Don’t Back Off

Mistakes that therapists often make when working with struggling teens by Doré E. Frances, PhD

Mistake 4: Telling Parents to Back Off

Teenagers almost always come into therapy as well a residential treatment, complaining their parents are too strict and controlling. As a result, therapists who specialize in individual work with teens often get a misguided impression of what goes on at home and frequently advise the parents of teens to be more lenient – to relax their control. In fact, parents who yell and cajole are usually trying to avoid imposing a consequence on their teen. In that respect, they are actually protective and lenient. 

Screen Shot 2015 06 02 at 1.12.12 PM 300x259 Dont Back OffAmong the most harmful “back off” positions that therapists sometimes take with families is that young people have an inherent right to privacy outside the therapy room. Many parents I see report that their therapist actually criticized them for nosy and intrusive actions. It is crucial to remember that proclamations of privacy by troubled teens are simply ways of concealing things from their parents and maintaining the power position. It is only a teenager who is responsible and doing well who has earned the right to privacy and trust.

Therapists who make parents feel guilty about reasonable investigation into their child’s activities send the message that the teen is in charge. The privacy issue extends to many areas. When parents discuss drugs or sex with their teen, they are likely to hear, “It’s my body and it’s my choice.” Through this logic, there isn’t much that parents can do to help a troubled child. Therapists must address with parents their right to change their teen’s behavior around sex, drugs, smoking and dangerous friends.

All of these issues have to be faced and an understanding reached.

The more information parents have, the calmer and more in control of themselves and their parenting they will be. Parents who have little information about their child’s life are likely to be angry, reactive and inconsistent. The final and critical area in which advising parents to back off is an error is when teenagers are diagnosed with psychiatric disorders. Too many clinicians seem to believe that the best course when a young person is acting aggressively because of a psychiatric problem is for parents to be patient.

The underlying message from such therapists often is, “You as parents don’t really understand about this problem and need to leave it to us experts.”

As parents do less, the problems get worse. Craziness pays off if the child is not expected to respond reasonably. In my work with parents, I always stress they have a right to expect reasonable behavior of their son or daughter and “repressed anger” doesn’t give children the right to be verbally or physically abusive or self-harming.

This affirmation helps parents get beyond the too common idea that if they put pressure on a son or daughter who has a psychiatric disorder, he or she will only get worse, . . . and it will be their fault.

Structure is a healthy form of pressure. As parents feel more like successful family leaders, the negative emotional pressure abates.

 

Almost all therapists who have worked with teenagers have found themselves stuck in a clinical impasse with an explosive teen and his or her family. Yet it’s never too late to make a paradigm shift and help a family.  

First, a therapist must become comfortable with the idea of dealing with power tactics rather than communication skills. Doing so also requires getting used to having teenage clients who don’t like the therapist. The more aggressive a teenager is, the more certain it is that they’ll try punishing the therapist.

When my teen clients call me names I usually say, “You can’t hurt my feelings because I am not your mother. So I’ll keep doing what needs to be done.”

Second, therapists must be ready for greater problems initially. Most therapists prefer their treatment to calm things down and leave people feeling better. This strong therapy may escalate the problems initially, and this is scary for both therapist and family. The therapist must reassure the family that this escalation is expected and will be momentary. Therapists are mostly kindly helpers, so it’s counter intuitive for a therapist who works toward nice outcomes to step toward the fire and heat things up.

However, once a therapist has helped parents take charge and has seen the remarkable positive transformationScreen Shot 2015 06 02 at 1.08.52 PM 300x195 Dont Back Off in a formerly tormented teenager, it becomes easier to work this way. Parents start out saying, “It looks like my daughter’s possessed.” At the end of six or eight sessions, the same parent says, “My son’s back. He isn’t always sweet, but the boy I love is back.”


Professional therapists are there to help individuals and families deal with their problems in a meaningful and productive way.

Using problem-solving therapy techniques, treatments for teens average six to ten sessions, and then if things have not changed an out of home placement may need to be discussed.

When appropriate, professional therapists have no difficulty in working closely with other referring professionals to be certain that everyone involved is working toward the same goal.

This collaborative partnership helps to resolve complex problems for teens and their families more quickly.

Check out this important video on Fear

The roller coaster of adolescent treatment

debate small The roller coaster of adolescent treatmentI am the mother of a 16 year old son.  We are in the midst of trying to discern if Shelterwood would be the best place for our son right now.  We have reached a point at home that we feel unable to help him.  He is failing school (He is very bright), angry at God, angry at his family, and has been stealing money from us.  He has become verbally abusive to our whole family.  We have been through numerous counselors, a psychologist, his pediatrician, pastor, etc. and no one has been able to help.  He has been accepted to Shelterwood, but as a mom, I am so torn with sending him away.  I was hoping to be in touch with a few parents to see how they dealt with this decision, what behaviors in their child led them to this decision, how the child felt about being sent to Shelterwood, and ultimately the result.  How long has your son been home?  Were you able to get the family counseling from Shelterwood that helped restore the relationship between you and your son?  Was coming home difficult for your son, and have the changes he made there at Shelterwood continued as he has remained home?  Anything that you could tell me, pros or cons regarding your experience would be so helpful.  I know your heart has been where mine is now, and I think it would help if I could hear from another parent who has been there.

Thanks, Concerned mom

 

Hi Concerned Mom

You are in such a tough place and I ache for you because I’m sure every day for your family is a roller coaster ride from what you described. Yes, we were in a similar condition and made the decision around thanksgiving time, but I couldn’t let go of our “holiday”.  Our son told us he wouldn’t go there and we’d need to have him taken by cops (escorts), so we did just that and it worked much smoother than I could have ever imagined. We did exactly what the service said to do and it worked. Our son was surprisingly calm by the time they got him there and cordial to us until the counselor let us alone for just a minute or two and then he lashed out in hate. Didn’t know if he’d ever speak to us again, but we had to pursue this for our other child and for our marriage…

Ten months later and a lot of emotional work, a few bumps and he came home. It has been working and I would do exactly the same thing again. He graduated recently. It isn’t perfect, but we grow and work through things much better and he is scheduled to graduate high school in May and go on a mission trip to Nepal in July!!!

You have done so much for your son, if you can possibly give him the gift of a chance to go to Shelterwood, follow their system and heal, God will bless you in a mighty way. If you do decide to send him, DO NOT PULL him at any cost or problem. Please work through the bumps and commit to see it through. I watched too many do the opposite and so did our son. He even said in his parting speech, “stop asking your patents to pull you and succeed in this.”

I’ve probably left a lot out, but will pray for you and would definitely appreciate a call from you even if we cry together. It shows what a great parent you are because you are even investigating this!
God bless you!

Shelterwood Alumni