Many adolescents fall through the cracks, only getting help when they’re in terrible trouble. Like in many things, the key is to pick up problems (like depression or anxiety) early on, when not much is at stake.  It will be easier for you and so much better for them.

Guest blogger, Donna Moss tells us about helping teenagers when they really need it.


These days we need to find a happy medium between "Race to Nowhere," a film about how to make school less competitive and more meaningful, and "Tiger Mom," a book about how to pressure your child toward success. 

What if your child is simply flying below the radar, doing just the minimum to get by, involved in nothing, with more screen time than a full time programmer? You think, maybe he'll go into computers, in some vague way. But all the kids can do that stuff. 

How do you motivate a teen who has few cares and doesn't care enough to care?  One of my clients claimed that his minority sounding last name will get him into a good college. That was the sum total of his effort. Or a girl who is in a gifted and talented school but whose parents were too busy working to structure her after school life in a proactive way. She spent the time alone, binging and purging in the bathroom. These are the kids I see in my practice and, arguably, the lucky ones, for at least there's some attempt for help, though they are often forced at first.

These teens often fall into three categories:

One: Adolescents who are not yet mature enough to take advantage of school.

  • Take Meredith, a very poor student with a single mom, who basically had no support throughout high school, although her parents kept up the pressure, they did nothing to actually help her succeed. No tutors, school supplies, structure or discipline.  Off to community college she went—and her lack of self-esteem with her. It's not simply that her family lacked the resources to help (a big problem in itself), they just didn't notice that their kid was falling through the cracks. They called her lazy when what she really needed was math help. The guidance counselors at the school knew this, but they were too busy (in a community near my work, they recently cut the guidance department to two, for 900 students).  Her parents had a vague idea there was something wrong, but there was no follow throughIn this case both the teen and the parent fell through the cracks...
  • Solution:  the therapy offered “re-parenting”, support and allowing the child to grieve the loss of both her father who physically left, and her mother who was “there but not there.” Once Meredith began to see she needed help, she was able to gain some crucial motivation for her future. While kids in the suburbs often look down on community college, it is often the perfect transition.

Two: Adolescents with an emerging identity who want what’s good for them and resist or rebel against their parents.

  • Take Howard, who came for therapy over the summer because he hated freshman year of college. He was the oldest and most capable of three children. And, he was pushed..hard.  This was an "A" student who dared to ask what every 19 year old asks at some point, what IS the point?  His parents went ballistic. The more they escalated, the more he seethed.  By the end of the summer they demanded, "Why is he so angry?!" No amount of politely pleading with them to listen to their son and back off the pressure would register. They wanted him to get ahead at all costs, but all he wanted to do was transfer or disappear.  
  • Solution: ask the parents to accept the child’s strengths and weaknesses more, and work with child to assert his own needs. Ultimately, school is not for mom and dad, it’s to have some power over one’s future and to discover what moves you. In therapy this young man got the courage to ask his parents if he could be a music major. After a heated battle, they allowed it…

The smart academic kids have lots to do generally. The emotionally and physically challenged hopefully get special services. However, those middle-of-the-road kids tend to get nothing. What's more, their parents often unwittingly contribute to this with a, "I don't want to label him" stance. 

Why not, I might ask, if FREE help is available?  The stigma is far worse they assure me.  So much for educational access.

Three:  The teen who suffers from depression privately, but his or her parents (and teachers) don’t see what’s really going on.

  • Teens who meet the criteria for mild depression can be tough to pick up. Slipping out of social contacts, staying in their rooms a lot, looking sullen and withdrawn and changing appearances can all be tell tale signs, along with falling grades, poor eye contact, changes in hygiene or eating/sleeping habits. It's very important for a therapist and even a doctor to thoroughly assess these things. 
  • Take Elise: pretty, smart and active, she suddenly withdrew from cheerleading after an incident of bullying with another girl. While we know plenty about depression from TV and celebrities, we still deny it in our own midst. Elise began cutting herself and watching dark YouTube videos with her door closed. When her parents discovered the depth of her struggle it had already been going on for six months
  • Solution: Therapy is required right away with a structured CBT program for learning distress-tolerance, relaxation and cognitive restructuring. The parents got a wake-up call but more importantly, Elise learned that uncomfortable feelings are OK.

CBT works very well in these situations. Ascertaining what goals the child has and structuring his/her time accordingly is often the first time they ever experienced freedom, ironically. For what better way to alleviate parental pressure than to just do your work and go to sleep on time?  I remind the kids, “You want mom and dad off your back? Do what you're supposed to, with these tools, and presto, they're gone!”

Falling through the cracks is a bad place to be; the trouble with cracks is that they’re hard to see.  These teens are at-risk for later difficulties. Sometimes the real problem surfaces around college, at which point there is less structured help available, especially academically.

Catch problems such as avoidance, low-level depression (dysthymia), and/or social withdrawal/learning disabilities early. Watch what your teen is up to and how he or she is feeling. The earlier you help your child get back on track, the better.

For more on how to boost a child’s self-confidence with basic organizational tools, see:; also set an alarm on your phone: do I have everything?  And check your locker at the end of the day!


To find out more about Donna Moss, LCSW-R see:


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