Tag Archives: teenager

Curfew is when?! Helping parents and teens see eye to eye on boundaries and rules

By Bethany Bray October 28, 2022

Le’Ann Solmonson, a licensed professional counselor (LPC) who owns a private practice in Nacogdoches, Texas, once worked with a teenager who was continually grounded by her parents. The client, a high school senior, was brought to counseling by her parents, who saw her rule-breaking behavior as the presenting concern.

The family was stuck in a repeating pattern where the teen would break her curfew and the parents would respond by grounding her and taking away her car and cell phone for a month to cut off all her social activities outside of school, Solmonson recalls. As soon as the punishment was lifted and the teen regained her freedom, she would immediately break her curfew, only to be grounded again.

Solmonson focused on strengthening the teen’s decision-making skills in counseling. However, she says it was equally — if not more — important to offer psychoeducation to the parents on the developmentally appropriate needs of adolescents, including social connection with peers.

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The parents did not understand that being grounded and cut off from social activities for a month is “forever” in the life of a high school senior, Solmonson says.

She worked with the parents and teen to create a plan for privilege restriction that gave the teen incentives to work toward, rather than a lengthy and complete shutoff of her freedoms. Whenever she broke curfew, the teen would be grounded without access to her car or cell phone for one week. After that, she was given access to her car to drive to school and other activities without friends as passengers. As the teen learned to respect the boundaries her parents established, she was gradually allowed to attend school football games and other events that were pivotal in the social life of a teenager.

The flexibility and freedom of this new plan further strengthened the teen’s decision-making skills on her own. In turn, the parents better understood their daughter.

Counselors are often “put in a hard spot,” Solmonson admits, because they can easily see patterns and reasons why rules and boundaries aren’t working in families where the parents and an adolescent child are at odds. For this young client, the parents’ punishments were too stringent, which curtailed any chance for the teen to learn to make better decisions on her own.

The counselor’s role, Solmonson says, is to help both parents and teens explore the factors that contribute to the child’s rule-breaking behaviors and meet in the middle to give the teen enough autonomy to mature and learn as they go.

Putting things into context

Skill building in areas such as communication, listening and distress tolerance is an essential part of counseling for teens and parents who are in conflict. Disagreements often arise over boundaries, and a key first step, Solmonson says, is to talk with parents about the importance of keeping an open dialogue with their child(ren) about the rules they set, including the context of why they’ve established them.

These conversations ensure that both parents and child have an opportunity to listen and voice their feelings even while the parents retain their rule-setting authority, Solmonson notes. She coaches parents to use phrases such as “This is the reason our family does (or doesn’t do) that,” “These are the reasons why this is the limit” or “I’ve given you my reasons and I understand that you don’t like my reasons and don’t agree, but we’re still going to do this.”

“One of the most important things parents can do is give their child a voice and make it clear that they’re open to hearing what they think,” says Solmonson, the immediate past president of the Association for Child and Adolescent Counseling, a division of the American Counseling Association.

A focus on context can also be helpful for parents who see their child’s rule breaking as the root of conflict in the home. Hayle Fisher, a licensed professional clinical counselor (LPCC) and director of adolescent services at a behavioral mental health provider in Mentor, Ohio, says she often spends time equipping parents with skills to identify what is and isn’t risky behavior. This can be especially helpful for parents whose worries are based on past experiences such as suicidality or self-harm in a child, notes Fisher, who runs her practice’s intensive outpatient program for adolescents as well as a counseling group for parents focused on navigating family challenges with teens.

For example, parents may blow up in anger when they find out that their child has used marijuana or become sexually active. A counselor can offer psychoeducation to parents that while it’s common for teenagers to experiment with substances, signs that indicate it’s a problem are when a teen is overusing a substance, using it to cope, driving under the influence, selling the drug or engaging in other illegal activity. Similarly, exploring one’s sexuality can be a normal part of adolescence, but engaging in risky behaviors such as having unprotected sex is a red flag.

