Being a teenager is really hard. There are so many demands coming from every direction – school, home, friends, jobs, college prep and planning, and the lingering effects of the pandemic. At times it can feel overwhelming, with no way out. You deserve more respect now that childhood is behind you, even though you’re still in the process of becoming a full adult. What you really need is for someone to hear you, truly hear you. We offer therapy for teens, specifically, to address these concerns.
Parenting a teenager is hard too. You remember how awkward it was for you, all the mistakes your parents made. As hard as you try to correct your parent’s errors, you find it a losing battle. While you might try to offer support, it seems you can never find the right words or approach, and as a result, no matter what you try, you often are making it worse. A teen therapist to hear you out and give you some pointers may be the answer you need.
FAQs for Therapy for Teens
FAQs for Caregivers of Teens
What can you expect from therapy for teens?
You can anticipate working with a therapist that wants to understand you. They will want to learn about the cause of your struggles, how you’ve tried to help yourself, and then give you options for success moving forward.
They can offer something that few others can – an objective, outside view of all the things that are making life hard for you. This perspective will then allow them to help you dig into the causes, and make meaningful change.
What can I expect if I put my teen in therapy?
You can anticipate working with a therapist that wants to understand your teen in the context of their life and experiences. They will want to learn about the cause of their struggles, how you’ve tried to help them, and then give you options for success moving forward.
However, they can offer something that few others can – an objective, outside view of all the things that are making life hard. This perspective will enable you and your teen to dig into the causes, and make meaningful change.
How much will my therapist share with my parents/caregivers?
While under the age of 18, your parents/caregivers can legally request access to all of your medical records. This includes any time you see a doctor or a mental health professional, like a therapist. Although guardians have the right to request your records, we ask that they respect your privacy. In order for therapy to be effective, you must feel emotionally safe within the therapeutic relationship. We do have to share safety concerns with them. We will make every effort to discuss it with you first and keep you involved in the process.
Specifically, we will share the following: if you have plans to hurt yourself or someone else, if you share that you have been abused in some way (neglect, physical or sexual), if we have written consent (like with your insurance company or a psychiatrist), or if your records get subpoenaed by a judge. Other situations are less clear, such as drug and alcohol use, self-harming and sexual behaviors. These are not automatic reasons to break confidentiality, each situation is different. Your therapist will talk about it with you. If you are concerned about what they will share, feel free to ask.
How much will my teen’s therapist share with me and what is kept confidential?
As a parent or caregiver, you have the legal right to request your teen’s medical records created before they turned 18. This includes any time they see a doctor or a mental health professional, like a therapist. Although you have the right to request these records, we ask that you respect their privacy. In order for therapy to be effective, they must feel emotionally safe within the therapeutic relationship. We will share safety concerns with you.
Specifically, we will share the following: if your teen has plans to hurt themselves or someone else, if they share that they have been abused in some way (neglect, physical or sexual), if we have written consent (like with your insurance company or a psychiatrist), or if their records get subpoenaed by a judge. Other situations are less clear, such as drug and alcohol use, self-harming and sexual behaviors. These are not automatic reasons to break confidentiality, each situation is different. If you are concerned about anything in particular, please speak directly with their therapist.
Throughout treatment you will remain an integral part of your teen’s therapy. You are welcome to schedule parent sessions and/or time during your teen’s session to meet privately with your teen’s therapist, or as a family. Your input helps the therapist see the bigger picture, and provides important feedback around your teen’s progress.
Why would I go to therapy for teens? How will it help me?
Everyone has experiences or thoughts that they feel embarrassed or uncomfortable sharing with others. Adults in your life have their own agenda and bias, they just don’t understand the pressure you are under. Friends might be able to relate to you better, but they’re in the same position as you – struggling and looking for helpful guidance too.
Teen therapists learn how to really listen, understand deeply, and support you without judgment. That’s their number one job, to really listen. Of course you’ve made mistakes and done some regrettable things, that’s a part of life.
Your therapist helps you explore the reasons behind your choices, repair any harm caused—like rebuilding your parents’ trust—and create a stronger plan for your future. All without judgement and big emotions. Does this sound like something that could help?
When should I be concerned about the teen in my life and consider therapy?
