Clients often come to therapy with significant difficulties that take significant dedication and effort to overcome. Yet they are often accustomed to standard medical care, in which the clinician does almost all the work and produces remarkable results with a minimal patient role (e.g., splinting an agonizing broken wrist; or prescribing antibiotics for a raging case of strep throat).
Most teens report feeling stressed out every so often, but for teens who chronically worry, the sense of being one step away from disaster never really goes away. Minor troubles are often blown out of proportion, leading to heightened anxiety and sometimes all-out panic attacks. Yet when parents try to coax teens to let go of their fears, their efforts are often met with resistance.
Research shows that gender and sexual minorities experience more mental health problems than their heterosexual cis-gender (when assigned sex at birth matches gender identity) counterparts. Here are some best practices that I have found beneficial while working with clients within these communities and for myself as a sexual minority:
Your session is almost complete and you and your client are ready to say goodbye. You are both walking to the door and suddenly your client says, “By the way…” and tells you something worrisome. It could be anything from “I’ve decided to go off my medication” to “I just met this woman and we’re getting married!” Why didn’t your client tell you this at the beginning of the session?
Hearing traumatic material from clients is tough work and can result in what the literature has termed vicarious traumatization of therapists. That is, the therapist can be traumatized by hearing a client’s story and absorb their pain. Therapists are human, and because we care, it hurts to hear another human’s pain. This is part of why we are effective helpers. However, it is crucial to have strategies for coping with our own pain and holding a client’s pain without feeling traumatized, so we can be effective helpers.
Therapists often struggle when they meet a teenager who is reluctant or downright refuses to engage in treatment. The self-assuredness and biting sarcasm of an angry adolescent sometimes provokes an authoritative response in the therapist that leads to a disintegrating treatment relationship. So, how do you turn this around, build a connection, and get results?
Parents who bring their children to therapy are often desperate, anxious, and scared. They wonder if they are responsible for the difficulties their child is experiencing and may worry that they will be judged as inadequate parents. They may feel guilty or act defensive.