Adolescent & Teen Therapy

The teen years are difficult. You’re old enough to have your own thoughts, values, opinions and emotions but still need your parents for a lot of things and generally have to lie by their rules. Emotions change from minute to minute, your relationships (with friends, significant others, parents, etc) are constantly evolving, and you’re expected to make major life decisions. Add in a little depression, the loss of a loved one, bullying at school or just about any other unexpected complication and it’s no wonder teens start to feel overwhelmed sometimes. You don’t have to face all of these challenges and emotions alone. Counseling can help.

Our Approach to Counseling with Teenagers

We see a lot of middle school and high school students, but our approach might be a little different than some other therapists you’ve seen.  You are the expert on yourself, and your therapist understands that.   We believe that you deserve respect and to be treated as an equal in the therapy process. This isn’t to say that we don’t  talk to your parents, because we do.  However, we consider you the expert on your own needs/goals and we listen closely to your take on things.

At the first session, or sometimes even in a phone call beforehand, we explain to your parents or caretaker the importance of respecting your confidentiality. It’s hard to open up to someone new. Your therapist will give you the chance to ask as many questions as you’d like to make sure they are a good fit before you start talking to them about your problems. We will give your parents general updates about what we are doing in therapy, but balance that with respecting that your privacy.

But Will Counseling Really Help Me?

It’s natural to be skeptical in your first few sessions.  We want you to help you feel comfortable and make sure that counseling is the right route for you. We will take time to get to know you personally and figure out how we can help you reach goals that you set for yourself. I encourage all teens to come to the first session with questions for your therapist about their style and how they can help you. Do you have a lot anxiety? Ask your therapist what experience and training they have related to social anxiety or how counseling can help with test anxiety. Do you feel depressed? It’s ok to ask if your therapist if depression gets better. Are you worried that your therapist might judge you? Express this concern to your therapist and we’ll tell you a little about our personality and our philosophy.

Reasons Teens may come to Counseling

Anytime you are facing a situation you find overwhelming, counseling may be able to help. Some of the most common reasons teens come to our office include:

  • Depression or often feeling “down” and perhaps even hopeless
  • Self Harm or thoughts of suicide
  • Low self esteem and generally not liking who you are
  • You’ve been through something very upsetting or traumatic
  • Difficulty concentrating
  • Feeling unsure about who you are
  • Conflict between teenagers and parents
  • Your grades start to drop or you stop wanting to go to school
  • Your parents divorce, you move, transition to high school or other major life changes
  • You’re worried about your future and feel overwhelmed
  • Nightmares or difficulty sleeping
  • Grief – someone you care about has died
  • Difficulty making and keeping friends
  • Anxiety – You sometimes feel so nervous that it gets in the way of doing things
    • Test Anxiety and Social Anxiety (being around others) are very common among teens

What will I do in Therapy?

This depends on what goals you and your therapist set for your treatment, the training and type of therapy your therapist does and your individual strengths and weaknesses. After you’ve met a couple times your therapist will talk to you about what they think will help. Your counselor may recommend that you process (talk) about things that are bothering you, practice coping skills, learn Mindfulness, keep track of certain feelings and behaviors during the week, express your feelings through art, work through emotions using Sand Tray or participate in exposure activities meant to help you “face your fears.”

It’s important to know that your therapist will treat you with respect and as a partner in the counseling process.  We work with teenagers every day and very little you can say will shock us.  A therapist isn’t here to judge you or tell you what to do.  Through counseling, you will become more confident in who you are as a person and learn new ways to cope with strong negative emotions.

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Dialectical Behavior Therapy

Youth who are at least 13 years old and struggle with strong emotions, self harm or have suicidal ideation often benefit from Dialectical Behavior Therapy (DBT). DBT includes a weekly skills training group where both the youth and a parent participate. If you participate in DBT will be asked to monitor their moods and behaviors on a daily diary card, closely examine difficult situations they’ve faced and practice using new coping and social skills. You can learn more about DBT treatment here.

