The Healthy Family Connections Podcast:

Are Psychotherapists Disempowering Parents?

Episode 028 · Duration: 00:16:51

Are Psychotherapists Disempowering Parents?

Is your child or teenager in therapy, with you wondering what’s going on? Today we’re answering a question from Keshia, of Brooklyn, NY. Keshia writes:

Our 15 year old daughter is experiencing depression with self-cutting and some substance abuse behavior as well. We asked for some recommendations and chose a therapist known to be good with teen girls. The therapist sees our daughter once a week and our daughter seems to like her, but we feel that we’re out in the dark. We’ve had a couple of sessions with the therapist, and she’s given us some reasonable advice, such as be sure to stay supportive, be more flexible with our rules, and not focus too much on grades right now, but we feel that we’re walking on eggshells. No matter what we say or do, our daughter acts annoyed with us and goes off to her room. How do we know if the therapy is helping or not? How can we get off of eggshells and feel more normal in our relationship with our daughter?

Keshia, you’ve asked a very important question and one I care deeply about from 2 points of view. Depression in teenagers, and particularly girls, is extremely high with recent data showing over 36% of girls having been depressed by age 17. I also feel strongly that therapists who treat teens too often undermine the parental role. But, adolescents need healthy empowered parents. So, to answer your question Keshia, let’s look at what depression is and how to best to treat it in teens. Then we can circle back to answer your question more directly.

Happiness Skills

In order to have good mental health, we need to have certain skills and circumstances that allow us to exercise those skills. Let me run through a short list of what I’ll call happiness skills:

• • Self-knowledge and self-acceptance: In other words, kids need to know a bit about who they are and aren’t, and have some comfort in that. Hopefully, as adults, we’ve figured out that while we might not be the best athlete, the top student, the best looking, or the most popular person, we can still have a great life with wonderful, loving relationships and deeply meaningful and rewarding work or activities in life. We’ve come to know and accept ourselves, but kids are just figuring this all out and they need some growing awareness in this area.
  • Passion and goals: Our teenagers need something to be excited and passionate about. Goals related to their passion and that generate activities move them forward towards those goals. That passionate energy helps them with identity development, skill development, and gives them incentive to manage the other responsibilities in their lives as well.
  • Emotional management skills: They need to have a relationship with their feelings, so that their feelings don’t overwhelm them. Needless to say, kids struggle in this area since they’re just growing up and learning all of this. Let’s face it, we all struggle in this area ourselves at times, so we need to cut our kids some slack here. But, they do need to have some beginning skill in this area to function successfully as adolescents.
  • Managing responsibilities: In order for kids to do well and feel well, they need to be able to manage the responsibilities in their lives. Those routine tasks that keep them from falling behind and getting into trouble. Much of this will relate to school, of course. If they don’t, they are always overwhelmed by the consequences that loom ahead. Most kids will need some help and structure from parents and teachers to be able to accomplish this, but with kids cooperating and parents and schools supporting, our teenagers will manage reasonably well.
  • Relationship skills: The ability to make and keep some friends and manage problems with others. Also, the ability to deal with adults reasonably well. I think we’re always learning and growing in this area, but kids need enough beginning skill in this area to build on.
  • And finally, faith that things will come out okay: Sure, they may be having a tough time in a relationship, on a team, or with a class or assignment, but kids need that basic sense that they’ll get through the rough spot and come out okay on the other side, that how they feel this minute is not how they will always feel, and support from family, friends, or some trustworthy adult will be there for them.

Mental Health Problems & Depression

If kids are way behind in their development in some of these areas, that can be a cause for mental health problems and depression. What if the circumstances a kid is facing is beyond their ability to manage them? In an extremely challenging social situation, bullying, or a situation in their family where they don’t feel safe or understood, and they don’t have the personal resources to deal with it, well, depression is going to show up.

There are a number of situations that many girls in particular are facing right now that cause them to be at risk for depression. Social media amplifies the already strong social pressure that teenagers, and particularly teen girls, feel. Now, instead of the social pressure ending at the end of the school day, it goes on endlessly and it can be nasty and hurtful, either because of meanness or simply by leaving someone out.

What if they are questioning their sexual identity? What if they have ADHD, a learning disability, are very shy and introverted, have a highly sensitive temperament, or are on the autism spectrum? These are all factors that will make feeling successful and fitting in challenging and can lead to mental health problems.

Of course, there can also be traumatic incidences: such as sexual assault, seeing something traumatic, the death of a family member, parents going through divorce or relationship struggles. These are all situations that can affect a teenager’s mental health and behavior, for which therapy is a good idea.

With any of these circumstances, our teenagers need their parents. In fact, when depressed kids are interviewed, they report that they’d like to talk with their parents if they felt their parents would listen and be understanding.