Fisher uses the acronym FIDIL (sounds like “fiddle”) that she learned while in graduate school to help parents consider the full context of their child’s behavior and decide whether it’s risky. This method prompts the parent to look at:

  • F: What is the frequency of the behavior? Is it once per day, once per month, etc.?
  • I: How intense is the behavior? (For example, does self-harm involve scratching oneself or cutting to the point the child needs stitches or medical attention?)
  • D: What is the duration of the behavior? How long does the behavior last?
  • IL: What is the interference level of the behavior? How does the behavior affect the child’s functioning (daily, academic, occupational or social)?

These questions also prompt parents to think more deeply about the reasons why their child is engaging in a behavior and to identify needs the child has that are going unmet, Fisher notes. The hope is that parents will come away with increased empathy for their child and the desire to help them make behavioral changes in a supportive way.

“A lot of the time, the fight is over ‘I found cannabis in your room’ rather than the reasons why they’re using,” Fisher says. So she sometimes poses the question to the parents: “Why do they feel the need to engage in this behavior? Even if all their friends are doing it, why are they?”

Consistency is key

Consequences must be appropriate for adolescents, but they also need to be consistently enforced.

Marcy Adams Sznewajs, an LPC who counsels teenagers and young adults at the therapy practice she co-owns in Beverly Hills, Michigan, finds that parents sometimes backslide or waver on the penalties they create because they either feel the punishment was too strict or feel bad about enforcing it. Not only does this pattern send a mixed message to the child, but it also sabotages the work Sznewajs does in counseling to foster young clients’ decision-making skills.

In these cases, it may be necessary to discuss with the parents the need for clear communication and consistent expectations for their child, Sznewajs says. She explains to parents that her role is to help their child grow and build skills, and that can’t happen when situations are fixed for the child before they can learn from them.

Sznewajs once worked with a teenage boy who, upon leaving home to attend college, began to use marijuana and failed two classes in his first semester. His parents gave him an ultimatum: They would take his car away if he didn’t start passing his classes and get a job, or he would need to come back and live at home.

In his second semester, he continued to fail his classes and didn’t get a job either, so the parents took his car away. In counseling, Sznewajs prompted the client to explore his values, including his desire to get an education, and think about choices that he could make differently to re-earn his parents’ trust.

In the next session, the client reported that his parents had given his car back after one week because they felt bad that he was struggling to get to class without it. The client lost an opportunity to problem-solve, Sznewajs notes, and the parents’ inconsistency made her job “infinitely harder.”

Ultimately, she had an honest conversation with the parents about the need to be consistent with consequences for their child so that he can learn to cope with challenges.

“It’s not my job to tell a parent what to do. It’s not appropriate to point out that I don’t think they’re doing the right thing,” she says, but “having boundaries set and then discarded gives a really inconsistent message to the child and does not help them cope with difficult situations. It doesn’t help them make better decisions.” 

Is it negotiable?

When seeing an adolescent client in a session with their parents, Solmonson often finds it helpful to moderate discussions about boundaries by prompting them to create two lists: one for rules that are negotiable and one for rules that aren’t. This activity allows both parties a chance to voice their feelings, give feedback and collaborate with her in session to guide the process.

For example, the family may decide that curfew is negotiable, depending on what the teen is leaving the house for and whether it’s an organized event with a set ending time. Or parents may agree not to dictate who the teen befriends so long as they’re making good choices when they’re with those friends, and the parents will only intervene in instances when the teen makes bad choices.

Examples of nonnegotiable rules that families have agreed on include not having drugs or illegal substances in the home and never sneaking out of the house without the parents’ knowledge, Solmonson explains.

“When you find things that you can negotiate on, it gives the adolescent a sense of empowerment and a sense of control over their own life,” Solmonson says.

Seeking safety

It’s natural for children to begin to seek more autonomy as they reach adolescence, but this aspect of development often causes friction between parents and children.

