“Yes, But:” Helping Teen Clients Move Forward

Michael A. Tompkins, PhD, ABPP

Teens who repeatedly respond with “Yes, but” are stuck; and their therapists are stuck too. “Yes, I’d feel better if I hung out with friends, but they’re too busy.” “Yes, I know you’re right, but it’s hard to do.” “Yes, I could try that, but I don’t know if it will work.” It’s imperative that you address the yes, but attitude early in treatment if the teen is to progress. Here are two ways to help teens understand the costs of a yes, but attitude:

• Reverse role-plays: Invite the teen to change roles with you. You play the yes, but attitude and the teen plays you, the therapist. To the suggestions from the teen, as the therapist, you answer yes, but. Take care that you don’t come off sarcastic. After several minutes, stop the role-play and ask the teen to reflect on what it was like to face all the yes, buts. “Did you feel frustrated, hopeless? Did you think, ‘They’re never going to get better?’ Did you question how helpful you are as the therapist?” Then, ask the teen whether having a therapist feeling and thinking that way is helpful to them.

• Yes, but-chairs: Make one chair the yes-chair and the other the yes, but-chair. Ask the teen to sit in the yes-chair and respond to your comments. After a few minutes, ask the teen to switch to the yes, but-chair and respond to your comments. Instruct the teen to switch between chairs for several minutes. Then, ask the teen to reflect on the experience. “How did you feel in each chair? What thoughts did you have in each chair? How might those thoughts and feelings get in the way of your progress toward your therapy goals?”

Michael A. Tompkins, PhD, ABPP, is a board-certified psychologist in behavioral and cognitive psychology. He is codirector of the San Francisco Bay Area Center for Cognitive Therapy, and is a faculty member of the Beck Institute for Cognitive Behavior Therapy. Tompkins is author or coauthor of fifteen books, and presents to national and international audiences on cognitive behavioral therapy (CBT) and related topics. His work has been highlighted by media outlets, including in The New York Times, The Wall Street Journal, on television (The Learning Channel, A&E), and on radio (KQED, NPR).