Your Recalcitrant Teen Client: What To Do
Dec 20, 2023- If I hadn’t been a teacher of adolescents first, I’m pretty sure that my initial therapeutic encounters with teenagers would have gone sideways quickly. The young people who ask for therapy or can see that perhaps it might be of personal benefit to them come in, for the most part, ready to go. But the teens who come into therapy either court- or adult-ordered are quite often resistant at best and recalcitrant at worst.
Recalcitrant – such a great word. Oxford Languages defines recalcitrant as “having an obstinately uncooperative attitude toward authority or discipline.” The example usage of the word is “a class of recalcitrant fifteen-year-olds”—no surprise there. The etymology of the word literally means “kicking back from the heel,” as the calc in the word comes from the Latin word for heel, the calcaneum.
So let’s put all of that together.
Here’s this 15-year-old kid in your office because an authority figure in his life has said “you will go to therapy.” His arms are crossed, he has a scowl on his face, and he refuses to give nothing more than a muttered, “Hey.” And no matter how friendly, open, and patient you are, the client gives you very little to work with over the next few sessions. He’s kicking back from the heels, not even facing you, but back turned (metaphorically or maybe even literally!), kicking back hoping to hit that sharp bony calcaneum (metaphorically) right square in your oh so patient compassionate therapist’s heart. He’s having none of it.
And why should he?
You are a stranger with whom he’s supposed to share all of his most vulnerable secrets. He has been told in so many words that he’s broken and that you are going to fix him. Not only is he kicking back against you but even more he’s defying the authority that placed him there in your office—parent, pediatrician, probation office, school counselor. It doesn’t matter; it wasn’t his decision. Even if there are parts of him that desperately want life to be different. He will remain recalcitrant until he doesn’t need to be any more.
In Internal Family Systems we would say that he has protector parts that manifest as recalcitrant behavior. It’s important to honor those parts. They are present because there is also vulnerability in the child’s system.
I’ve had a few such kids show up in my office.
Martine’s grandmother brought her in after Martine had a breakdown of sorts as a result of a run-in with some of her friends. Martine stood in my office, arms crossed, refused to sit, and said, “Just so you know, I’m not going to stop drinking.”
Ezra had been to three therapists before they landed in my office. They had had multiple suicide attempts and was actively self-harming. They, too, stood. Though their arms hung loosely at their sides, and silence emanated from them in waves. It was weeks before they said more than a handful of words in our sessions.
I could hear Hazel’s withering tone and words directed towards her mother as they sat in the waiting room. Hazel refused to even enter the therapy room her first session, and then in subsequent sessions, she kept her eyes on her phone for most of the hour.
All three went on to do brilliant work in therapy, though their adolescent journey was a rough roller coaster ride. But they stayed the course with me and I with them. I have learned over the years, both in my teaching and in my counseling, that if the child is “kicking from the back of the heel,” then I need to learn how to use that fancy footwork to dance with them rather than engaging in a battle of wills.
So what do you do?
How do you establish therapeutic rapport with someone who will have none of it? How do we do this dance?
#1 Identify and validate your own parts, then ask those parts to make room for you to access your Self energy.
Some parts that might show up are:
the rescuer/savior part - you’ll save them when no one else will or could
the part that needs to prove you’re a good therapist
the anxious, impatient, helpless, insecure parts
#2 Meet the client where they are at. Don’t get ahead of them; stay close beside them. Let them be just a little bit in the lead. See yourself as the Wise Guide, letting them figure out some of this on their own while also being there in case they lose their way. Take the time needed to build a foundation for the therapy. This can take quite some time, so be patient with yourself and with your client. Take your time to learn the dance steps.
#3 Be yourself and be the therapist. If there is any one demographic where a therapist's self-disclosure can benefit the therapy it’s with teenagers. Be real. Let yourself laugh at yourself. Let them see your righteous indignation for them. Make sure they know you’re in their corner. And, at the same time, be clear that you also have another perspective that has value—one that comes from Self energy. Offer these perspectives with an open hand and heart when the time is ripe.
#4 Let go of the DSM5 and the intake process if your position allows you to do so. Save these behavioral health requirements for a later session when the rapport has been built. Let the kid tell you what he wants to tell you. Observe with a keen, compassionate, curious eye. Notice what’s not being said, not mentioned, not offered. Let the client hold their secrets as long as they need. Trust in this mutual process between the two of you.
#5 Be transparent and keep a gold standard level of confidentiality. Be sure that your informed consent forms are very clear about confidentiality with teenagers. Let your clients know when you are talking with parents, the school, or others involved in their care and what you are talking to them about, even if it seems to be of no consequence to you. The recalcitrant teen client is defended, defensive, and guarded. Nothing will undermine this teenager’s trust in you more than a break in confidentiality. I have learned this from painful experiences—painful for both me and the client.
#6 Align yourself with the child rather than the authority figure that brought them there. Always let the parents know that the child is your client not the parents. Let them know you will be advocating for your client while at the same time honoring their role as the parent. It’s a delicate dance for sure and is most likely one of the most challenging aspects of working as an adolescent therapist. This alignment is of utmost importance with the recalcitrant child. Work with parents so they can understand that this is, indeed, in the best interest of the child. And in the long run, also most likely in the best interest of the parents and the family as a whole. I have found that what is healthiest and most effective for kids is what’s healthiest and most effective for the family.
It’s all worth it.
While working with “difficult” teens comes with a boatload of challenges, the rewards are infinite when you know that you are making a difference in this child’s life. Your patience, validation, and presence tell them that they matter—even in their recalcitrance. Their relationship with you, however brief, may be one of the vital protective factors that ultimately saves their life, their sanity, their relationships, and their future. Those recalcitrant parts have a certain grace and dignity. Honor and respect them, and the dance steps between you and your client will begin to shift into one that incorporates trust and connection.
Image by: saeid yaghoubi