For many parents, behavior that is within the family’s rules “feels safe,” whereas rule breaking can feel like a rejection of the parents, says Martina Moore, an LPCC and counselor supervisor who is president and CEO of an outpatient treatment center for co-occurring disorders in Euclid, Ohio. The heart of what sparks disagreements with children during this stage is fear.

Parents feel discomfort when they don’t have the relationship with their child that they’ve always pictured, or when the child is not fulfilling the ambitions and hopes the parents had for them. Parents often overcompensate with strict rules to try and find control, notes Moore, the president of the International Association of Marriage and Family Counselors, a division of ACA.

Moore uses these situations as an opportunity to foster discussions with parents about the vision they have for their child versus the vision the child has for themselves. She encourages parents to ask their child what they want out of life – a question that many parents have never considered before, Moore notes.

She empathizes with parents while addressing their fear directly, telling them, “What you’re afraid is that they [the child] are going down a path that derails the hopes you have for them.”

“We see the world as a scary place that can be so unforgiving that we get really fearful of what’s going to happen with our children,” she adds.

Solmonson says that she encourages parents to focus on connecting with their child despite the disagreements, frustration and discord that happen during adolescence. Putting energy and care into the relationship with their child now, when it’s difficult, may result in the child choosing to have a relationship with them later in life, when it’s optional, Solmonson explains.

She urges parents, “Don’t let the conflict destroy the relationship. Conflict is inevitable and will always happen. Take a step back, [think of the big picture] and prioritize the relationship.”

 

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Read more on how counselors can help parents and teens navigate conflict in Counseling Today’s November cover story.

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Confidentiality comes first: Navigating parent involvement with minor clients

By Bethany Bray

What is said between a counselor and an individual client is confidential, even when the client is a minor. But parents often want to be kept in the loop about their child’s progress in therapy. This can put the counselor in a tricky situation, especially when the parents want to control or influence the counseling process.

The only scenario in which counselor-client confidentiality can be broken is in situations that necessitate protecting the client or others “from serious and foreseeable harm,” such as suicidal intent. (For more on this, see Standard B.2.a. of the 2014 ACA Code of Ethics.)

Marcy Adams Sznewajs, a licensed professional counselor (LPC) who often works with teenage and young adult clients at her group therapy practice in Beverly Hills, Michigan, says she empathizes with parents who ask about what she’s covering in counseling sessions with their child. However, she finds it helpful — and necessary — to offer a firm explanation of counselor-client confidentiality whenever she begins counseling a young client.

Sznewajs says that she emphasizes to parents that she will let them know if their child discloses anything that will put the child in danger. She also makes it clear to both parties that she will only invite parents into the counseling sessions if the young client grants permission.

This conversation is often not what the parents want to hear, Sznewajs admits, but it is important because it spells out the boundaries of what the counselor is obligated to tell the parents and reassures the client that their privacy will be respected.

Sznewajs stresses to families that they all must trust the process for her work to be effective.

“It’s important for the teenager to trust an adult with these difficult thoughts and feelings, and legally and ethically I have to keep it confidential,” says Sznewajs. “I’d be doing my client a huge disservice [if I disclosed session details to the parents]. That’s not only unethical, it’s damaging — and what does it teach the kid? That this person that you’re supposed to trust, you can’t.”

The feelings behind the questions

Parents’ concerns and questions about the work their child is doing in therapy are often rooted in fear, says Martina Moore, a licensed professional clinical counselor supervisor with a mediation and counseling practice in Euclid, Ohio. Not only do parents worry that the challenging behaviors that caused their child to seek counseling, such as rule breaking, isolation, defiance or problems at school, will have negative long-term outcomes in the child’s life, but they might also feel these issues are a reflection of their parenting abilities.

“Parents sometimes have such anxiety about their children it’s [gotten] to the point where they are increasing their child’s anxiety,” notes Moore, president of the International Association of Marriage and Family Counselors, a division of the American Counseling Association.

