As parents, watching your teen struggle with mental health issues can be heart-wrenching, and often very confusing. You want to do everything in your power to help, and maybe even jump in there and try to fix it for them. On the other hand, maybe you’ve been trying to help so much that you’re fatigued and don’t know how you can do anything else. When it comes to mental health counseling, the path to support is not always straightforward and it’s important to keep in mind that there are different roles for different people. In most cases one person can’t do it all. Let me give you a sense of how those roles can cooperate most effectively.

Professional Expectations

While you can certainly consider a good therapist to be on your team in supporting your child’s mental health, it’s important to remember the therapist’s first obligation is to their client, and that can potentially be the source of some friction. First, it’s important to realize the counselor’s obligation starts with strict confidentiality guidelines. I feel like over the years this has come to be much better understood generally, but this means that what your teen shares in therapy stays between them and their therapist. There is one obvious, and vital, exception: safety concerns. If there’s a risk of harm to your teen or others, therapists are obligated to take necessary steps to prevent harm, which may involve breaking confidentiality. This principle protects your child’s privacy (and ultimately self-respect) while ensuring their safety and the safety of others.

Parent Values

Sometimes this standard sounds very reasonable in theory, but is a bit harder for a parent to handle in actual practice. Yes, this may mean that a therapist knows there are vapes stashed in their room, or sexual experimentation going on and won’t mention it. The trade off is obviously that any behavior like this is something they’re only likely to talk with other teens about, but in a counseling environment a teen can get a professional adult’s opinion without having to fear the consequences of sharing. Along with that, as a parent, you get the backstop of knowing that you’ll hear about anything that seems to present an actual safety concern.  

Also, I want to add that I have the philosophic stance that a therapist shouldn’t advocate for anything against the parental family values, even if the teen essentially wants help rebelling against them. Clarifying thinking is different than advocacy. They are free to have whatever rebellious beliefs they like, but as a therapist I attempt to remain neutral outside of mental health issues. This has, on occasions, lead to conversations with parents to help clarify the beliefs the family has.

How this works practically

When there are things that aren’t safety related that I believe a parent would want to know about, I try to suggest the teen have a conversation about this. I might suggest ways to present it, or offer to referee the discussion if they think that would be helpful. While I may directly suggest they let someone know, I’m not going to be pushy about it as that might make it harder to process details about that topic and would obviously taint their willingness to share other things. If it helps, 9 out of 10 times, a teen will eventually share this kind of information, or be willing to at least take up the offer a refereed discussion.

The therapist isn’t an enforcer

Although I’ve only seen this happen on rare occasions, it’s worth pointing out that a therapist shouldn’t be considered an external enforcer.  Again, rarely, I’ve had parents seem to think I was going to fuss at their teen for something done during the week. I’ve also seen an approach like “I’m telling your therapist,” in an attempt to use the embarrassment of talking about something as a punishment. If punitive action is needed, the therapist can work individually to help the parent to develop a behavior plan, but ethical obligations aside, if negative consequences are enforced by the therapist, this actually undermines the strength of the parental role.

I’ve seen this become a difficulty for other therapist in teen clients that become non-compliant, although I don’t think this is something I’ve had happen for over a decade. Some of that is due to my philosophic approach and a commitment to allowing self-determination. It would take a different entry to discuss whether client “resistance” is even a real thing or just a matter of therapist’s presentation (asking the question obviously tells you which side I’m on), but I will suggest that in most cases non-compliance needs to be seen as a symptom, not a root problem. If things aren’t working, the approach needs to be re-evaluated.

Parental Involvement

Despite this picture of the therapist’s role and duty to the client, it can’t be understated that the parental role remains crucial. Whenever feasible, I begin our sessions with a brief 5 to 10-minute discussion with parents. This approach serves multiple purposes. First and foremost, it ensures that I’m immediately aware of any significant events that have occurred during the week—especially those that might not be shared by the teen themselves. Just because the therapist is limited in what can be shared with others, doesn’t mean there are restrictions in the other direction. Share whatever you think would be helpful. Also learning about significant events at the end of / after a session means missing the opportunity to address it while it’s still relevant. 

Beginning sessions

This initial parent segment opens the door to more than just information sharing. It’s a valuable time for us to collaborate on setting expectations, establishing boundaries, educating about symptoms, and discussing strategies for positive engagement at home as well as in the therapeutic process. These discussions are not only about enhancing your skills in supporting your child, but also about developing the teamwork between us, and measuring progress as we go. This ensures that everyone involved is on the same page.

Teens may not always have the insight or willingness to report significant events or accurately gauge their progress. Communication between parents and therapists can bridge this gap, ensuring that nothing important is overlooked. It’s about creating a supportive network around your teen, one that complements the therapeutic process rather than intrudes upon it.

What Kind of Adult do we want?

Some challenges are problems that need solutions, others are tensions that need to be balanced. It’s important to recognize that not every source of stress or conflict has to be immediately resolved, some stress makes us stronger in the end. No one looks back at their moments of greatest growth and thinks “oh that was easy.”

When there are different roles in your child’s team of supporters, individuals specializing in different roles, it may create some of those tensions. The differences between productive tension and unproductive conflict is whether everyone involved, teen included, are keeping the big question in mind: “what kind of adult do we want to create here?” Gaining compliance may be helpful in the short term, but then you may sacrifice their ability to act interdependently. Forcing someone to be too independent, even when they’re successful, may undermine their ability to rely on others when needed. Everything is a balancing act of continual adjustment. (Which is really a true statement about life in general as much as it is true of parenting.)

Remain future-focused

Sometimes it can feel like we get tangled up in a web of past regrets and worries about whether we’re doing the “right” thing. Let me add another aphorism that applies to all kinds of problems: “We can’t usefully move forward while looking backward.” Certainly organizing our past and getting closure to events is vital for growth, but this can be done while embracing a “forward focus” that can be incredibly transformative. There’s even an entire therapeutic approach to trauma treatment by that name. (See the work of Eric Gentry). It’s hard to think in terms of blame or shame when we speak in the future tense. When we focus on goals, specific plans for the future, and the person we’d like to be, or would like our children to be, we reduce the unhelpful distractions.

Parent Well-Being

Let’s take a moment to point out that your own well-being is part of your teens improvement as well. You have to be sure you’re taking care of yourself as well. The effects of a teen’s behavior on a parent shouldn’t be underestimated, particularly in cases of events as serious as suicide attempts. The diagnostic criteria for trauma includes a serious threat to the life or safety of a close family member, but even if it doesn’t rise to that level, a teen’s behavior can obviously have serious effects on you as well. It’s not uncommon for a parent to become destabilized when they discover their child has been assaulted or has hurt themselves in some way. Depending on circumstances I’ll often suggest that a parent check in with a therapist for their own support.

Short Answer FAQs 

• How can parents support their teen’s independence while still being actively involved in their care?
  • Engage with the therapist directly and be involved in treatment planning. Make attempts to understand your child’s diagnosis / needs, and set reasonable expectations. Also it might be a therapist cliche at this point, but that’s only the case because it’s true, work on improving honest two-way communication.
• How can parents and therapists work together to ensure the teen’s safety and progress?
  • If there are safety concerns these need to be addressed first, and planned for as early as possible. You should have a clear plan of response to various levels of behavior: preventative, supportive, and emergency.