Therapists have known for years that working with adolescents was akin to a roller coaster ride, the adolescent’s perception of their world was often positive and negative—up and down; relationships were confusing—twisting and turning, and as maturity developed—life began to settle and level-out. Adolescence is a time of growth and struggle; indeed, it is often the struggle that produces the growth. It is our job as adults to guide them through the wilderness of shifting hormones, emotionality, increased cognitive abilities, and the navigation of relationships. Adolescents are full of life and wonderment as well as angst and struggle; they can be amusing and exasperating at the same time. As a therapist, it is my goal to assist the adolescent client to find strength in a time of worry, to find hope in adversity, to find resilience in times of rejection, and to revel in the blossoming sense of self—a unique individual with their own sense of values, beliefs, talents, and contributions to their world.
A Time for Personal Discovery
It is during the teen years that individuals are solving the Eriksonian theory’s developmental crisis of Identity versus Role Confusion. This is the time of asking the questions:
- “Who am I as a person?”
- “What are my beliefs?”
- “How do I see myself compared to my peers?”
- “What are my similarities and my differences to those around me?”
Ironically, adolescents answer these questions and learn about themselves by associating and comparing themselves to their peers. They learn in the “school-age years,” the years of about 5 years old to 12 years old, that they are capable of learning. By the end of these years, it is hoped that the individual feels competent and capable—they learn that they may not be successful 100% of the time, but in general, they know that they are capable of accomplishment. This is the foundation for the onset of adolescent development.
The Role of Peers In Developing a Sense of Self
During adolescence, the peer group becomes the vehicle for developmental learning. Through association with others, they learn about themselves:
- “How should I handle this situation?”
- “What have I learned from my family about my values and what do I find to be important?”
- “How will I treat others?”
These questions become prominent and the answers are often tested in the peer group. Sometimes, they enjoy success and at other times, they struggle. Therapy can be helpful in assisting adolescents with these peer relationships—understanding when to listen and learn from others and understanding when to speak up and advocate for themselves or others.
Emotional Highs and Emotional Lows
Emotionality heightens during adolescence. It is not uncommon for adolescents to experience emotional extremes of exuberant joy to deep sadness, irritability to contentment, sullen to happy, withdrawn to outgoing, and interest in activities to indifference.
Helping teens to experience and name their emotions provides insight, emotional regulation, and increases emotional intelligence.
In therapy, the work is to assist adolescent clients to attend to their emotions in session, in the here-and-now. This provides for experiential learning which then translates to real life, outside of the therapist’s office.
Developing Cognitive and Critical Thinking Skills
Cognitive skills increase in adolescence as the adolescent learns critical thinking and the ability to analyze a situation. In therapy, they establish insight into themselves and others. For example, they might ask themselves in regard to a given situation: “Why did I respond that way? or “Why did I say what I did—was I defending myself or was I angry and trying to hurt someone else?” “Should I tell that person they hurt my feelings, or is that too vulnerable for me—which is the best way to protect myself?”
In addition, critical thinking reflects the teen’s ability to integrate their family values and belief systems into their daily life. They reflect: “What kind of a person am I? “What do I believe?” “Based on what I believe and value how will I respond to this situation?” These questions are often the underlying topics in therapy sessions.
Confidentiality in Adolescent Therapy
Parents often wonder about confidentiality in therapy. They may feel somewhat apprehensive trusting their child, who is hurt and struggling, to a professional they do not know.
At Riverview Therapy, the first session is an assessment in which the parents are invited to attend. This helps the parent and adolescent to feel comfortable. The parent is able to meet the therapist and knows what questions are asked, the adolescent has some comfort of the parent being present, and the therapist is able to “get the big picture” hearing from both the child and the parent at the same time.
Note that confidentiality in the state of Wisconsin is guaranteed to adolescents age 14 and older. Their therapeutic record is secure as well as communication about their care. Parents are not allowed to review the record without the consent of the adolescent. However, rest assured, if there is information relayed in therapy that might be a detriment to the adolescent’s wellbeing, the therapist will work with the adolescent to disclose this information to the parent, and if the adolescent agrees, the therapist will assist with the disclosure.
Furthermore, there are exceptions to confidentiality. If an adolescent client is assessed to be suicidal or homicidal then confidentiality must be broken in order to protect the teen or others. Typically, the parents are the first to be informed as they are the first avenue for protection. Together, parents and the therapist work to establish a safety plan.
Length of Treatment in Adolescent Therapy
It is difficult to predict the length of time an adolescent is in need of treatment, as individual needs vary. Therapy has a beginning, middle, and an end. Therapy, especially for an adolescent, is not drawn out and prolonged for years.
It is important that by the end of therapy an adolescent client in general feels better, is able to identify and manage problems, and completes therapy feeling that they are able to manage life challenges. It is at this point that therapy is ended with the assurance that should another stumbling block arise they are always welcome to return to therapy.
Change and Growth
In summary, adolescence is a time of great change and growth. There will undoubtedly be days or periods of time in which life struggles require a listening ear and gentle guidance. Therapy can be a positive and rewarding experience as an adolescent learns to understand themselves emotionally, cognitively and socially.
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