Although Moore makes a point to validate these fears with parents, she also emphasizes that it’s good for the child to grow and build autonomy through counseling on their own. She applauds parents for seeking help while explaining that she needs the freedom to work with the child alone for the counseling process to work.

“I also spend time with parents to dig into what their fear is. They’ve come to counseling [with their child], so they must believe that there is benefit in this process,” Moore says. She emphasizes to parents that they need to trust the process. “I spend a lot of time with parents getting their buy-in,” she notes.

In addition to fear, parents may also struggle with strong feelings of shame for having a child who is engaging in risky behavior and failing to thrive.

Le’Ann Solmonson, an LPC in Texas who has extensive experience working with children and adolescents, says she makes a point to acknowledge and normalize parents’ feelings of vulnerability and worry. If appropriate, Solmonson says she will sometimes disclose that she’s experienced similar feelings when her adult children sought therapy.

“No parent is perfect, and you worry over feeling like they are talking [in therapy] about what you’ve done wrong,” says Solmonson, the immediate past president of the Association for Child and Adolescent Counseling, a division of ACA. “It’s a very vulnerable thing to have your child go to counseling. You can’t help but feel that it’s a reflection on you as a parent and feeds into fears that you’re ‘screwing your kids up.’”

Navigating the balance

Counselors often need to get creative and act diplomatically to keep parents in the loop while maintaining young clients’ confidentiality and trust.

When parents insist on being involved in their child’s counseling, Moore negotiates with both the parents and client to find a plan that they all agree on while staying within ethical boundaries.

This was the case for a teenage client Moore once counseled who had substance use disorder. The parents were worried about their child and wanted to be involved in the counseling process. Moore facilitated a discussion and, eventually, they all came to an agreement that Moore would work with the teen alone but would let the parents know whenever the client had a relapse or break in recovery, she says.

Keeping lines of communication open and having regular check-ins with parents is beneficial to the counseling process with young clients, Solmonson notes. She often prompts child or adolescent clients to identify one small thing they are comfortable sharing with their parents at the conclusion of each counseling session, such a breathing technique they learned or new words they discovered to describe their emotions. This keeps the parents in the loop while ensuring that the client maintains control over the process.

When parents are left completely in the dark about their child’s work in counseling, it can exacerbate worry, cause them to “fear the worst” and catastrophize about what the child might be saying, Solmonson adds.

Sznewajs notes that talking with young clients about keeping their parents updated also provides the opportunity to check in with the client and ask what they feel is going well. She sometimes begins by asking the client how they feel things are going in counseling and transitions to what (or if) they would want her to share with their parents about their progress.

Disclosure of life-threatening behavior

When a young client is engaging in risk-taking behaviors that are life threatening (i.e., suicidal actions, self-harm), ethically, parents need to be brought into the conversation, says Hayle Fisher, a licensed professional clinical counselor and director of adolescent services at a behavioral mental health provider in Mentor, Ohio. While this is crucial to do, it can also impair the therapeutic relationship with the teen, she adds.

Fisher finds the vignettes in the 2016 British Journal of Psychiatry article “‘Shhh! Please don’t tell…’ Confidentiality in child and adolescent mental health” particularly helpful for examples on navigating these conversations. She keeps the following notes for herself, drawn from that article, for situations when she must disclose a young client’s harmful behavior:

  • Tell the client what you (the counselor) are planning on disclosing to the parents, with an emphasis on the full context of why you need to. Ask for their feedback on how they might like to edit what you plan to say.
  • Talk through the potential benefits and costs of disclosing to the parents. Ask the client how they feel about the disclosure and consider their views as you move forward.
  • Validate any fears the client may have about the disclosure, such as losing access to resources and freedoms, feeling blamed or ashamed, or being concerned that the police or social services will become involved.

