Sunday, January 8, 2012

Therapeutic relationship with the teenager

When counseling a teenager this is the therapeutic situation that I am wanting to set up with the various parties. This is the best case scenario and actually occurs in varying degrees.

Chap 10, fig

1. In counselling the teenager one is wanting the parents or those people who are responsible for the teenager involved. Most often they are willing to be part of it but at times they refuse to do so or they may simply not be around all that much.

The age of the teenager is directly inverse to the importance of the parents in this process. If the teenager is fourteen years old the parents are central in the therapy process as shown by the diagram. If the teenager is nineteen then they are usually much less involved. However if there is an emeshed family structure then the parents remain pivotal to the process until the child can gain some kind of psychological separation.

2. The diagram is to scale in terms of the relationships of the three parties involved. I am wanting to establish myself off to the side of the relationship between parents and teenager but a bit closer to the teenager side.

Teen goth 3

3. In the teenagers mind I am wanting to establish myself as a benign confidant and advisor. I am not with the parents and at the same time I am not against the parents. This is at times a hard position to maintain. I try to sit off to the side of the teenager parent relationship in this way.

4. The more emotionally important I become for the teenager the better. I am wanting to be benign in the sense of not seen as an adversary by the teenager but if they can emotionally depend on the me this is a desirable situation.

5. I will actively interfere in the relationship between the parents and the teenager. Indeed I can use this to keep my position off to the side. For instance at times parents need to put limits and controls on the teenager. I will discuss with them how they do this and encourage it. This in one way is not fair to the parents as they take all the heat and it allows me to avoid conflict with the teenager and remain in the position I am in the diagram.

Bowling girl



  1. Sometimes Parents threaten to cancel counselling for their teens because they are frustrated that therapy is not working and teens miss a few sessions because the last session was too close to the issues they ignore. Like it or not the therapist is at the centre of the teenage/parent dilemma but I hear what you say about "sitting off to the side Tony".

    I tell parents "its hard for me too". I tell teens "your parents are concerned about you and they do seem to want to help".

    Some teenagers are rampant because of less structure and too many parental permissions so if there is a way to use a good therapeutic relationship to imply the edges of negative behaviours, they do take it on, rather than rejecting. One doesnt need to spell it out to teens because they are sensitive to getting things wrong with a poor perception of self(seen through a faulty - under developed ego),and they refuse to be seen as 'the problem'. If therapist can model a different kind of Parent to client it gives another dimension for change unless that is, they are taking you for a ride too. Such is antisocial/borderline work! k

  2. Yes ken,
    As you say the more people involved the more there are to terminate the therapy contract. I may disagree with you, or maybe we just do it different ways. Teens do need structure. If I can I get that to the teen via the parents rather than me