Fluctuations in identity, such as hairstyle, clothing, and musical taste are a normal and healthy part of development. You should be concerned when the teen in your life shows significant changes – sleeping and eating habits, their friend group, drops in school performance, quits activities, and non-descript physical symptoms (headaches, upset stomach). Other red flags include a consistent increase in isolation (not just from family), irritability, anxiety and aggression. Life changes, such as a move, divorce, or death in the family would also be grounds for extra support.
As a teen, what can you help me with?
We can help with a wide range of topics you might be facing:
- Peer pressure
- Self-esteem
- Expressing big emotions, like anger
- Better ways to communicate
- Big life events – parent’s divorce/remarriage, changing schools, moving
- Traumatic events – car accident, a death, abuse
- Questioning your identity
- Self-harming behaviors
- Suicidal thoughts
- Drugs, alcohol or other addictions
- Managing social media
As a parent, how can I support my teen through therapy?
The most effective way to support your teen, is also the hardest thing to do. You’ll have to relinquish some control. What they need more than anything is a unbiased, trusted adult. Being their parent or caregiver means your hopes and dreams for them shape how you see things.
Even though it comes from a place of love, fear, or insecurity, you need to take a step back and allow their therapy to be private. It is appropriate for them to have boundaries and not share everything with you – a crush on the new kid, thoughts about trying out for or leaving a sport, every disagreement with their BFF. At this age, they are learning how to work through things on their own, it’s healthy and empowers them for future decision-making.
If this is what your teens talks sound like, and you drill them about it, you will create a bigger wall between you; they will be less likely to open up in the future. If the therapist tells you about the details of the session, they will lose your teen’s trust and therapy will be ineffective. The therapist has just become another adult that they can’t rely on.
Again, the most effective way to support your teen, is also the hardest thing to do. Give them the space to explore whatever it is they need exploring.
- Before session – help them be intentional about what to bring to therapy. Do you have something on your mind that you’d like to take to therapy today? Have you thought about what is the most important thing to share today?
- After session – ask about how it was, get a temperature check to see if it was particularly emotional and if they need some extra TLC to help regulate. Did you get what you needed? Anything you’d like me to know or that we should talk about? This reminds them they CAN talk with you if/when they are ready.
- Share your concerns/observations with the therapist. Let them know if life is improving or getting harder. Teens don’t always know how to communicate this effectively or explicitly.
- Be open to feed-back from the therapist. If they share parenting tips, it’s because they see it as an area of improvement for you and something that will help family dynamics. They have the same objective as you – to help your teen live a happy and healthy life. They can also see when we get in our own way, when our baggage and insecurities has a negative impact on our parenting style.
- You therapist will inform you of any safety concerns. Therapists are mandated to, and will, report child/elder abuse/neglect and imminent suicidal and homicidal intentions. In session, the therapist will address the nature of these concerns, then work with your teen to develop a way to talk with you about it. This can work in too many ways to list out, know that the therapist will do what is necessary to keep your teen safe from harm. This warrants breaching confidentiality.
What happens in the first few sessions in therapy for teens?
Great question!
- Intake/first session: Depending on your age and what’s going on, your therapist may divide up the time between just you, just your parent, and all together. It’s important to have individual time with the therapist so each of you can share your concerns as openly as possible. It also helps to have you together so that they can see how the family communicates with one another. For your individual time, it will be about getting to know you. Why did you come to the appointment? What do you want to change in your life? What are some of your interests? Remember, you decide how much you want to share. These things take a little time.
- Ongoing sessions: As you and your therapist get to know each other, and your therapist has a better understanding of what is happening in your life, you’ll work together to develop a plan. Often this means just you and your therapist meeting together, with your parent checking in at the beginning or end of the appointment.
Are there any tips to approaching the topic of therapy for teens?
The good news is that you’re off to a great start by reading up on it. This proves you genuinely care and want to support change. Communicating this in a compassionate and unified way will make all the difference. In a calm conversation, it can sound like ‘I’m really concerned about your change in mood, you’ve been very (isolated, quiet, sad, unmotivated…) lately. Maybe it’s time to find someone who can help, since we haven’t been able to tackle it on our own.’
On the other hand, if therapy is used as a threat, that’s a quick way to gain resistance from an already defiant teen. Avoid heated comments such as ‘If you can’t snap yourself out of it (or improve your grades, stop cutting…), then you’re going to go therapy and see if they can put some sense into you.’ I promise you, this is NEVER helpful!! If this sounds like your household, it may be helpful for you to meet with a therapist for a few sessions. They can help you understand why it’s so stressful for you and give you some communication tips.
As far as frequency, how often do I have to go to therapy for teens and how long will it take?
The short answer to this question is ‘it depends’. There are a lot of factors that influence these decisions. Often, it’s best to meet once a week. This will help you move forward faster than if you meet every other week or monthly. Your therapist will be able to monitor how you’re implementing the skills you talk about and make adjustments faster with weekly appointments. However, there are other conflicts, such as school, after-school activities, jobs and finances that may make weekly sessions hard.
As to how long it takes, typically a couple of months. If you are needing more coping skills to deal with stress and anxiety, your therapist will focus on helping you find ones that work really well for you. For some teens, their struggles go deeper and take longer to work through. It is a very individualized process, so this is a great question to ask of your therapist.
As far as frequency, how often will my teen have to go to therapy for teens and how long will it take?
The short answer to this question is ‘it depends’. There are a lot of factors that influence these decisions. Often, it’s best to meet once a week. This will help your teen move forward faster than if they meet every other week or monthly. Your teen’s therapist will be able to monitor how they’re implementing the skills they talk about and make adjustments faster with weekly appointments. However, there are other conflicts, such as school, after-school activities, jobs and finances that may make weekly sessions hard.
As to how long it takes, typically a couple of months. If they are needing more coping skills to deal with stress and anxiety, their therapist will focus on helping them find ones that work really well for them. For some teens, their struggles go deeper and take longer to work through. It is a very individualized process, so this is a great question to ask of your teen’s therapist.
Will my teen therapist give me homework?
Again, it depends. Some therapies do use homework. This can be worksheets to help you track your moods and coping skills, or to practice using coping skills you and your therapist come up with. The purpose of homework is to help you make changes to your behaviors out in the real world. It’s one thing to talk about how to handle a bully in the safety of the therapy office, it’s another thing altogether to try it out in the school hallway. We develop bad habits (avoiding that hallway, giving in to the bully), it takes intention and practice to change those habits for healthier ones.
General FAQs about Topics in Therapy for Teens
When should I be concerned about Social Media use?
Social Media has it’s benefits, it’s a quick way to connect with others, join groups of interest and learn information. It becomes concerning when our identities become wrapped up in the feed-back it provides us – in particular how many friends/followers we have, and the number of likes and/or comments per post. For some, it escalates to equating with our self-worth.
It’s helpful to be aware of the biology of the teenage brain. The prefrontal cortex (directly behind your forehead) doesn’t completely develop until around age 25. This is the part of the brain that helps with weighing pros/cons for good decision making. Teenagers struggle with evaluating if they are reading something that is true or not, and how what they share/post will affect others in their life because their brain hasn’t fully developed yet. Having open discussions about consequences will help them develop this skill.
Be sure to be involved in your teen’s on-line presence. Regularly log into their account (not just as a friend/follower) to see what is being shared privately.
My teen is suicidal, what can I do?
Nothing sends a parent into panic like the thought that their child is suicidal, and rightfully so. It’s important to keep in mind that even though they may be expressing suicidal thoughts, it may not mean that they are actively suicidal. When you learn your teen is thinking of suicide as an option, you want to be calm, supportive and the voice of reason. The most important thing for them to hear is validation of their emotions, even if/especially if, you don’t understand them.
When people outcry, they are looking for support and help. Minimizing their experiences/feelings/pain, giving them advice about how to handle it or labeling it as attention seeking, will only direct them into deeper despair. Giving them a listening ear, without judgement or opinions, allows for human connection and being seen. Only after this is done should you move into supporting them with solution oriented problem-solving.
If they have made an attempt, or have a specific plan (overdosing on pills, walking into busy traffic, using an accessible gun or razor blades), then it is time to get immediate help. Get them to a hospital for professional evaluation and to enforce safety measures.
If you are concerned, for yourself or someone else, call or visit the 988 website. The suicide and crisis lifeline is available 24 hours a day in English and Spanish to offer support.
If there are immediate safety concerns, call 911.
Could my teen’s poor sleep habits be linked to changes in their mood or behavior?
Teens require 8-10 hours of sleep a night; their bodies are physically maturing and growing, and their brain continues to make connections and develop. 8-10 hours is hard to negotiate as their natural tendency is to stay up later and school tends to start earlier. Lack of sleep can result in mental health issues, such as anxiety and depression, which greatly influences sleep habits.
Sleep hygiene is important to support a healthy balance. Planning ahead with school work (around other responsibilities such as sports and jobs), a bedtime routine (same time every night – brush teeth, read a book, turn off electronics), avoiding caffeine and energy drinks and making the bedroom a comfortable and relaxing place to be (cool, dark and quiet, for example) will all be helpful.
At what point does alcohol or drug experimentation become a concern?
The teenage population is particularly susceptible to experimenting with drugs and alcohol. Transitioning to adulthood and trying to figure out who they are is an incredibly stressful time. Learning their own boundaries, identifying values and establishing career goals can give way to curiosity with unhealthy ways of coping.
For many, experimenting with a substance a few times is enough and doesn’t escalate. For others, it can spark concerns of misuse and potential addiction. Although it is impossible to predict, there are some warning signs. Adolescents that have a family history of addiction, experience depression, have low self-esteem or feel as though they don’t fit in are more susceptible are more likely to have uncontrolled use.
At this time, we don’t have any therapists that specialize in addictions, we are happy to help you find someone that would be a good fit.
What do I do about my teen’s sexual orientation and gender identity?
Since adolescence is a time of curiosity and confusion, this can also relate to their sexual orientation and gender identity. Emerging hormones and social media influences exacerbate this often chaotic time. Should your child express uncertainty about who they are, don’t be alarmed. This is a normal and common part of development. For the wellbeing of your teen, and your long-term relationship with them, it is helpful to be supportive and validate their process.
Are there ways to help my teen have a healthy relationship with sex?
Puberty brings with it an explosion of hormones. It not only brings acne, awkward growth spurts, but sexual interest. It is a universal experience. Unfortunately, it comes at a time when the brain is not fully developed and able to make wise, thought out decisions. How these urges are handled can be a difficult balance.
It typically starts around age 13/14 with curiosity, and increases from there. Self-exploration (masturbation) is very common and developmentally appropriate. Should you discover your teen engaging in these behaviors, it’s important to validate it as a typical response to normal feelings. If it is addressed with the intent to shame or embarass, the teen may struggle with healthy sexuality and sexual relationships in the future.
As they get older, their exploration will start to include others, usually in similar age. If there is an age difference (more than a year or two), that would be cause for concern regarding coercion and pressure. This is considered abuse. Legally, any sexual activity with anyone under the age of 18 is considered statutory abuse, even if it is mutually agreed upon (consented) and between agemates.
Puberty is starting earlier and earlier. This can be as young as 10 years old. In these situations we may see sexual interest starting at a younger age. Early interest may also be connected with early sexual trauma. Young children that engage in behaviors beyond exploring bodies, or have a strong fixation may benefit from an evaluation.
Although it may be uncomfortable, having open conversations with your teen is the most effective way to ensure sexual interactions are emotionally and physically safe. These conversations can be around setting boundaries and saying ‘no’ to unwanted sexual acts/advances, being able to hear and respect when they are told ‘no’, pregnancy and STD prevention and healthy relationships.
My teen is self-harming, what do I need to know?
Self-harming is not a new phenomenon, however in the digital age it seems to have gotten more attention. Typically, it manifests as non-suicidal cutting. This is done on various parts of the body, often forearms, upper arms, torso and upper thighs. Other behaviors include burning (with fire or an eraser), biting themselves, and head-banging.
The intention behind this behavior is to experience relief from emotional discomfort – anxiety, depression, guilt, shame, overwhelm, loneliness. The creation of physical pain can be experienced as a tangible expression of the emotional pain. The most effective way to treat it is to identify the underlying source of emotional pain and address it. See our other pages regarding specific diagnosis for more support. Treating anxiety, depression, grief and PTSD.
When are my teen’s eating habits are excessive?
Disordered eating takes 2 forms:
- Anorexia is typically found in people that are high achievers. Despite their success, they feel out of control and restrict their diet as a way to manifest power over their life.
- Bulimia is when a person binge eats (eats excessively in a short time period), feels regret, and purges through self-induced vomiting, extreme exercise or using laxatives.
Both forms are very hard on the body and can result in long-lasting medical issues. Both forms show up in both genders. Early intervention goes a long way.
How to Start Therapy for Teens Today
Blue Horizon Counseling is excited to provide support for teens and their families, both in person and virtually across Texas. We understand the unique needs of adolescents. We also recognize that teenagers are not one size fits all. Several therapists are on staff to meet your individual needs and preferences, offering a variety of different kinds of therapy. Follow these steps to get started today:
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Contact Us
Have your first session
Address your Stressors
Once we’ve verified your insurance benefits, you will schedule your first appointment, the intake. This is where you’ll get to know your therapist and set therapy goals.
As you continue to meet with your therapist, and develop a relationship, you will start to notice progress towards your goals. Life will feel more manageable, and you can plan for a better future.
Resources about/for teens
BHC Approach to Therapy for Teens in Texas
We use several different treatments to work with teens and adolescents. Which one is the best fit for you?
Cognitive Behavior Therapy
CBT is perhaps the most widely known type of intervention and one that most graduate schools teach their new therapists. It uses a model that says after an event happens (a friend doesn’t text back), you have a thought about it (they hate me, or they are busy), which produces a feeling (rejection or indifference) and then a behavior (isolation, or going on with your day). Your thought influences your feelings and behaviors. By changing your thoughts, you change your feelings and behaviors.
Learn more Cognitive Behavioral Therapy.
These therapists offer CBT: Barbara, Heather R, Lee Ann and Madeline
Eye Movement Desensitization Reprocessing
EMDR has been around since the late 1980’s. It takes advantage of natural brain processes to ‘thaw’ memories that have been ‘frozen’ in time. These memories lay the foundation to current struggles (depression, anxiety, PTSD). Once the memory is processed, it no longer influences how we think and feel about ourselves and the world.
Learn more about Eye Movement Desensitization and Reprocessing.
These therapists offer EMDR: Barbara, Heather, Lee Ann and Madeline
Family Systems Therapy
Family systems therapy sees each member of the family as one peice of the larger family. This approach will focus on relationship patterns, roles in the system and how communication occurs (or doesn’t). The family is ‘the problem’, rather than one person.
By healing the family, or the system, you also heal the individuals. We can visualize this as a ripple in a pond. One individual’s struggle (with mental health, sobriety, or work issues) creates waves that affect the whole family (the pond). When the surrounding water learns to absorb the impact differently, the disruptive ripple loses its power.
Learn more about Family Systems Therapy.
These therapists offer Family Systems Therapy: Madeline
Holistic/Integrative Approach
In an era where personalized care is increasingly valued, integrative therapy has emerged as a flexible, client-centered approach to mental health treatment. Unlike traditional models that adhere strictly to one theoretical framework, integrative therapy blends elements from various schools of thought to tailor interventions to the unique needs of each individual. This holistic approach not only acknowledges the complexity of human experience but also maximizes therapeutic effectiveness by drawing from a broader range of techniques and philosophies.
Learn more about Integrative therapies.
These therapists offer Integrative therapies: Barbara
Person Centered Therapy
Person Centered Therapy focuses on 3 core principles. ‘Unconditional positive regard’, you are accepted and valued as you are, regardless of anything else. Empathic understanding is the ability to perceive another’s feelings and thoughts. Demonstrating congruence refers to therapist’s willingness to be genuine and true to who they are.
Your therapist will follow your lead in a supportive and empathetic manner. This approach allows you to focus on your own needs.
Learn more about Person Centered Therapy.
These therapists offer Person Centered:
BHC approach to medication
Medication can be a very useful addition to the therapy provided by your therapist. We are open to discussing medication options with you. It is important to note that we will never require medication, or try to persuade you in either direction (to use or not to); however, we will share observations and insights from our own experiences and observations.
We do not have anyone on staff that is able to prescribe medication, however, we can help you find someone that can.
