The prominent psychologist Erik Erikson in 1968 described adolescents as "shiftless Wanderschaft"—shiftless wanderers, implying that adolescents are best served by helping them focus on the future and getting down to the work of becoming adults. In my therapeutic work with adolescents and their families, my aim is not only to support these important tasks of adolescence but to also highlight and give space to what it means to be an adolescent—child no longer but not an adult.
Adolescents are just that—adolescents. They are not mature children or immature adults, their behavior neither mature or immature; it is adolescent behavior. Behaviors that people perceive as "problematic"—rebellious and defiant, argumentative, dramatic (or melodramatic), risk-taking and impulsive, isolating, bullying, even self-harming—are appropriate to the circumstances to which they are responding or reacting. Sometimes they are even necessary. Every behavior has a reason beneath it; every behavior or symptom is the adolescent's soul speaking.
Sometimes—often times—teenagers can find their way through the challenging landscape of their adolescent years relatively unscathed. Other times they get lost. They wander. Depression, anxiety, trauma, anger, despair, and resistance catch them up. But they are not shiftless. They are trying to find their way in whatever way they can. Sometimes the teenager and the family need someone to help them find the thread again, so they can continue on the journey.
Goals in Therapy with Adolescents
The first and most important goal in my work with adolescents is to build trust between the client and myself. No work can be done without this trust. Often adolescents come to my office with a profound mistrust of adults and authority figures for a variety of reasons—founded or unfounded.
Tools for building and maintaining trust are:
impeccable therapeutic boundaries
a gold-standard in confidentiality
transparency in communications between the client, myself, and their parents
an enormous respect for what it means to be an adolescent in today's world
and a profound regard for all of the ways the young person has attempted to make his/her life work in the face of extreme challenges.
Once there is enough trust, then we begin to take a closer and more challenging look at what's working, what's not working, what are "effective" and "ineffective" behaviors and choices. I do not use value-laden words such as "right, wrong, good, or bad." Behaviors such as threatening suicide or bullying or drug use can be understood as a logical choice under certain circumstances. Whether it is an effective choice is something that the client and I can discuss, entertaining a wide variety of perspectives to see if they might make the same choice next time or something different.
Gaining skills, tools, support, and resources, and learning how and when to implement them are an essential part of the healing. Clear communication with parents, caregivers, teachers, and other important persons in the child's life, and sometimes coaching and psychoeducation regarding the issues the teen is dealing with set within the context of adolescent development is part of the child's therapy as well. This is crucial. Helping parents set realistic expectations and eliciting their help in the therapeutic process are vital to the success of the therapy. (For more information regarding parents and the child's therapy, please see Where Do I Fit In?: Adolescent Therapy and Parents.) Adolescence is a stand-alone developmental stage with critical differences in the adolescent's brain, body, spirit, worldview, and psyche from those in children and adults. These differences are brought to the forefront, acknowledged and honored.
The Course of Therapy
The course of therapy with teenagers varies. It may be that we will work together weekly or every other week. We may meet weekly for a few months, take a break for a few months, then pick up where we left off. Sometimes teenagers will come weekly for a long time. Sometimes they take a break for a year or so, then they realize they're ready to work on some new challenge.
Adolescence typically begins at about age 12 and continues well into the 20's. The brain remains adolescent in nature until about 26-29 years of age. That is a long journey! It's not going to go smoothly the entire time. It's not supposed to. Learning how to effectively meet life's challenges through the mistakes, failures, and success experienced in adolescence is the groundwork for meeting life's challenges in the years to come. We must allow the adolescents in our lives to stumble and fall; our job as the supportive adults is to help them get back up, look back with some introspection and perspective, and move forward from there. The course of therapy often reflects these movements in adolescent development.
I always meet with parents and/or caregivers or guardians at the beginning of the therapy and as often as needed thereafter. I am available for questions and parent coaching at any given time in the child's therapy. Sometimes family therapy might be in order, if the client is in agreement.
The Necessity (and Gift) of Adolescence
Adolescence is a stage in human development that must not be overlooked or rushed through. The adolescent's energy brings change, upends the status quo, questions everything, refuses to accept conformity and normalization, challenges injustice and unfairness, and is often unafraid to look into the dark places of humanity. It can be a distinctly uncomfortable time for both the child and the adults in his/her life. With support, guidance, facilitation, and mentoring during these critical years, the adolescent gathers most of what she/he needs to make a successful, celebratory launch into adulthood and the rest of their life.