To maintain trust and a therapeutic alliance with young clients, Fisher emphasizes that it’s important for a counselor to give the client as much control as possible over how this communication will occur. If the disclosure happens during an in-person session and the parents are nearby, she gives the client the choice to either stay in the room or step out and wait in the lobby when she invites the parent(s) in to tell them.

Fisher also gives young clients the option to tell their parents before she does. However, this is only appropriate if the client’s risk of harm is not imminent, Fisher stresses. In this scenario, she tells the client that she will call at a certain time the following day to speak with their parents, check in and provide support for the parents and client.

“This option is especially powerful,” Fisher explains, because it “reinforces the adolescent taking accountability for their actions, increases communication skills and fosters independence in the situation so they are not dependent on the counselor for navigating conflicts with their parents.”

Sznewajs also takes a collaborative approach when it’s necessary to break confidentiality to inform a client’s parent or guardian about harmful behavior or intent. She says she tries to take the client’s feelings into consideration while modeling firm boundaries.

Although not having the conversation with the parents isn’t an option, client can choose how and when it happens, Sznewajs explains. She offers to involve the parents in person, call them on the phone, do a video chat during the counseling session or wait until after the session ends.

Sznewajs says she explains to young clients: “I want to make sure you stay safe, so we have to bring your parents into this conversation.” She adds that she tries to “do it in a collaborative way, even when it [the situation] is dire.”

 

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

De-escalating conflict between parents and teens

By Bethany Bray October 26, 2022

It’s natural for adolescent development and parent-child conflict to go hand in hand.

Le’Ann Solmonson, a licensed professional counselor (LPC) who owns a private practice in Nacogdoches, Texas, has worked with children and adolescents in school and clinical settings throughout her career. Time and time again, she’s seen families fall into a pattern as children reach adolescence: The youth wants more autonomy — a normal aspect of adolescent development — and begins to push against their parent’s rules and boundaries. In response, the parents tighten their control or inflict punishment, only to have the adolescent push back harder, break more rules and chafe against their parents’ preferences. Thus begins a repeating spiral of friction, frustration and misunderstanding — on the part of both the teenager and the parents.

“Conflict is very much a product of adolescent development,” says Solmonson, the immediate past president of the Association for Child and Adolescent Counseling, a division of the American Counseling Association. “Adolescents’ whole goal is to figure out ‘Who am I? Where do I fit in?’ and begin that separation from their parents and become more independent. … Some of that development leads to trying out new things, thinking a little differently [than their parents] and not having the cognitive development to think through something that looks fun but might be dangerous. These are natural things that can fuel conflict and disagreements.”

Parents vs. teen

Hayle Fisher, a licensed professional clinical counselor (LPCC) and director of adolescent services at a behavioral mental health provider in Mentor, Ohio, runs her practice’s intensive outpatient program for adolescents as well as a counseling group for parents focused on navigating family challenges with teens. In her experience, a teen’s risk-taking behaviors are often what the family names as the presenting problem. And while problems such as reckless driving, disordered eating, skipping school, risky sexual behaviors, substance use and self-harm or suicidal ideation do need attention in therapy, there is often conflict in the home that is exacerbating the teen’s behavior. Even if a family is not having traditional “blowout” style arguments, conflict is often present in the form of unhealthy patterns and instability, says Fisher, the president of the Ohio Association for Specialists in Group Work. Examples include invalidating behaviors and dialectical dilemmas (e.g., forcing independence vs. fostering dependence, normalizing pathological behavior vs. pathologizing normal developmental behavior, extremes in excessive leniency vs. authoritarian control).

Because of this, Fisher feels that a systems approach works best for counseling teenage clients who are in conflict with their parents. The intensive outpatient program at Fisher’s practice provides individual and group counseling for adolescents as well as group counseling for the parents.

