Whenever I consider taking on a new teenage patient I speak to the parents about what they can do to support their teenager’s treatment. The single most important way parents can help their teenagers benefit from therapy is to bring them to their sessions as consistently as possible. The ideal is for the patient to attend every session, which always takes place on the same day of the week, at the same time, in the same room with the same therapist for as long as necessary until positive behavioral change and emotional growth are achieved. This consistency is a crucial part of the therapeutic process and no therapy can be successful without it.
It can be useful to think of therapy as an education on the patient’s own mind. Just like a traditional education, students get the most out of it when the go to every class offered with minimal disturbances. Also, just like a traditional education the positive effects of therapy come with time, consistency and dedication. However, maintaining the consistency can be very challenging for parents for reasons that I will discuss below.
Another way for parents to support their teenager’s therapy is to respect their privacy. Teenagers must feel confident that whatever they chose to discuss in therapy will not be shared with others. (Of course, this excludes suicide, homicide and child abuse, and these exceptions are clearly explained to the patient.) If the teenage patient believes what is discussed is shared with parents or others then it will be very difficult for them to trust the therapist. This is disastrous for therapy. Essentially I ask my patients to take emotional risks with me in therapy to explore the more painful, shameful and difficult-to-express aspects of their life experience. The more they understand and accept these experiences, the more healing and emotional growth can happen. This process requires a lot of trust and if that trust is gone, the therapy becomes impossible.
Parents can inadvertently threaten this trust by pressuring teenagers to talk about what was discussed in therapy or by applying intense pressure to produce good results quickly. This can produce what I call “back-end censorship” that interferes with the patient’s ability to be open and honest in therapy. The idea in the teenager’s mind being that if I keep the discussion safe and clean then I don’t have to lie to my parents when they pressure me about what I spoke about. At the same time they are avoiding talking about what they really need to talk about. This censorship becomes a major obstacle to a therapeutic process that requires openness, honesty and trust. I do not mean to imply that as a parent you should never ask about how therapy is going for your teenager. It is definitely OK to ask. It is not OK to pressure them to give you information they want to keep private. Respect their right to keep information about therapy from you.
All of this, very understandably, can put parents in a difficult position. It is common for teenagers to participate in therapy for months without a noticeable change in their mood or behavior. Teenagers may even be actively sabotaging the therapy in an attempt to convince their parents that they should stop bringing them. All the while parents could know next to nothing about what is happening in the treatment. This is not an easy situation for parents. It is hard to feel that your efforts of time and money are not producing results and the temptation to quit can be quite strong. It can be very helpful for parents in this situation to share their concerns with their teenager’s therapist so they can understand what is happening. The therapist should be able to explain and also avoid violating the patient’s privacy. After all, the parents also must develop trust in the therapist! Teenagersare very perceptive to their parent’s emotional state. They will notice if parents are experiencing internal conflict regarding whether to keep their teenager in therapy or not. If this happens they can choose shut down for fear that they will be abruptly taken out of treatment anyway. As you can see this situation would make it difficult for teenagers to justify taking the emotional risks that produce positive results in therapy. So as a parent, addressing your concerns about therapy to your teenager’s therapist is another good way to support their treatment.
By Miguel Brown