Part III: The Family at an Impasse: Therapeutic guidelines and practical resources for parents

This is the third in a series of four articles on adolescence.

A family with a teenager in trouble is a family in crisis. Whether there is a daughter who refuses to eat and rapidly loses weight or a rebellious and out-of-control son, whether a teenager seems to oscillate between periods of high energy and extreme lethargy, or whether a kid is isolating himself, seemingly confused and hopeless, – her or his immediate family members are always the first to be affected. Parents and siblings begin to worry and search for remedies.

Consistent with the approach recommended here, i.e. to look at the behavioral and interpersonal picture first, we suggest to parents concerned about their teenager to search for a professional who is trained and experienced in family therapy. Research strongly suggests for parents to start their inquiry into the nature of their adolescent’s crisis with a comprehensive scrutiny across multiple contexts. With the assistance of the therapist they should review the dynamics of the relationships in the family, the teenager’s individual development and educational history, and her or his social life among friends, at sport activities, or in a work context. Any diagnostic inferences should be based on this kind of multi-contextual examination.

Several crucial advantages make a contextual perspective the state of the art approach. Whatever treatment steps may be necessary later on, they will be taken from a wide ranging and broad overview of the adolescent’s problems rather than from a narrow one. Treatment will be based on the family’s knowledge of the developmental history of the teenager, on the strengths of the family relationships, and on the family’s emotional and intellectual resources. Throughout the process the parents stay in charge and can get the support and guidance they need.

And finally, the teenager will not have to carry the entire burden of change. Any progress or improvement of symptoms will not just depend on the (often reluctant) teen’s commitment. Growing up, emotional healing, and transformation of the individual and the relationships will be a collaborative effort of the family members involved. The basic insight about adolescence, that relational connection and individual self mature together, will be put into practice.

Here are some practical guidelines as parents and teens, hopefully with the guidance of a family therapist, go through a healing process together.

  • Families in crisis tend to isolate themselves from the community around them, out of shame or out of fear they may be blamed for the situation. Yet, the frightening or puzzling experiences and behaviors of teenagers and the effects on parents present a tremendous burden.
  • When your adolescent is in trouble, it is vital to seek constructive and critical support from your partner, your relatives and your friends, and to form alliances with teachers and with other parents, especially those of your kids’ friends. You should not go it alone; instead, build a virtual “extended family network” as your support structure.
  • Whenever possible, look at the resources and strengths that you and other adults in your family have available to you. Discuss, pursue, and implement alternative and innovative ways of responding to your teenager. Your accustomed ways of reacting to the troubles your kid is exhibiting may not be helpful; they may actually exacerbate the problems. As the adult you are more capable of change and flexibility.
  • Adolescents need their parents to provide predictable and clear structures. They ought to grapple with conflicts within themselves instead of endlessly arguing with the external parental authority or acting out their inner tensions or withdrawing into the maelstrom of their inner world. A firm, but calm parental “no” may precipitate a crisis with a teenager, but usually it is easier contained and resolved than an escalating quarrel that started with too many parental accommodations or long lectures.
  • A common misperception undermining the authority of parents is the idea, quite widespread in our society, that a teenager’s troubles, especially destructive “symptomatic” behaviors, are indicative of deep-seated underlying problems that can only be helped by long-term individual psychotherapy and/or psychiatric intervention with medication. State of the art family therapy includes coordination with individual psychologists or psychiatrists, but should start with family meetings, support the strengths of the family, and allow the parents to be an essential part of the therapeutic process.

Available research confirms the professional experience that in-depth family therapy that may include individual sessions with the teenager can accomplish significant transformations in adolescent behaviors, attitudes, and symptoms, particularly when the parents’ commitment to overcome the family impasse is supported. The power of relational healing can be comprehensive enough to reach the developing mind’s underlying bio- physiological processes in the brain.

In the last part of our series, we will address traumatic family experiences, such as adolescent violence, illness, drugs and madness.

teens, adolescence