While it’s vital for the teen to focus on decision-making, emotion regulation and other skills in counseling, sometimes it’s even more important for the parents to work on similar issues in counseling themselves, she adds. Not only are parents often unequipped with the tools they need to navigate conflict, but they sometimes carry bad experiences and patterns they picked up from their own parents and upbringing.

When working with teenage clients who are at odds with their parents, counselors are often given the difficult task of fostering growth in the adolescent while knowing they have little control over their home environment and their parents’ willingness — or lack of willingness — to work on their own unhealthy patterns and behaviors. Counselors must also strike a balance between fostering trust with the teen and maintaining client confidentially and accommodating parents who want to be kept in the loop about their child’s progress, perhaps even to the point of wanting to control or influence the process, notes Marcy Adams Sznewajs, an LPC who co-owns a group therapy practice in Beverly Hills, Michigan.

(For more on maintaining client confidentiality while managing parents’ requests to be kept in the loop about their teen’s progress in counseling, see the online exclusive article “Confidentiality comes first: Navigating parent involvement with minor clients.”)

“It’s very challenging to work with teenagers because of parents,” says Sznewajs, who often works with older teens (15+) and emerging adults. “It’s a dance between involving the parents, helping the parents parent better and maintaining the trust of the teenager, and there’s no formula that always works.”

Getting started

The counselors interviewed for this article agree that when counseling adolescents who are in conflict with their parents, an important first step is for the practitioner to offer an honest yet firm explanation on the limits of client confidentiality to both parties. This includes explaining that what is said in counseling sessions is confidential — even when the client is a minor — except in situations that necessitate protecting the client or others “from serious and foreseeable harm,” such as suicidal intent. (For more on this, see Standard B.2.a. of the 2014 ACA Code of Ethics at counseling.org/ethics).

This conversation is often not what the parents want to hear, Sznewajs admits, but it is important because it spells out the boundaries of what the counselor is obligated to tell the parents and reassures the adolescent that their privacy will be respected.

In addition to conversations about confidentiality and the counseling process, clinicians should conduct a thorough assessment, including screening for mental illnesses that can surface during adolescence, notes Martina Moore, an LPCC and counselor supervisor who is president and CEO of an outpatient treatment center for co-occurring disorders in Euclid, Ohio.

It’s not uncommon for family conflict to crescendo with the onset of a mental illness in a teenage child, says Moore, a faculty member in the clinical mental health counseling program at John Carroll University.

Challenges with concentration, irritability, sleep problems, and mood spikes and swings can be a normal part of adolescence, but they can also be symptoms of a developing mental illness, Moore says. In counseling, completing a thorough assessment before creating a treatment plan with teenage clients is important to gather more information and parse out symptoms that may be part of adolescent development and/or signs of mental illness. The Diagnostic and Statistical Manual of Mental Disorders can be a particularly helpful resource in this process, she adds.

When counseling teens who are in conflict with their parents, getting the full picture during the assessment process often involves speaking with the parent(s) to learn what they see as the teen’s symptoms and challenges. However, there is no hard-and-fast method to do this, and the counselors interviewed for this article say that they vary their approach depending on the family dynamics and the client’s needs.

Moore and Solmonson say they often meet with the parents alone to hear their perspective as the teen begins counseling. It’s simply not helpful to have the client (the teen) in the room while the parents “rant” about the family’s situation, notes Moore, president of the International Association of Marriage and Family Counselors, a division of ACA.

“If there’s so much anger between them, it may be better to see them separately for a while to diffuse and process their anger and prepare them for a better way to come back into dialogue,” Solmonson says. “If I’m just playing referee, then everyone being in the same room is not effective.”

At the same time, having everyone in the room together — either at intake or later in therapy — can tell a counselor volumes about the family’s dynamics and issues that need addressing, adds Solmonson, an ACA member. “Sometimes it’s needed to get the whole picture of what’s going on,” she says.

Talking with the parents also creates an opportunity to ask them about their upbringing and things they have learned or internalized from their parents, Solmonson says. She asks parents what they did and didn’t like about the way their parents brought them up and what they want to emulate or keep from repeating.