How Parents Should Be Involved

That’s exactly what therapy should be accomplishing—helping kids and parents get aligned so that kids can get the guidance and support they need from their parents as well as the structure and limits that virtually all kids realize they need and will need to accept. When teenagers are seen privately away from their parents, with minimal information coming back to the parents, it’s a setup for the parental role to be undermined. Parents will feel very much like Keshia feels, out in the dark and walking on eggshells.

As parents, we don’t always know what we need to do differently to more successfully support our teenagers. We don’t always know where we need to do more and where we need to do less. Heck, I’m a family therapist and I’ve always been pretty good at seeing what’s going on in my clients’ families, but I’m sometimes clueless in my own family. Sometimes we’re just too close to our kids to be able to see them (or ourselves, for that matter) clearly.

I read a study recently that reported that parents who taught breathing and mindfulness exercises to their teens with anxiety disorders benefited the kids just as well as therapists teaching those same exercises to kids. I’d submit that the benefit of getting those exercises from the family far outweighs getting them from a therapist. Why? Think of all the events that are happening when parents teach and lead the exercises. For one thing, the parents are role modeling healthy behavior. Second, if they do it regularly together, they’re building a healthy family routine and culture that will be part of that teen’s reality. Third, parents are learning and practicing healthy behavior that’s benefiting them as well as the whole family. If the parent’s anxiety is causing or adding to the teen’s anxiety, then the kid will now have a less anxious parent. And the parent will feel empowered to help their kid instead of anxiously waiting for the professional to help them. When the family culture changes for the good, every member of the family benefits.

First and foremost, mental health and behavioral issues with children and teenagers should be fully assessed and treated in the context of the family. Sometimes, a teenager wants to talk with someone other than their parents about their more personal issues and individual therapy then makes sense. If there has been trauma, grief, or intimate issues that a teen needs privacy with, by all means individual therapy is great. Sometimes, parents simply aren’t available due to illness, or a major mismatch in temperament, and a teenager needs the listening, support, and therapeutic guidance they can’t get a home. But, that must be determined after the family therapy option is addressed.

The Relationship Between Your Teen & His/Her Therapist

So, Keshia. In your case, I’d say the therapist may be helping your daughter, but not in the best way possible. You should not be on eggshells and the fact that you are makes me think you are in a passive form of a control battle with your daughter. I’d be surprised if you aren’t experiencing symptoms of parental burnout. Your daughter and her parents should be able to talk openly together with a therapist about her depression, what she needs to do for herself, what her parents need to do to support her, and what the therapist is going to do to help. Individual therapy in addition to that would be fine. As the parents, you need to feel like you know what the problem is, what the causes are, and the best way to help. You need to feel empowered. If your daughter’s therapist isn’t comfortable with that, I’d suggest that you find a therapist who is good with families and teens and go there together. If your daughter wants to continue with her current therapist additionally, that could work out fine as well. Both therapists will need to communicate together to make sure that they have the same understandings and goals.

I’ve seen some very poor outcomes of therapists working individually with teenagers and leaving the parents out. After all, if the only reality the therapist has is the one reported by the teenager, they will have a very skewed understanding of what’s going on in the family. Too often I’ve seen therapists take the side of a teenager and vilify the parents. Of course, even the concept of sides doesn’t belong in therapy, but if that’s the way the teenager conceptualizes things and the therapist gets caught up in it, then the therapist is supporting the problem and not a solution.

One situation I know of had a therapist threatening to call Child Protective Services on their client’s parents if they didn’t keep their young teenage daughter away from her older teenage sister who yelled at her on one occasion. There was another situation where the parents were desperately trying to get help for their daughter who was stressing herself out by saying yes to every opportunity that presented itself, only to have a kind of nervous breakdown. The parents were made to feel like it was their fault. In the end they were glad for the help their daughter received, but wouldn’t it have been so much better if they were part of the therapy and learned more about who their daughter was and how to support her, perhaps by helping her set better limits for herself? As therapists, we shouldn’t be taking over parental functions, we should be empowering parents, empowering kids, empowering families to be their best selves and achieve their goals.

Get The Help Everyone Needs

When our kids are having problems and our best attempts at helping them doesn’t seem to help, by all means, let’s get the help. Are we getting help for a kid, or are we getting help for a family? Here is my question and my challenge to both therapists and parents: are we counting parents in or out?

Remember, in the scheme of things, a therapist will be in a kid and their family’s life for a short period of time. A family’s influence is forever. If we help a family, we may be giving a gift that affects generations.

Thanks to Keshia from Brooklyn, for bringing up this important topic. Please feel free to come to my website at neildbrown.com and sign up for my weekly newsletter, where there is plenty of helpful stuff there right now, and plenty more in the pipeline. If you haven’t already done so, grab a copy of my book, Ending the Parent-Teen Control Battle. Many readers have told me it is the least expensive and best counseling session they’ve ever had.

If you’re enjoying my podcast, I’d love it if you’d go to my iTunes site at Healthy Family Connections, and leave a review there.

And please, take care of yourselves; you need it, you deserve it, you’re worth it.

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