In March this year I completed Irish Association for Counselling and Psychotherapy (IACP) accredited training which qualifies me to work with adolescents aged 13- to 17-years-old. It truly has been a privilege to step into adolescent client’s lives since I started working with teens and it is certainly different than working with adults. You might read this and wonder why a teenager would ‘need’ therapy! Since March I have been quite reflective on this myself and have spent considerable time thinking about my own years as a teen. I cannot say I knew what psychotherapy, counselling, mental health or self-care was when I was that age.
I do remember having a meeting with a teacher towards the end of the Leaving Certificate and answering questions on a computer, a machine that would have been considered old-fashioned even in 2004! It then printed out a list of jobs that might suit me with the top two being woodworker and boat-maker. I smile thinking of this now compared to the educational experience that is on offer today. I walked out of that room with my printout and threw it in the bin. I barely knew myself, not to mind how much an out-of-date computer could know me. I could have done with some psychotherapy and counselling in my teens, instead I kept things to myself and got on with it. Maybe that was easier 20 years ago when the internet and smart devices were not readily at hand with endless information and social media…or maybe it was even more isolated and harder?
From a neurobiological perspective, adolescence involves significant restructuring of the brain. The limbic system, responsible for processing emotion, is highly active while the prefrontal cortex, which governs executive functioning, planning, and impulse control, is still developing into the mid-20s. That is a generalised statement that does not even take into consideration neurodivergence, which can present many extra challenges to a teen if it is unacknowledged and not supported. This explains much of the risk-taking, intensity and reactivity often seen in teenage behaviour. In the classroom or the home, this can be labelled as rebellion, disruption or bold behaviour.
In the therapy room this can be understood developmentally in the presence of an objective, non-judgemental and safe person. Instead of pathologising behaviour, therapists can help young people develop emotional literacy and regulation skills in a way that honours their developmental stage. Dan Siegel’s concept of the ‘Window of Tolerance’ can be especially useful when working with adolescents who move rapidly between hyperarousal, for example anger or anxiety, and hypoarousal, for example numbness or shutdown. Offering co-regulation, psychoeducation and gentle exploration can gradually expand a teenagers capacity to understand their experience, feel their feelings and stay connected to themselves and the world around them. This can often lead to better communication skills, more fulfilling relationships and healthier approaches to decision making.
Adolescence is a time which is a developmental bridge between childhood and adulthood where identity, belonging, autonomy and regulation are all in a state of flux. It is a period marked by emotional intensity, neurobiological transformation and increasing social complexity. Even more so today when teens have access to smart devices and social media, which influences them and puts a further layer of complex issues into their hands. Therapy with teenagers can meet this unique life stage with sensitivity, flexibility and a deep respect for the young person’s developing sense of self and identity.
In ‘My World Survey 2, the National Study of Youth Mental Health in Ireland’ developed by UCD School of Psychology and Jigsaw with 10,459 participants aged 12- to 19-years-old, it was found that nearly half of the participants experienced depression and/or anxiety. 627 of those teens shared that they had attempted to end their life. According to the World Health Organization, mental health challenges account for 16 per cent of the global burden of disease and injury in people aged 10- to 19-years-old. Depression, anxiety, self-harm and suicide are among the leading causes of adolescent illness and death. These are not just numbers on a page, they reflect profound unmet needs, relational ruptures and often the lack of a safe and attuned adult presence in teen’s lives across our country.
I must add here that this information is not intended to blame parents or teachers and so on, rather this is to highlight that adolescents are in a time in life, in which they may not even share their challenging experiences with best friends, not to mind any adult. Therapy for adolescents is not a specific technique, it is more so about building a relationship. Irvin Yalom, an American existential psychiatrist, professor and widely read author of both fiction and nonfiction, states insightfully that “It’s the relationship that heals”. This is true of all therapy, but for teenagers especially, as the therapist has the potential to be the first adult to really see them, listen without an agenda and honour their pain without trying to fix it.
By the time you are reading this it will be July. I cannot help but remember a few Julys in my teen years. More specifically the end of my Junior Certificate and end of my Leaving Certificate, as both of those times were stressful for me. Both of those times were also a paradox for me, relieved the exams were over, yet deeply uncertain about what comes next. For so many teens across our country that time is right now and could quite likely be defined for them by frightening uncertainty too. Maybe some teens are even wondering what the results will bring and incorrectly believe the results are a marker of their worth. A therapist and therapy can provide a teen the space in which they can experience no demands upon them, unchanging acceptance and an invite to get to know themselves better. It can be a place for an adolescent to unpack things and make sense of their lived experiences.
All of the things that show up in my therapy practice with adults, such as suicide, abuse, trauma, self-esteem, shame, anxiety, addiction, depression and more, can all be present for teens too. However, for teens, it can be much more closely guarded and well hidden from concerned parents and so on. Many teenagers come to therapy with experiences of trauma, whether acute, chronic, relational or systemic. Much research, including the Adverse Childhood Experiences (ACE) studies, have shown clear links between early trauma and later mental health challenges. A trauma approach with teens means understanding that behaviour is a form of communication and subsequently building safety through transparency, consent and pacing. This is very important when working with those whose trust has might have been repeatedly broken. Identity is also a core theme in adolescent development. For LGBTQ+ and neurodivergent teens, I offer therapy, which is not only inclusive but affirmative. This includes challenging pathologising narratives, validating lived experience and making space for fluidity and exploration. For many young people, the therapeutic relationship is where connection can be slowly rebuilt through being seen, believed and met with care.
If you are reading this and have felt concerned about your teenage child then therapy may be a supportive fit for them. I offer all parent(s)/guardian(s) a free 30 minute phone call consultation to discuss therapy for their teen and see if I might be the right fit. Therapy can be a place in which your teen experiences a steady adult who doesn’t flinch, lecture or abandon them with their thoughts, feelings and behaviours. Therapy with adolescents is not about solving their problems, more so it is about accompanying them, as they begin to face those problems themselves. As D.W. Winnicott, a famous English pediatrician and psychoanalyst, wrote in his book ‘Playing and Reality’, “It is a joy to be hidden, and a disaster not to be found”. Psychotherapy and counselling for adolescents can provide the space for a teen in which a therapist is present, not to unearth them, but to be there when they are ready to come into view, in their own time and on their own terms.
For more information on Leo’s services,
phone: 085 1300573
email: info@leomuckley.com
web: www.leomuckley.com
@leomuckleypsychotherapy