This information is so valuable that Solmonson says she makes a point to have this conversation with the parent(s) of every teen she counsels.

Building better communication skills

When there is friction between parents and teenagers, communication is often the primary and most important skill they all need to build in counseling, Sznewajs notes. The relationship often naturally improves, she says, when a family begins to communicate better, truly listen and empathize with each other’s perspectives.

The counselors interviewed for this article suggest using the following techniques with parents and adolescents to strengthen their communication skills — and, in turn, their ability to tolerate and navigate disagreements.

Active listening: Sznewajs begins communication skill building with teens and parents by seeking the client’s permission to involve all of them in a session together. Once together, she thanks them for agreeing to work as a group and asks the family to name a minor conflict that they struggle with, such as squabbles over expecting the teen to drive a younger sibling to school. Because it’s a learning exercise, it’s best if they stay away from larger, high-stakes conflict, Sznewajs explains.

When she prompts the family to explain the disagreement, usually “everyone starts talking at once,” Sznewajs says. If this happens, she asks them to slow down and take turns so she can fully understand the situation and invites the teenager to start by explaining their perspective. Then, she prompts the parents to speak and give their perspective as well as reiterate what their child said.

Usually, the parents immediately jump to why the teen’s take is wrong rather than summarizing the teen’s experience. If this happens, Sznewajs will gently remind them that she wants to hear what they think their child’s perspective is, not whether it’s right or wrong, and explains that this response is common among families she works with. She also gives the adolescent the same assignment: Paraphrase your parents’ position without giving an opinion on what was said.

Sznewajs then continues the discussion by asking the teen and the parents to talk about how it felt when the other party paraphrased their experience. The aim, she explains, is to foster active listening skills and empathy toward the other party’s point of view.

“I emphasize that the important thing isn’t to agree but to feel heard,” Sznewajs adds.

Responding to “mistakes”: Parents often need to work on how they respond to their teen when what they see as a failure or mistake occurs. Sznewajs says she does this work either with the parents alone or with the family together, depending on what is appropriate and preferred by the client.

When a teenager or young adult makes a poor decision or has a slip-up such as failing a class, parents often default to anger, blame or “I told you so” lectures, Sznewajs says.

However, a better approach — and one that quells patterns of conflict — is to consider the full context of what happened and support the child so they can solve the problem on their own. Sznewajs says she often offers psychoeducation to parents on how becoming angry or interfering in the situation to circumvent conflict — such as paying for the child to retake a college class they failed — may not be helpful in the long run. Collaborating with the teen to find out what led to the situation and what they need to resolve it will keep them from feeling misunderstood and fueling further conflict, she stresses.

Instead of responding in anger, she coaches parents to use supportive statements such as “That must have been so stressful. How can we keep that from happening again?”

Sznewajs takes a truthful, direct approach with parents. She explains that their child “is trying to figure out life” and reminds them that mistakes happen. She may tell parents, for example, “Sometimes kids do dumb stuff, and they learn through trial and error, just like you did.” It’s often teaching parents to “be empathetic about the disaster that just occurred instead of angry,” Sznewajs says, “One of the most important pieces of work I do with families is helping them collaborate with their kids when they make a mistake rather than getting angry at them.”

It can be hard for parents to resist the urge to become involved in their child’s challenges, Sznewajs acknowledges, but allowing them to fail — within a supportive setting — furthers them on the path to becoming an autonomous adult. Teens who aren’t “allowed” to make mistakes because their parents respond with anger and blame often struggle to problem-solve and navigate challenges later in life, she says.

“The overarching goal [of counseling] with teenagers is to help them become autonomous, self-sufficient, confident adults,” Sznewajs notes. “And the best way to do that is to help them communicate effectively and support them as they learn to solve their own problems.”

