Therapy for Teens

When Teens Are Struggling, Parents Are Struggling: Therapy Can Help

Working with teens in our NYC therapy practice's offices in Lower Manhattan and Park Slope, Brooklyn, as well as through teletherapy and video chat therapy, we know that when teens are struggling, parents are struggling. It’s agonizing to go through a hard time with your teen. Your teen is your kid, your child. As a parent, you worry more than your teen likely knows. One of the great challenges of parenting teenagers is that there can be a lot to worry about. Parents sometimes get a reputation for being disconnected from their kid’s struggles, but we’ve found that doesn’t usually match up with reality. Plenty of parents are involved in teens’ lives, but still struggle to connect with what’s going on or, more relevantly, how to help.

As therapists who focus on families in our therapy with teens (and all patients really), we appreciate this. We like to think of families as tight systems–when one member of the family is struggling, everyone is struggling. What this translates to in our practice is that we don’t just work with teens in isolation. How do we do this? We don’t relate to the teen only as our patient. Sure, they need attention, and our job is to sort out how to get close to them and get them help. But, teens live their lives as part of a family and families need help too. Can this be a tricky balance at times? Of course. But, that’s our expertise.

We Figure Out What Teens And Parents Need

We are experts at building relationships with teens in which we can talk and get real, while at the same time, we understand parents’ fears, worries and needs. Teens need a therapist who is on their side and they can trust to talk about the hard stuff in their lives (perhaps including tough stuff with their parents). This needs to be balanced with parents’ very real concerns. The art in what we do at Tribeca Therapy is helping a teen feel confident we aren’t going to betray his or her trust, while recognizing that parents need to be a part of the therapy, as well as need access and guidance. Rather than offer teens a rigid set of rules (as in “I won’t share x, y or z”), we offer a deeper trust as in, “I’m on your side, but I’m also on your parents’ side.”

At times, a teen needs some time to build trust with a therapist first, especially if he or she feels trust has been violated in the past. We’ll be honest–sometimes teens feel very hurt by one or both parents. Our job is to take that very seriously. But, we don’t take that seriously in a manner that just says, “Yeah, your parents suck.” Instead, we may offer, “Let's help you figure out how to talk to your parents about that, and see how I, as the therapist, might help them do that better.” Of course, we, both teen and therapist, might need to work to better understand where Mom and Dad are coming from.

We Speak Teen

What makes us really good at therapy with teens? We’re terrific at connecting with teenagers. How do we do this? We aren’t old and stuffy. For lack of a better word, we can relate to teenagers. This has a lot to do with how we came to be therapists and how we approach therapy. With any age group we work with, either in person at our Lower Manhattan and Brooklyn therapy offices or virtually, we don’t fall into the traditional therapist mode. We’re not cold and distant. We talk back. We engage. We’re willing to be unorthodox. Sometimes we’ll listen to music or go for a walk. We never just hang out with teens, but we recognize that it sometimes takes different methods to connect with different kids. We’re also never ever fake. We don’t pretend to be cool, know more about music or what’s happening in a teen’s life. We’re willing to laugh at ourselves and invite teens to do this as well.

Another strength we have in connecting with teens is that we work with a lot of teenagers and have for many years. Teens talk to us a lot in therapy about what they’re dealing with, including depression, anxiety, school, fighting with family, bullying, trauma, preparing for college, grades, sex, sexual orientation, gender identity, dating, and more. We are fluent in and familiar with some of what’s really going on with teens. We have a sort of inside track. Teens talk to us and because of that, we’re more experienced at talking to teens.

It’s More Than Adolescent Angst, Moodiness Or Hormones: We Take Teens’ Struggles Seriously

At Tribeca Therapy, we believe it’s much too easy to attribute what’s happening in teens’ lives to a hormonal or developmental process of disruption. We don’t believe that being fifteen automatically makes you crazy. We do, in fact, take exception to that narrative. We don’t just blow off problems as “teenage angst” or “just a phase.”

Teens have real problems and have genuinely difficult issues going on in their lives. Teens can tell right away that we see this and get this. When adults shrug at a teen in distress, who is making poor decisions and expressing emotional disruption, by saying, “Oh typical teenager!” or simply, “Hormones!” with an eye roll, we’re letting teens down. Often teens show us things about the world that we’d rather not see. It’s incredibly difficult to get close to teens and to work to really understand what’s going on with them. In our therapy with teens, we are deeply invested in this, bound and determined to build relationships with teens where their struggles are taken seriously.

While We’re Not Moralists, We Understand Acting Out Deserves Both Consequences And Understanding

In our NYC therapy practice, we work hard in all of our work not to be moralists. This is especially meaningful in our work with teens. What do we mean by that? Our job isn’t to judge or try to impose a certain set of moral values. However, this doesn’t mean we’re uninterested in questions of morality. We may not judge a teen for smoking on a class trip (or at all), but we’re available (and interested in) talking about how that choice fits into the sort of person he or she wants to be.

