Rather than picking a mental health issue this month, I’d like to shift to a "back to basics" concept today: the basics of the counseling world. It’s easy for counselors like myself to forget that people new to the counseling experience might not be familiar with basic, but important guidelines, like how to determine if a counselor is a good fit, what practices will bring about the best results, and who all should be involved. I consistently get asked the same questions:
Mom: "Will you tell me if my daughter tells you she kissed a
boy?"
Teenager: "How much do my Mom and Dad need to know?"
Dad: "How can I know how to help my teenager when they are
seeing you alone?"
Mom: "You are not just sitting there talking but working on her
issues, right?"
Here are some pointers that teens (and their parents) should know about counseling.
The First Appointment
In scheduling the first appointment people are often nervous because they don't know what to expect. While each clinician will have their own style, there are foundational guidelines every family of teenagers should know to ensure their counseling experience is successful.
1.) The teen must like and trust the counselor. Clients must like their counselor. Research says the number one indicator of positive outcome in counseling is the strength of the relationship between the client and the counselor. This doesn't mean the counselor won't say something upsetting at one point, but rather that the teen enjoys ‘their person’ overall. Let teens be a part of the selection process by interviewing, checking out websites, and asking what is important in a counselor (i.e. qualities like a sense of humor, gender, age). Giving them choices helps them invest personally in the process. Just as in any field, some personalities ‘click’ more than others.
It’s also helpful if parents like the counselor, since they too are trusting their teen in the hands of an influential adult. This may be one of the reasons the counselor spends more time 'just talking' with your teen than you would choose. It takes time to develop trust.
2.) Be frank for best results. Teenager Lauren once asked me "Why are counselor's so nosy?" We only ask so much because the more information we have, the more we are able to help. Just like telling the doctor all your symptoms for diagnosis and medication, counselors need to know what life has been like for you and your current situation. If you don't want to answer a question though, let the counselor know. If you disagree with a statement, don't nod your head and agree- tell them. If you're confused, ask for clarification. Being frank and honest makes counseling more effective.
3.) Pay attention to your body. Sydney's stomach hurt whenever the subject of her trauma came up. Logan gets headaches when we talk about his dad. Sophia's heart races when she feels stressed. A physical response can even happen in anticipation to a session. Counselors are not mind/body readers but they do want to know what is going on. Tell the counselor what is happening physically and if you need a break. This is not a sign of weakness. Our bodies can recognize before our head what we are feeling. It is our job to pay attention to them and communicate.
4.) The more family involved the quicker change happens. This guideline only applies when all parties are willing participants. Research shows when teenagers are brought to therapy, family counseling over individual counseling is much more effective. It is so much easier to change when everyone in the household is trying too and being held accountable by one another. Think of a dieter trying to eat veggies when the family is chowing down on milkshakes, burgers, and fries- it’s so much harder to change. Unfortunately, many teens will only agree to attend counseling if they have one on one sessions with a counselor and their parents don't know all the details of a session. While this is their prerogative (many times for good reason) it is not my first choice. Other times, one or both parents are unwilling to come in because they see the issue needing to be worked out by the teen alone. I suspect some parents are also fearful of being blamed if they attend, though blaming is not a therapeutic tactic used by most clinicians.
5.) Attendance frequency is up to you. Just like with exercise, the more often we are engaged, the quicker we are able to see the changes we want. Traditional counseling is done weekly. In some urgent crisis, I have agreed to do twice weekly -- once with the individual, and once with the whole family. This is not the norm though. Caregivers may be encouraged to come in without their teen in order to have a conversation that does not undermine parental authority or increase the teen's negative self-concept. Weekly sessions give time to implement changes and have feedback for the next session. Some families will attend every other week or even monthly. While clinicians can give their input, it is really up to the client. Weekly counseling can be too intense for some teens. Monthly counseling is good for maintenance of progress but often not enough if change is still needed. If finances are the reason for needing to cut back, discuss the options with counselor. They may be able to discount sessions or refer to clinicians that do.
Finally, if you are ever in doubt about anything in a session, ask. Counselors may assume you know something, so asking for clarification is critical. While you should never force anyone into counseling, this article on How To Motivate Your Teen To Attend/Engage in Counseling is a good resource for parents of teens initially resistant to counseling. Remember that in Washington State, once a minor turns 13 they have a right to refuse counseling and limit contact with parents unless it is an emergency.
For a full list of helpful counseling guidelines, look for them coming soon on the Heartprints website. If you have specific questions to counseling/counselors, comment, text, call, email and I will do my best to answer thoroughly.
