Author: Esther Krohner

Effective Therapy for Teens

How to survive teens and help their parents too with Problem Solving Brief Therapy

Help teens with mental health while helping parents help their teens.

Have you worked with parents of teens who have good intentions and are lost as to how to help their teen with their mental-health? No surprise here: most parents want what is best for their kids! This is an inclination that has ups and downs, it can be challenging to figure out what is good enough especially as it relates to teens. It requires dedication and support to figure out the dance. We would like to share our opinion about how to help teens and parents while avoiding the risk of becoming myopic and overly pathologizing in the world of raising youth, with the best of intentions.

Why is raising teens so hard from a solution focus point of view?

Kids don’t come with a manual so parents are forced to continuously make difficult risk management decisions for their kids to help them survive and hopefully, later in life, even enjoy them. To make matters more complex, as kids develop the risk management target moves! Throw in family conflict, loss, drugs/alcohol, romance, mixed messages or unclear expectations and things can escalate quickly. Teens and parents can get stuck in vicious cycles that perpetuate power struggles and exacerbate common problems that often get resolved on their own (with patience and a bit of deep breathing.) When they don’t resolve is when we as interventionists hear about it.

I, Esther, had a teen and a parent in my office and heard this phrase at least three times in under 5 minutes. “I hate you, stop telling me what to do, I am my own person. Why can’t you just drive me to a movie without controlling me?” Obviously, the parent cringed. How the parent can respond to that sort of tantrum is crucial in making a positive difference in future interactions that might work better for both parties. It is hard to think on one’s toes when such conflicting statements are being thrown in one’s face. Parents often report feeling shocked, angry and stupefied by the statements their teens make in heated exchanges. The feedback loops of communication and contextual challenges make it difficult for teens and their parents to hear each other and collaborate.

Help me with my teen! What do we do in solution focused brief therapy with this plea?

My teen is out of control, please help me?! Is a common “headline” for phone calls with parents seeking therapy for their tween or teen.
When a parent calls with this frantic request, it can be very tempting for most traditional therapists to jump in to try to make suggestions or at least to blindly accept to work with the person that is being complained about. However, before we start working, we lay the track with the parent that since they know their kid so well, we might want to work with their child through them. We also might ask, “how eager is your child to come in for therapy?” We ask this to help see if their child is interested in change or if it is mostly the parent. When we ask this question, we set the stage for the parent involvement in therapy, which is crucial for promoting change and succeeding.

What do we tell parents to do when implementing Problem Solving Brief Therapy?

Firstly, we do a lot of acknowledging of the general difficulties of raising teens especially with the hope of having some friendship in the future. We do a lot of sorting, organizing and helping parent figure out how to focus and on what to do so. We ask questions like; what are you trying to accomplish when you say xyz? We help parents implement problem solving by being respectful, listening and clarifying what is most important to them and what is good enough. We try to focus on the results they are hoping to accomplish in the near future. As we said earlier: the target will move in the further future, so we try to improve “here and now” and give them tools they can utilize in the future too. We shy away from getting into a lecturing place because we think it interferes with their growth.

How do we help teenagers who are depressed and/or anxious?

We try not to put the kids/ teens in boxes/diagnoses, if possible. We try to help them find their own words and descriptions for what is bothering them and what they would like to change. What the young people want and what the parents are asking for are often complimentary: they don’t want vastly different things, there is usually some overlap , but neither party can hear that by the time they ask for help.

We also often work through their parents. We believe that we need to work with the people who are most motivated to change. Sometimes that is the teen, sometimes it is not. Sometimes parents and teens are interested. Sometimes we work with a teacher or whomever the concerned adult is, if the parent is not in the picture. Part of how we help is by being flexible in our approach with who we work with and when. We work with the system of the identified patient -the person who is being complained about- and this often takes some of the pressure off of the identified patient, so we can find a motivated person in the system who is able and willing to do some work.

It is hard to talk about this without thinking about the many mixed messages that teens face as they go through the middle school and high school systems. They are exposed to all sorts of things with their peers and the current digital age. We do a lot of putting words to the messages they are getting or the stressful forces that parents and kids are trying to digest. We address anxiety and depression in the context of each case and with sensitivity to their strengths, challenges, motivations. Mostly we emphasize how they are going about trying to manage these challenges and problem solve around what we can do differently. We don’t follow a protocol and that is partially what ironically makes our work so effective and brief. We can focus more easily on what is important to the person in front of us and in this way the therapeutic alliance is achieved and utilized.

What are some key tips for helping teens depression and anxiety from a brief therapy model?

Dealing with teens is complicated. They often send mixed messages. They want their independence BUT also want someone to do all the work for them. Everyone thinks less clearly when we face mixed messages. We help parents identify the communication, select what they actually want to change . We model how to focus and slow down when faced with complexity and competing priorities.

Help empower them to use clear communication around expectations, compliance and connection. It is easy to get distracted when there is so much going on. We help them think ahead and prepare words and their tone that will be useful in the heat of the moment.

Of course, there is no one answer and a main distinction we emphasize is working with parents and finding common language to describe the challenges and problems they face. We try to decrease the complexity and stay focused on the communication and what is most important for them to change. When we empower adults and teens to tune into their gut and voice and also pay attention to the context; they can be less reactive. We create a positive domino effect.

Teens are complicated BUT the communication patterns that parents get stuck in are somewhat predictable. When we step out of lecturing, protocol or ideology, we show parents how to move into engaging with their kids in a different way, we model the exact thing we want them to do.

Come and join us for our upcoming training about how to work with teens and maybe be their friend down the line. How to Survive Tenage Years and Maybe Be Friends Later in Life Tickets, Fri, Mar 29, 2024 at 1:00 PM | Eventbrite

Esther Krohner

Master en Psic.
I have 14 years of experience working in mental health settings. I am and LMFT and RYT. I have been training and practicing  family therapy with Karin Schlanger for 5 years at the Mental Research Institute. I help couples, families, kids and teens  to make the changes they want to. When faced wit...

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