This also doesn’t mean we don’t take acting out behavior seriously. We’re not going to dismiss behavior like cutting class or smoking pot and simply say, “Well, she’s anxious.” We’ve seen a good amount of the following acting out from teens in therapy: pot, drinking, sneaking out, sudden drop in grades, cutting class, shoplifting, and risky sexual behavior. We see all sorts of other behaviors in teens (depression, anxiety, cutting, withholding food/excessive exercising, etc.). The above behaviors are the ones that teens tend to get in trouble for (There was a time when these would be referred to as "delinquent." Teenagers who are white-appearing are less likely to have these issues result in encounters with law enforcement). To be clear: Teens should get in trouble. Consequences from both outside the home and at home are an important part of raising teens.

But there’s always more going on. The challenge–and we guide parents through this–is balancing understanding that some actions need consequences, while also working to locate our understanding of acting out as a product of emotional distress. Sometimes a parent’s job is to step in and take charge, including setting restrictions on certain behaviors and getting close to what’s going on with the teen emotionally. We should note being able to be both the disciplinarian and partner in your teen’s emotionality is tough. It taxes your relationship and if the relationship isn’t solid, that is going to need repair.

We help teens understand that, in certain instances, they’re not giving their parents much choice. We work to help teens with this complexity: “Yes, your dad is being putative–you put him in a position where he has to be. Yes, you’re mad at him and yes, you’re struggling and need things from him.” Some parents need help being tougher; others need to cut their teens some slack. And often, parents are on different pages with this. That’s part of our job too.

The First Appointment

Although we do get calls and emails from teens who searched for therapy for teens, found us online themselves and want to make an appointment (which we do once their parents are on board), plenty of parents call to ask about therapy and are nervous about getting their kid to go along. What we always say in this case is that if you can get them to show up for the first appointment, either in person at our therapy offices in Tribeca and Park Slope or for online therapy, our job is to take it from there. Part of the skill of being therapists who work with adolescents is to figure out how to connect in the first session and help them see the value in coming back next week. We have a pretty good success rate with that.

As far as making the first appointment happen, honestly, you’ve got to do whatever it takes. Be serious with your kid about what your concerns are, let them know you’re asking them to come in once and they don’t need to be ready to commit to more than that. Honor the fact that however involved in the therapy you end up being, ultimately, this is an important relationship that will be deeply personal to them (at least if it’s going to work). You need a therapist you feel comfortable with, who you trust will take things seriously and will really help your kid, but you’ve also got to get your teenager to sign on. If it makes sense, share our website with them (we’re also on Facebook and Twitter) and even, invite them to email or call themselves to talk about what the work would look like. And in a pinch, there’s nothing wrong with begging or bribery to help make that first session happen. Seriously.

Do I Come To The Session? Will I Know What’s Being Talked About?

Teenagers fall in a funny sort of in-between that can make these questions tricky. On the one hand, having a parent (or parents) involved in the therapy can be crucial in helping get issues out in the open so they can be dealt with. Sometimes we give parents guidance in how best to support their child through hard stuff. Part of this work is supporting a parent and child to communicate better about what’s going on in their life together.

On the other hand, teenagers also generally need space from parents to have room to talk about things they don’t know how to talk about with their parents (or in ways they don’t want to talk with their parents). Everyone deserves some privacy in their emotional lives.

To be clear: There are some things that just aren’t going to be kept secret. We’re honest and upfront with everyone (including teens) about that. If a teenager is talking about hurting him or herself, or someone else, or is involved in a serious, dangerous situation, we’re going to bring their parents into the loop. Other things need to be kept private, even if Mom and Dad really, really want to know. And then, there’s the grey area. Of course, this can be challenging for parents. There’s likely some delicate navigating that needs to happen and our job is to lead that process. We work with teens to talk through the consequences of sharing versus not, the pros and cons of secrets, and understanding what parents may feel when they are not included in some vital happenings in their kids’ lives. We do that with respect for everyone and transparency. It’s delicate at times and it should be.

Parents, You Are An Important Part Of Your Teen’s Therapy

You can be crucial in supporting your teen around what they are working on and towards. While you might not always be physically present in the therapy session in our Lower Manhattan or Park Slope, Brooklyn therapy offices, your support matters and we will be in communication as much as you, your teen, and their therapist decides is appropriate. Sometimes coming in for sessions will be needed, either alone or with the whole family. At the same time, we want this place to be a safe zone for your child so we work hard to be sure that happens. Family sessions do not have to be horrible. We want to create something positive and meaningful in our time together so you can feel good about it when you walk out of here.

Medications are not something we push or reject. Sometimes they are helpful in supporting people briefly or for longer periods of time. We work with some great psychiatrists to determine if and when medications are appropriate. If they are then we prefer to maintain communication to be sure you and your teen receive well-coordinated care.