A Message to Parents and Caretakers

You want the best for your child. As a parent, you want to protect them from the “real” world as long as you can. If your child opens up to you, you try to be there and offer them a safe haven. You try to give them everything they need. Yet, your teen may be struggling and sometimes you’re not even sure how to be helpful. If any of this sounds familiar, you’ve come to the right place.

It is important that your child is involved in the process of choosing a new therapist. Teenagers are old enough to develop strong opinions. We know from research that your son or daughter will get more out of therapy if they feel a connection with the counselor. If you are looking for a counselor for your teenager, I encourage you to show them websites and profiles of potential therapists and/or make a list of things they think would make a good therapist.  Teenagers seem to respond well to seeing a video of a potential therapist like the ones on our therapist’s individual pages.  This gives them a good idea of the counselor’s personality before they even come in.

Communication between Counselors & Physicians

We understand that there is a strong connection between a teenager’s mental, physical and emotional health.  In fact, there’s a good chance that your child’s pediatrician recommended counseling.  At Aspire Counseling, we are always willing to work with pediatricians, family physicians and psychiatrists.  The American Academy of Pediatrics recommends physicians support the family in securing mental health care and counseling for depressed teenagers.  We are fortunate to have many physicians in the Columbia and Jefferson City area who understand the value of counseling and often send clients our direction.

At Aspire Counseling, parents have the option of giving us permission to communicate with your physician.  Physicians often appreciate brief updates. In fact, it can help inform their decisions about medication management to know that a teenager is also actively involved in counseling.  For instance, if a teenager is beginning an antidepressant for the first time, the physician may feel more comfortable prescribing it knowing a trained mental health professional is monitoring any changes in mood or suicidal thoughts.

We also place great emphasis on your family’s confidentiality and follow all laws related to confidentiality. We will not speak to the physician about your child or family without permission from parents/guardians.  Your therapist can create a short letter to fax to the physician simply confirming that you followed up on their recommendation for counseling and use very general terms to describe your child’s progress.  As an example, an update may state your teenager “is fully engaged in the counseling process.  They have excellent attendance are are motivated to work on their ____.”  You can fill in the blank with depression, trauma, etc.  We do not divulge details of your child’s treatment, because we want your teen to feel that this is a safe place to openly express their emotions.  In fact, it is very common to show the teenager what was shared with the physician so your teen doesn’t worry about what is being said “behind their back.”

Resource for Parents & Physicians of Suicidal Teenagers

Suicidal thoughts in teenagers are much more common than most people are aware of or want to acknowledge.  We have the option of hospitalizing a teenager who is in danger of killing themselves either at the University of Missouri Psychiatric Center here in town or another psychiatric hospital further away. Your therapist is able to work with parents to take reasonable steps to reduce your child’s risk of hurting themselves the majority of the time. Aspire Counseling therapists are also trained in how to assess and manage suicide risk in teenagers.

Counseling for teens with depression, anxiety and mental health concerns in Columbia, MO

As parents, you value your child’s mental health and care about their happiness. We can help.

A couple of years ago, I was introduced to the Counseling on Access to Lethal Means course.  This is an online training that takes about 2 hours originally developed for mental health professionals.  This is an excellent resource for health care professionals who work with suicidal individuals. It can also be a resource for parents of children and teenagers who are chronically suicidal.  If your child or teenager has stated that they have thoughts about suicide, please consider taking this free online training.  You can develop new ways to keep your child safe and often avoid a psychiatric hospital admission.

*Please note, if your child is in immediate danger of hurting themselves, please do not hesitate to seek professional help.  Either call your child’s therapist for a crisis appointment or take them to the local emergency room for evaluation. All suicidal threats should be taken seriously and discussed with a mental health expert. Seek immediate help if your child has a plan to kill themselves, is stating they intend to commit suicide, have said goodbye or given away possessions and their plan is something they might be able to realistically carry out.*


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