After many years of working with adolescents who have been referred to therapy by their parents or other authority figures, I have come to realize that most teenagers are (at best) reluctant clients who engage poorly in the therapeutic process. Of course, some adolescents are self-referred and recognize the need for changing their own behavior. More frequently, these teens are referred by parents who are frustrated, lost, and feeling out of control when it comes to managing their child. It is in these situations where I have found parent coaching to be the most effective intervention: better than either individual therapy for the adolescent or family therapy for the entire system. Often, there is no psychiatric disorder involved; instead, there is ongoing tension arising out of the conflict between the adolescent's desire for greater autonomy and freedom, and the parents' need to keep their child safe and out of trouble. When the parent is the one who is experiencing the greatest level of distress, then I often recommend parent coaching where the goal is to help the adult develop more effective strategies for dealing with their adolescent's problem behaviors. Unlike traditional psychotherapy, parent coaching tends to be short term (5 to 8 sessions) and focused on developing strategies targeting particular behaviors.
Depending upon the situation, I may want to meet briefly with the adolescent to better assess the nature of the problem. However, most of the time, the work will be with the guardian adults since they are the ones who are most invested in change and have the greatest capacity to control contingencies. Depending upon the nature of the conflicts, coaching may be covered by medical insurance. If the problems stem from expectable parent-child conflict, then it is more likely that the service will not be covered by insurance. Please call for additional information and to set up an initial session.