Advice about Having a Teen in Therapy

Archived Q&A and Reviews


Questions

Therapy more than once a week is better?

May 2013

My question is has anyone had the experience of taking their child to therapy more than 1 time/week? If so, why did you choose to do so and do you think it helped?

We have a young teen who is struggling, angry, and resistant to almost any direction from us. She has been in therapy once/week yet I wonder if more frequent therapy might really help given the 24/7 level of her irritation, anger, resentment, and defiance. I'm wondering if something like a before (or after)-school therapy schedule several days a week might help build a bridge from where she is to a place of more peace within herself.

And if you have had such an experience, are there any therapists you'd recommend? Thanks for any advice you can give


I have no experience with therapy more than once/week for my traumatized foster child--we've only done weekly.

But I can say that quality of the therapy, and the level of the bond between therapist and child, is in my opinion what matters above all. I never wished my son could go more than once/week to see his amazing psychologist, but I did sometimes wish she could move in with us.

Does your daughter have a good relationship with her therapist? How does she feel about going? My son hated his first therapist and said he would never talk to her about anything. We interviewed other therapists and he liked the one we settled on immediately. He has resisted any efforts to cut back to every other week.

I hope you get some good referrals; I'm just outside the Bay Area so don't have any for you. good luck


I'm not a professional, but in my experience as a parent, if therapy isn't working then more of the same won't work any better. In my family's experience, more of what wasn't working was even damaging.

One of my children was in therapy from an early age for behavior problems that included anger, tantrums, struggles over homework, defiance. After several years of therapy with a clinical psychologist, which at best took the edge off at times, I had an epiphany that we needed to switch our attention to understanding the behavior rather than just trying to change it. The therapist's response was to pressure us to increase to two sessions a week, and if that didn't work, consider medication. More therapy made absolutely no difference.

What changed our son's life was his pediatrician's recommendation for a neuropsych evaluation, once I worked up the courage to open up to the doctor about our struggles. The neuropsychologist's findings, which totally surprised me, led to the first really effective interventions my son ever had. I still carry a lot of guilt that I kept forcing him to go to therapy, and more therapy, when he was being totally misunderstood. And for allowing myself to be guilt tripped into following the therapist's advice about doling out more and more ''consequences,'' when we were misinterpreting our sons needs and behaviors and not seeing any improvement with the punishment. His therapy delayed our finding the right kind of help.

He couldn't express it, but he knew all of us adults were getting it wrong, which has had a long-term negative effect on our relationship with him and his willingness to seek and use help. On the other hand, our relationship and his behavior improved on the few occasions when we said ''Ok, you've tried that, it doesn't seem to be working -- if you agree, we can take a break and look for something more appropriate.''

Our other child, who had totally different needs, was also in therapy for several years. After an initial improvement he plateaued, and we followed the therapists advice to increase to twice a week. As I learned more about this child's condition and the treatments that are proven effective, I realized that the therapist's training did not mesh up with my child's needs and that was the reason we saw no further improvement.

I'm a big believer in the motto in Ross Greene's ''The Explosive Child,'' that children do well if they can. If they can't it's our job to find out why not and help them. Finding out why is the hard part


Teens in therapy: rights of teen vs. rights of parents

March 2012

I would like to hear from others what the counseling policy is at their middle schools/high schools regarding teens who are in counseling at school. Our 8th grade daughter regularly sees the school counselor by choice (and we are thrilled with this and it has been helpful to her). That said, we had a recent experience that we have serious concerns about. My husband had called the counselor and asked her to call him back. There was some phone tag, but no live conversation and no information shared about what he wanted to talk to the counselor about. The counselor, the next time she saw our daughter, told her, ''Your dad called. I haven't spoken to him yet, but what do you think that is about?'' Apparently this is routine for the counselor to say this kind of thing. Well, my daughter was so upset by this that she is no longer interested in going to counseling. While in the best of all worlds, you want the family to all talk about things as a family and be open and yadda yadda yadda, we are not that family (hence the counseling). So where we are at is that my husband and I have lost trust in the counselor (whom our daughter had adored until this incident, to the point of wanting to become a counselor herself, which she now no longer wants to do either), and our daughter has lost trust in us for what she sees as us intruding in her life.

So, my question is, is this standard/acceptable procedure for school counselors? Do parents really not have the right to ask the counselor (as my husband had) to please not tell our child that we called? Do we not have the right to expect that the counselor call us back and talk to us live to (a) find out what it is we want to talk with her about, and (b) at least inform us that it is their policy that the counselors tell the student that their parent has called? We find this really disturbing. Our daughter is a minor child and we, as her parents, are responsible for her physical and mental well being. We do NOT ask the counselor what was discussed in the sessions. We do, however, occasionally have information we feel might be useful for the counselor to know, or simply have general questions.

This has been very very upsetting to my husband and me, and has been very disruptive to our family. I have subsequently talked with the counselor, but do not agree with this policy of telling the student that their parent has called (why is that the student's business?!??!??!).

Thanks for your feedback. unhappy with counseling policy


Your daughter is the counselor's client, not your family or your husband. That said, her first responsibility is to her client. She behaved ethically by putting her client's needs first. Keeping secrets from her client would not be ethical. As far as the legal issues go, California Family Code states: ''The mental health treatment or counseling of a minor authorized by this section shall include involvement of the minor's parent or guardian unless, in the opinion of the professional person who is treating or counseling the minor, the involvement would be inappropriate. The professional person who is treating or counseling the minor shall state in the client record whether and when the person attempted to contact the minor's parent or guardian, and whether the attempt to contact was successful or unsuccessful, or the reason why, in the professional person's opinion, it would be inappropriate to contact the minor's parent or guardian.''

It sounds like your daughter perceived her counselor as breeching her trust by even taking a call from her father. That is very unfortunate. Depending on the skill of the counselor, she may be able to repair the relationship from her side. My recommendation to you, as parents, is if you want your teenager to receive treatment that will help her you need to stay out of it UNTIL she invites you in, which she may do at some point in the future. Good luck!
a Bay Area LCSW


How has therapy helped your teen?

Feb 2012

I notice a lot of parents referring therapists and I would like to hear specifically how therapy has helped their teen and/or family. We have had therapy for/with our teen for over 2 years now and all the problems remain, we are in no better place, only completely broke. The issues are defiance, opposition, extreme disrespect, substance use/abuse (and other programs, including wilderness, have been used), anger, troubling choice of peers, poor self esteem, barely getting through school and with constant behavior problems, etc etc. We did switch therapists once (before these 2 years) and the newer one seemed competent and our teen liked him, so we stayed. I would like to hear how, or what, in therapy has helped other families. thank you. anon


Therapy has not helped us. In fact, I think the therapy has made things worse. I think that some people are able to act ''normal'' and charm the therapist, throwing them entirely off-course. In other cases, I think therapists don't really want to help, because if the situation improves, they will lose a client, and they will make less money. In a lot of cases, therapists feel that it their job to listen, and the clients' job to ''find their way.'' Maybe I am just cynical, but I think 90 of the whole therapy thing is a racket. If you want someone to talk to, go to therapy. If you want to learn about your problems and find a way to solve them, read a book. Or, more likely, read 100 books. S.