiety are clear consequences of extended isolation, separation from peers, and lack of in-person schooling, as well as perhaps too much time spent together as a family under difficult circumstances. Most importantly, many teens missed important developmental moments in which different phases of independence would have otherwise taken place, like riding the subway, learning to socialize and make friends, and navigating different rules, contexts, and degrees of self-direction. By missing out on learning how to do certain things when they otherwise might have, these adolescents are now behind. Some compensated by developing an overreliance on gaming, screens, and social media, adding inertia to the effort to support them in engaging with in-person social relationships.

These struggles can interfere with a teen’s ability to leave the house and be in the world, including for in-person therapy. In some instances, there is a benefit to starting online therapy with teens with the plan to shift to in-person therapy as a near-term goal. This allows teens who might feel stuck to move into in-person work more gradually and ease their path toward a richer experience in the office.

Play isn’t only for kids: In-person therapy provides endless opportunities to connect with teens creatively

We often think of teens as being past the age of playing. In reality, even adults have a playful side. It’s generally not difficult to invite that part of teenagers into the treatment room for therapy. Play is a way of working through difficult feelings, a kind of healthy defense, and even a form of helpful regression in which teens can access earlier parts of themselves, such as past experiences and feelings. Play can also be a useful tool to help teens connect with their therapist and build something together with the difficult contents of their lives. 

There are endlessly more opportunities in in-person therapy to invite and engage in play, as well as include forms of creativity to add dimension to that play, which can be helpful for treatment. Teens can make art, goof around, share music—all things that benefit from being in the room together.

Showing up is an important part of therapy with teens

Showing up is an underrated part of therapy. Letting the therapist know the train is late or they need to stay after school a bit longer are small ways that teens can own their own therapy and foster accountability. For teens struggling with depression or anxiety, just the act of getting out of bed to travel to a therapist’s office can disrupt cycles in which they feel stuck. Of course, these kinds of struggles can interfere with a teen’s ability to be in the world, including in-person therapy. This can make in-person therapy take more effort, but that effort can be an essential part of the treatment.

Building relationships with teens is hard: Therapists need all the help we can get

Building relationships with teens can be a challenge. Deadass. Even having worked with teens for years, therapists sometimes still need all the help we can get, especially when teens are afraid to open up. In person, therapists have more to work with to build trust and connection. Existing in the same room with a therapist who maintains eye contact, attunes to their different emotional states, can laugh with them, can understand body language, and work with them to articulate different emotions all help. There are also things in a therapist’s office that can be tools for engagement with teens. It’s easier to listen to live music, make art, play around and be silly, and otherwise engage in all the ways that physical presence invites.