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Counsellors and psychotherapists are experiencing ever-increasing complexity in their work with adolescents, as these young people try to navigate:

  • a post-pandemic world;
  • hyperconnectivity to social networks and uncensored information;
  • sexuality and sexual expression;
  • gender identity;
  • family and peer relationships;
  • emerging romantic relationships;
  • neurodiversity;
  • academic and achievement pressures;
  • parental separation;
  • adoption;
  • grief;
  • exposure to alcohol, drugs, gaming, pornography, and gambling.

Adolescents can often portray symptoms that are a reflection of their current ‘lifespace’ experience including anxiety; depression; self-harm; suicidal ideation; unhealthy relationships with food, alcohol, and drugs; obsessive compulsive behaviours; perfectionism; social phobia; and avoidance behaviours.

Whilst adolescents can often have a healthy, close relationship with a parent or guardian, they can avoid confiding in them due to feelings of shame, a legitimate fear of receiving a barrage of invasive questioning, or a desire to not worry them. In contrast, the young person tends to find the therapeutic encounter a valuable space to speak freely and make sense of their world with an objective adult and a recognised goal to enhance their wellbeing. The development of a trusting, safe, therapeutic relationship is paramount in facilitating this.

Parents/guardians can oftentimes contact a mental health professional in a state of urgency to either reduce the young person’s presenting symptom or eradicate a behaviour deemed to be inappropriate or dysfunctional such as panic disorder or school refusal. Patience is required by everyone in order to allow space for the adolescent to feel comfortable in sharing their lived experience in therapy, rather than introducing a pressure to ‘feel better’ or ‘do better’ prematurely.

A usual therapeutic experience can involve an initial ‘contact assessment’ session with at least one parent/guardian present together with the adolescent in order to gather as much background detail as possible; explore goals for therapy and boundaries regarding confidentiality and communication with parents; and establish consent to work with the young person. Psychotherapy then proceeds with the young person if they are agreeable to do so, on a 1-1 basis. Further interaction with parents may occur over time and as the need arises.