Therapy for Teenage Boys
How do I get him to talk about his feelings?
In a lot of ways, teenage years are like “through the looking glass.” It is contrary to the real world, and things are not as they should be.
But, that is from the perspective of an adult.
For a teenager, all the behavior is as it should be even if it is not understood.
We sat there for two sessions in relative silence.
Most teens do not voluntarily choose to go to therapy. This makes therapy with teenagers different in some ways. And, so, expectations of how it should go are different.
I, as the therapist, cannot be like any other adult in their life, including caregivers. Otherwise, the teen wouldn’t be brought to my office – they would already be talking.
Flour, brown sugar, eggs, butter, and chocolate chips
These are the ingredients to make easy chocolate chip cookies. For therapy with teens, it can be made even simpler:
Power, Competence, and Significance
These are three core ingredients for successfully engaging teens in the therapeutic alliance –
Power – the teen feels he is making a difference in the relationship and the world
Competence – the teen is aware of their talents and strengths
Significance – the teen feels an important member of the relationship
Therapeutic Alliance is Key to any Therapy
Just as putting together ingredients does not mean you have made a cookie, there is more that I focus on with a teen.
I use survey measures at the beginning of session to see how the last week was and then at the end of the session for how the teen felt the session went. This gives the teen control over their therapy – they oversee their life for that time.
Sticking with therapy leads to better outcomes. That is why we focus intently on the relationship.
Have you heard the latest Post Malone?
Now we are getting somewhere. The minute a teenager is willing to share some of their world they are considering this therapy thing. There is almost an unlimited acceptance and acknowledgement for the teenager at that moment.
Judgement goes out the door – the only thing that remains is genuine curiosity. The teenager needs to feel in control of their life because they don’t perceive they have it anywhere else.
This is incredibly powerful for them because they can test out their thoughts and ideas… and often realize on their own what is the best course of action.
What do you talk about in therapy?
Caregivers are often very curious about what their teen talks about. Here is my standard response – if there is concern about safety or significantly risky behaviors, then you will be brought in.
Otherwise, the teen directs what you will know or not know – I often facilitate conversations between teens and caregivers in my office – when the teen requests it.
For this to work, caregivers often do need to be on the sideline. If therapy is not working or the relationship is not there – we will discuss it together… otherwise, trust they are doing exactly what they need to be doing in therapy.