Therapy for Teens

Teens are usually ready for therapy, but when that’s not the case, we offer guidance on the initial call about managing this. In some cases, we schedule a longer consultation with a parent or parents to address the nuances of getting a teen on board. Like many things with teens, there is a balance between using some authority as a parent versus pushing so hard that the work becomes unsustainable. Once a teen completes a first session, we find that if the therapist is a good fit, we should be able to help them see value. That’s our job.

A great thing about working with teens is that they usually make it very clear if a therapist isn’t a good fit. And that’s okay! While we have an excellent track record in setting up a match for success, that doesn’t mean we always get it right. Step one for therapy is usually for a teen to meet with the therapist and for both of them to decide if it is the right fit. If not, no worries, we’ll try again. 

This is common in New York City. Often, there’s a need for an “upgrade” from a previous therapist—someone to match the teen’s evolving maturity. When deemed helpful to a teen’s well-being, we might coordinate care with that provider. Teens who’ve done therapy before often feel that some of the work is familiar and much of it, like other parts of their lives, is an evolution.

This is one of the trickiest parts of therapy with teens. For therapy at any age to work, psychotherapy needs to be a space of trust and privacy. At the same time, there are critical issues that we can’t and won’t keep from parents; some concerns that come up in teen therapy are dangerous, such as self-harm and abuse, that need to be shared with parents in the interest of safety. In cases of a “gray area,” we work with teens to navigate the tension between privacy and the importance of including parents as a part of the solution.

While teens usually get to therapy on their own and, in most cases, benefit from that relationship belonging to them, they also live with and need guidance from their parents (even if they don’t think they do!). We always meet with a parent or parents early in the process to gain insight into the current situation and what emotional and social issues predate the current interest in therapy. We’re not shy about asking parents for what we need, and we collaborate best with families who are willing to be involved as much as is necessary to help their teen.

Parental conflict can be a particular challenge for teens. It’s important that teens and their parents get what they need, even when parents struggle to get along. If possible, we work to provide therapeutic leadership toward improving the workability of that relationship. When that’s not possible, we get creative about how to still provide parental support even when parents don’t work well together.

In most cases, it’s important for a teen’s therapist to have a contact at school. In middle school and high school, this can mean coordinating contact with multiple teachers or with a designated contact on the teaching or counseling staff. Whatever is necessary for us to get a complete picture and offer guidance for a teen’s mental health support, we’re there.

Family involvement is always a part of our work, sometimes quite consistently. There is a lot to juggle in terms of building trust and confidence in a teen while being actively engaged with family members. This is a balance we’re skilled at and will offer leadership on from the beginning of therapy.