Where Do I Fit In?: Adolescent Psychotherapy and Parents

As a parent seeking therapy for your adolescent child, you may wonder what your role will be as your child establishes a confidential and deeply personal relationship with the therapist. Over the course of your child’s therapy, you may have many questions and concerns. I address some of the common concerns below.

Am I giving over control of my child to his or her therapist?

backpack-1836594_640.jpg

Psychotherapy is an extraordinary relationship outside the norms of our regular day-to-day interactions. If the rapport between the client and therapist is strong, then the client has the opportunity to share things that he has never shared with anyone and may never share again. This rapport requires that parents take a step back for a little while and let the therapist and the child work on this relationship.

It is true: you as the parent give up some control when your child enters into therapy. Remember, however, you are the parent and will always be the parent. Your role is the most important one in your child's life.

What will my child say about our family and/or my parenting? The therapist is hearing only one side of the story.
OR 
My child confides in the therapist yet barely speaks to me about anything

Trust in the therapist gives your child the freedom to share what is troubling and some of the root causes for the presenting issues. It is essential that your child feel safe enough to reveal day-to-day experiences. Your child’s therapist will receive this information with the understanding that this narrative is from your child’s perspective and that there is always more to the story. When the time is right and with your child's permission, the therapist may invite you to present your perspective so she can begin to get the larger picture.

It is important for parents to understand that the adolescent therapist is the child’s therapist and therefore an advocate for the child. This may or may not mean that your child’s therapist is an advocate for the parents and the family. Many times, the underlying issues for which clients come into therapy originate from interactions and patterns within the family system. In these cases, the therapist will help your child recognize and come to understand the family system and invite parents to explore different options. This may include recommending that one or both parents seek out therapy and/or that the family enter into therapy to support the child’s individual therapy.

I have the right to know if my child is engaged in risky or dangerous behaviors.  

This can be an especially frightening issue for parents and requires a great deal of trust in your child’s therapist. A skilled adolescent therapist understands that behaviors, symptoms, and relationships are situated within the norms of human development and within the range of expected reactions to extenuating circumstances. The therapist can help you and your child understand what’s normal and what might cause alarm and warrant further action.

The therapist will approach troublesome and even dangerous behaviors (such as cutting, drug use, or sexual acting out) with calm, compassion, and perspective. The therapist should make every attempt to inform, educate, and provide resources regarding these issues, provided she is allowed to reveal the information.

If your child is 13 years or older in Washington State, then almost all information revealed in the session is confidential and the therapist, by law, may not reveal this to anyone, including you, the parent. The exceptions include: if there is reason to suspect that your child or any child, elder, or dependent adult is at risk of or is being subject to abuse or neglect; if your child is in serious danger of suicide or harming another person; or if your child signs a Release of Information.

If your child is younger than 13 years old in Washington State, then an effective therapist will work to share information with you at the appropriate time while maintaining your child's trust. Part of therapy with a child of any age is helping him gather courage and skills to approach you directly with relevant issues. The therapist may also facilitate a conversation between you and your child. This conversation will be a critical component for your relationship going forward. How you receive the information will impact your child's willingness to share with you in the future.

I have recently discovered that our family values are not aligned with the values of my child's therapist.    

It is helpful to ask the therapist at the onset what her values are. This way the decision can be made early on if the therapist will be the right fit for your child and your family. A therapist often conveys her values through her website, social media, and choices of printed material in her office. Ask if you’re not sure.

It’s important to remember that values and beliefs are not the same thing. People who have different beliefs can still share common values. For example, one value that the therapist and parents may both hold is that children are precious and to do no harm. However, they may have different beliefs about what this means. The parents may believe that social media is harmful, and therefore to do no harm means to keep the child off of social media until they are an adult. The therapist may believe that it is in the child's best interest to have exposure to social media while under the supervision of her parents. The therapist and parent can work together regarding the beliefs, meeting on the common ground of shared values.

If it’s important for your child to see a therapist who has the same beliefs as you and your family, then don’t hesitate to ask about this as well. While the therapist’s beliefs and stances on issues should not affect her ability to do strong therapeutic work and be fully present to your child, it may be that you yourself are not comfortable and this may interfere with the efficacy of the work with your child.

My child is actually more defiant and angry (or more depressed, withdrawn, anxious) now than he was when he came in to therapy. I thought the therapist was supposed to fix him and make him feel better.

Although this can concern parents, this can be quite typical in the course of psychotherapy—for the client to get worse before he gets better. For instance, if your child’s presenting issue is depression, it may be that underneath the depression is an overwhelming anger that has not yet been expressed or resolved. In this case, anger that is exhibited and expressed can actually point to progress in therapy.

It is important to talk with the therapist about your concerns, what behaviors you are seeing, and any new developments in your child’s life. It may be that there are extenuating circumstances that have triggered such behaviors. It's also good for you to know that the psychotherapist’s goal for your child is most likely not only to resolve the depression but to address the underlying causes for the depression—or defiant behavior, anxiety, self-harming behavior, etc. Stopping the behaviors or banishing the symptoms does not always heal your child. It can take a long time to get to the symptoms' roots and may, indeed, involve the family in the work at some point in time. In these cases, the most effective course of action is to consult with the therapist to address these concerns.

In conclusion

As the parent of a child engaged in psychotherapy, you continue to be your child's primary influence and have the final say about your child's treatment. If there is concern regarding the treatment, your therapist should welcome your feedback and questions. You may feel it is best to withdraw your child from therapy if something goes awry between you and the therapist. However, slowing down and making space to address the concerns is almost always in the best interest of your child, especially if there is a solid therapeutic rapport.

Wanting your child to behave a certain way is not the goal of therapy and is not always in keeping with your child's mental health needs and her self-actualization. Ideally when your child leaves therapy, she will have access to tools, skills, and resources to courageously meet life's challenges and will have a stronger sense of who she is in the world. It may be that who you want your child to be is exactly who your child is. If not, then navigating these discrepancies with your child's therapist is crucial for her therapeutic progress.

Working with your child's therapist to develop a strong partnership in service to your child's health, welfare, and happiness is where you, the parent, belongs. The therapist needs you, your wisdom, knowledge, and love for your child.