It’s no surprise that we have endless options of high school and middle school sitcoms, movies, and TV shows centered on the drama of the teen and pre-teen experience. These are often highly tumultuous phases in development, with the brain and body experiencing radical transformations paired with massive shifts in identity, sexuality, values, individuation and social understanding. All of this can create a pressure cooker of confusion, stress, mental health challenges, and relational conflicts with family and friends.
Teens and pre-teens are now faced with added pressures and different existential threats than their caregivers as our geopolitical and social landscapes have completely changed since the 1980s and 90s. Many of the teens who now sit in front of me have profound concerns and heightened awareness about issues like climate change, collapsing job sectors, technology, war, politics, and social currency. I notice rampant vicarious trauma symptoms in many of the teens I counsel due to the impacts of the pandemic and exposure to graphic news and content via social media. I also note a shifted zeitgeist around nihilism and a sense of powerlessness amongst some of the Gen-Z and Gen-Alpha clients that I’ve counseled.
I see a number of common themes and issues in my work with teen clients, including:
Many teens come to therapy to work through trauma and C-PTSD. Survivors of trauma experience issues with nervous system regulation, including challenges with emotional waves and oscillations between hypo/ hyperarousal. Trauma symptoms can feel heightened during this phase due to significant physiological changes and continued brain development.
The adolescents I work with often grapple with feeling a lack of emotional security in their social environments. In today’s digital age, the influence of social media has introduced new complexities to issues of belonging. With constant online access to their peers, teens and pre-teens may find it particularly challenging to escape from instances of bullying and social pressure. In 2023, bullying can take on an alarming and inescapable dimension that can have profound and lasting impacts.
Many teenagers come to therapy grappling with family-related challenges that significantly impact their emotional well-being. Issues such as acculturation, divorce, value differences, high conflict styles, blended family dynamics, intergenerational trauma, or changes in the family structure are common challenges. Adolescent-parent conflicts sometimes amplify during this developmental phase, compounding family conflicts.
Adolescence is a transformative phase of life marked by significant physical, emotional, and cognitive changes. This period of rapid brain development and shifting identity can bring about unique challenges for teens. This is a period of rapid transition, including graduation from middle to high school and the leaps to college or the workforce. These transitions, while exciting, can also be fraught with uncertainty and anxiety. As the adolescent brain adapts and matures, it can contribute to various emotions and behaviors that may be difficult for teens to manage with only their family and friends.
Adolescence is a time of immense emotional growth, but it can also be marked by the onset of mental health challenges. Many teenagers experience symptoms of depression and anxiety, which can be overwhelming and difficult to manage. These conditions can disrupt their daily lives and relationships. Additionally, the adolescent nervous system continually develops and evolves, contributing to the intensification of emotional experiences.
Many teenagers are in the process of understanding issues of sexuality, gender, intimacy, and connection. My teens clients often grapple with shifting identities and how to express themselves safely and authentically, given familial expectations and societal norms. Many teens unfortunately find their way to therapy in the wake of domestic and sexual violence, along with painful first romantic and sexual relationships. Therapy can provide a supportive and affirming environment where teens can discuss their thoughts, feelings, and experiences without judgment.
Many teens have self-worth injuries and struggles with “enoughness,” often influenced by societal pressures, academic stress, and peer comparisons. These feelings can undermine confidence and personal growth. Therapy offers a safe and non-judgmental space for teens to explore their self-worth, understand the origin of their self-esteem injury, and develop a more positive and resilient self-image. I work with my teen clients on fostering greater resilience, self-acceptance, and personal empowerment to create a lifelong foundation of positive self-regard.
Self-discovery and identity formation is a core aspect of adolescence, yet it can also be marked by feelings of insecurity and low self-esteem. Many teenagers grapple with doubts about their self-worth, often influenced by family values, formative relationships, media, societal pressures, academic stressors, and peer comparisons. These feelings of low self worth and insecure identity can hinder social, academic, and romantic experiences in adolescence. Therapy offers a safe and non-judgmental space for teens to explore their self-worth, understand the sources of their self-esteem issues, and develop a more positive and resilient self-image.
Adolescents are faced with the task of self-discovery and establishing autonomy. Teenagers are in the process of figuring out who they are, what they believe in, and what values resonate with them. This exploration often involves a complex interplay of societal, familial, and peer influences. I spend a lot of time in sessions engaging in narrative therapy with teen clients to clarify their values, aspirations, and develop a clearer sense of self. This ultimately helps them head out into the world with heightened confidence to make informed decisions that align with their emerging identities.
I am passionate about helping teenagers navigate the complex journey of self-discovery and healing through Internal Family Systems (IFS) informed parts work. This model is a radically compassionate and non-judgemental approach that looks at conflicting feelings, motivations, and behaviors as a natural part of the human experience. I join my teen clients as we explore their inner worlds and understand the various parts of themselves. Through an IFS-informed approach, we uncover the protective, wounded, and often conflicting aspects of their inner selves, promoting self-awareness and self-compassion. The benefits of this work can be profound – it empowers teens to better manage their emotions, build healthier relationships, and ultimately find harmony within themselves through radical self-compassion.
Since adolescence is the launch pad into adulthood, I usually weave a hefty amount of future-focused identity formation work into sessions with teens, offering Narrative Therapy and Solution-Focused interventions. With this approach, I help my teen clients uncover and rewrite the narratives that shape their self-concept, aspirations, and goals. Meanwhile, Solution-Focused work allows us to harness their strengths and explore practical strategies for achieving their desired future. By exploring their personal stories and values and learning tools for setting those values in motion, teens can feel more empowered to make intentional choices about who they want to be and strengthen their vision of the future.
I also integrate Eye Movement Desensitization and Reprocessing (EMDR) into my therapeutic toolkit to assist teenagers in processing and healing from past traumatic experiences. EMDR is an evidence-based therapy that can help individuals reprocess distressing memories, connect those memories to engrained negative cognitions, install new positive beliefs, and learn tools for coping and nervous system regulation.
Along with the above talk-therapy and EMDR interventions, I incorporate expressive arts, music therapy interventions, play therapy, and somatic, body-based work for many teens. This can look like: