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Adolescence
Helping Teenagers who Live in Dysfunctional Families: Part 2
Can We Actually be Helpful When They Still Go Home to Trauma?
Posted May 13, 2015
Last week I posed a question that so many therapists grapple with in their work:
How can therapy with teenagers be effective when every week they leave the session and have to return to a family system that is dysfunctional or unsupportive at best, or actually attempts to undermine or sabotage the progress that is made in treatment?
How do we navigate this? And does it make sense to work with these teenagers? I believe that despite this very real challenge and the fact that their parents might be uncooperative or uninvolved in their treatment, there are issues that are worth focusing on and ideas that can be processed in therapy.
Teach the teenagers you work with that their wellbeing is not actually contingent upon whether or not their parents get their acts together. This is often a new concept for them. As teens continue to evolve, their behavioral choices become the arbiters of their wellbeing. Their parents might never change or “get it” but adolescents can still gain insight and move forward. This can restore a sense of hope for you and your clients.
Empower the teens you work with to take full responsibility for the things in their lives that they can control and help them to recognize and let go of what’s not in their control. Helping teens to make this distinction adds to the process of individuation and can reduce the cognitive distortions that promote self-blame and shame. Naming the things that are in their control like getting decent grades, hanging out with healthy friends, choosing to not engage in self-destructive behaviors is a way to install genuine empowerment and accountability.
Make the therapy future oriented. Look towards a time when they can be more independent in their lives. Put it on their radar screen and normalize the process of individuation to reduce their feelings of guilt. Encourage them to discuss their dreams and goals so they recognize there will be many chapters in their lives beyond living with their parents.
Help teenagers to focus on cause and effect. When they make specific behavioral choices, process how that will impact their ability to realize their future goals. The adolescent brain is not fully able to do this degree of abstract thinking so teenagers need therapists to model the skill of assessing future consequences before making a decision.
Normalize that teenagers can feel opposing feelings towards their parents at the same time. Most adolescents need support in balancing the combination of holding love for their parents as well as resentment or anger when their parents fall short or let them down. As you create a safe space for them to express their frustrations, try to include a discussion of their parents’ strengths as well.
Put dysfunctional family dynamics in a generational context. Explain that their parents might not have effective parenting tools because they were not parented effectively. Empower teenagers to break that generational cycle of neglect or inadequate parenting by learning from their parents and making conscious choices that are different.
Never underestimate the power of the therapeutic relationship and the modeling it offers teenagers even if they can't totally integrate it until later in life. Know that you are still planting invaluable seeds, offering the reparative experience of a secure attachment and helping that teenager to feel seen and understood in the world. We never want them to choose between their parents or us, but we can still leave a lasting impression of compassion that they will carry with them long after they terminate their therapy with us.
What has been your experience in working with teens who live in dysfunctional families; and what issues do you find helpful to process with them in therapy?
