Teenagers usually get sent to therapy by parents, schools or courts for acting out in school, violent behavior, depression or sudden changes in demeanor that cause concern. Since they didn’t initiate the therapy, teens often resist. Worn-out or ineffective methods for dealing with teens in therapy make the situation more difficult.

“We already know some of the things teens don’t respond to well in therapy – excessive questioning, standardized treatment protocols, enforced between-session homework – so let’s stop using them,” said psychologist Janet Sasson Edgette in “Teen Therapy: Common Mistakes to Avoid,” a special report by Psychotherapy Networker.

“They do respond well to active, authentic, and respectful relating, direct feedback and advice. If these were to become a standard part of clinical training and treatment, we’d be taking a great step toward providing services to teens that they’d be interested in getting…,” said Edgette, who is the author of Adolescent Therapy That Really Works: Helping Kids Who Never Asked for Your Help in the First Place.

“Most of us were never trained to talk to adolescents. I was taught psychotherapy by psychoanalysts who worked hard to instill in me an understanding of the importance of
unconscious conflict, character structure, object relations, interpersonal dynamics and transference,” said Edgette. She discovered the weak links in that training when she took her first job as “…a staff psychologist at a residential treatment center for socially and emotionally disturbed boys and girls who didn’t give a crap about their unconscious conflicts or anything else having to do with therapy.

Edgette would ask them, “What are your treatment goals?” Then, “…They’d look at me as if to say, ‘Lady, is there anything on my face that says I have a treatment goal?’ So I realized that if I wanted to keep one of them sitting in my office for more than half a session, I’d have to change how I spoke with them. We needed language that was more natural, shared, mutually revealing than the questioning, interpreting, ritualized clinical language I’d been taught.”

Traditional models often put the relationship in the background, but that should be in the center of the therapist’s work with teens.” said Ron Taffel, in a “Lighting the Spark in Teen Clients,” in a Psychotherapy Networker video.