Thinking Teen: Tips for Working with Adolescents

Pamela Montazer M.A. LMFT

There is nothing quite like the relationship that develops between a therapist and a teenage client. It’s a genuine, hopeful, and frustrating experience. The beauty in it is the raw authenticity teenagers bring to the table.  They are unencumbered by many of the social niceties of adulthood and unimpressed/ uninterested in the status or accolades of the therapist. The meeting between the therapist and a teenage client is a raw meeting of two real people. Through the rawness of that relationship comes great potential for growth and healing. This is what makes working with teenagers so rewarding.  However, many clinical professionals struggle when confronted with an adolescent client or patient. Adolescents’ require a different approach than adults or young children. This article provides some tips on how to approach working with an adolescent.

Teenagers are often cagey at the onset of therapy.  This can be the frustrating part of the work. They make you work to earn their regard. They appear uninterested, resistant and worst of all silent.  A new teenage client may sit in complete silence or respond with the shortest possible answers.  A terse teen can make the therapy hour feel never ending.  However, once you have gotten an “in” with a teen there is no stronger bond. Looking back on my own work with teens, the clients who where most apathetic about me and about therapy at the onset of our work, shed the most tears when it was time for the relationship to come to an end.  To get an “in” with a teenager you can’t try to coerce the teen into your idea of what therapy is.  I often tell clinicians who have never worked with teens not to “try so hard to do therapy.” Therapy with a teen has to be an authentic offshoot of the relationship.  It can’t be forced. With a teenager (with any client really) the therapy is in the relationship more so than in any particular intervention.  Therapists who get too stuck in their interventions and ideas of therapy as a formal process will find they struggle with teenage clients.

Teenagers are going through a phase in life where they are not children any more but not yet adults.  This is a time when they are caught between independence and dependence. They are riddled with self- doubt, insecurity and confusion.  Adolescence is tumultuous time for most people. Think back to your own teenage years- weren’t you feeling much the same?  Therefore, to join with a teenage client you must first meet them in their confusion and search for identity.  You must meet them with structure, boundaries, empathy and unconditional positive regard.  After all, like most people, teenagers just want to feel understood and accepted. Teens especially need to feel safe. Providing a holding environment for a teen can look different than when working with an adult.  Adolescents usually respond better to informality than formality.  However, teens also need clear boundaries and structure to feel safe.  Adolescents, have enough parental authority figures in their life, they less you act and appear like one the better your teen client is likely respond to you. Distracting teens from with activities like card games and crafts can help them feel more at ease and likely to open up with you.  Be curious about their life but avoid interviewing them.  When a teen feels like they are being interviewed they will clam up. Early into your work with an adolescent you really have to disguise therapy as “just hanging out.” Appropriate self – disclosure helps teens relate and open up to you. They want to know you are human.  Just remember to only use self-disclosure if it’s in the benefit of the client.  Also, make sure its something you are ok with them possibly repeating to their parents.

In summary, earning the trust and rapport of an adolescent can be challenging.  However, that makes it all the more rewarding, once earned.  It is one of the most important aspects of working with teens. Having awareness of the particular needs, and life phase struggles of a teen can help with the joining process.  Working with and adolescent is fine balance between providing structure for them to feel safe and informality for them to trust you.  Most importantly, be authentic when working with a teen, because they know when you aren’t.  If you are able to provide an adolescent with the raw authenticity that they give you then you will find much more success and fulfillment in your work with them.