Modeling respect: Counselors may need to work on self-awareness and patience with both teenage clients and their parents to bridge communication gaps. When parents and teenagers are at odds, both parties often come to counseling feeling disrespected, Sznewajs says. “Parents who demand respect [from children] but don’t give it back make for a pretty high-conflict home,” she adds.

Solmonson often stresses to parents that if they want respect during disagreements with their child, they’ll need to model that. For example, if a teen replies to a question in a sarcastic or disrespectful way, Solmonson coaches parents to respond by saying, “I’m going to give you a do-over. Do you need a minute to think about how to say that?” rather than blowing up in anger and furthering the conflict.

“If you [parents] raise your voice [at a child], you’re giving them permission to raise their voice back. If when they escalate, you escalate with them, you’re just fueling the fire,” Solmonson says. “Parents need to know how to handle things when feelings are big, and sometimes that means [saying,] ‘We’re going to take a minute apart’ and recognizing that ‘I don’t want to speak to you from the [emotionally escalated] place I’m at right now.’”

Taking a break: In moments of friction, parents often overcompensate and repeat themselves because they feel a child is not listening, Solmonson notes. It can be helpful to validate this experience for parents, she says, and explain that it’s a natural reflex to repeat yourself when you don’t get acknowledgment or a response from the person you’re talking to. But it doesn’t mean they’re not listening.

Solmonson also finds it can be helpful to establish a signal — such as making the timeout “T” signal used in sports with your hands — that either party can use when they need to take a break from a conversation or indicate that a topic is exhausted.

Fisher sometimes encourages families to use a signal or ring a bell she has available during in-person sessions to indicate that a member of the family is feeling invalidated or steamrolled during family conversations and disagreements.

The use of a “timeout” signal proved helpful  when Solmonson once worked with a family that had three adolescent sons. The mother “was very willing to work on becoming a better parent, but she would just talk and talk and talk” during disagreements, Solomon recalls. So the sons needed a tool to let their mom know, “OK, we’ve heard you. You’ve explained it enough. We understand.” 

It’s also important to emphasize to parents and teens that taking a break means walking away for a minute to calm yourself before returning to the conversation, Solmonson says. It doesn’t mean storming off to fume and feed your anger or leave the house entirely. A counselor can also equip both teens and parents with calming techniques and self-talk affirmations that focus on needing to hear what the other party has to say, she adds.

Part of this work , Solmonson notes, includes psychoeducation on the importance of “picking your battles.” She says she often tells parents and adolescents, “If you wait until something is really important to you and engage in a discussion on why it is important to you, you’re more likely to be listened to. But if you argue [about] every little point, the other person is going to stop listening.”

Reading nonverbals: Moore finds that she often needs to explain to parents that it can be a developmentally appropriate response for an adolescent to shut down when they become overwhelmed. During conflict, the reflex to stop talking and disengage can be one of a teen’s strongest tools, she says. Sometimes, they simply don’t have any more words.

Parents often need coaching on ways to respond to this behavior without losing their cool, says Moore, an ACA member. They may need to learn to gently ask their teen “Do you understand what I’m asking?” without expecting anything more than a nod. Moore sometimes serves as the moderator when families practice this technique in counseling.

“Children and adolescents have a built-in process to shut down and stop communicating [when overwhelmed], but their body language and their lack of words are telling us a lot,” Moore says. She has noticed that parents’ reaction is often to escalate, yell and become agitated. Instead, Moore teaches parents to notice their child’s body language and nonverbal cues and ask what it is telling them. 

“It tells you that what you’re doing is not working and you’ve hit a roadblock,” she says. “I have to teach parents that it’s not defiance. It’s gotten to a point when they [the adolescent] can’t go any further. They don’t have the capacity.”

Returning to the wise mind: Fisher works at a practice that uses dialectical behavior therapy (DBT) and finds the method particularly helpful and appropriate for adolescent clients because of its focus on differentiating between human’s emotional and rational states of mind. DBT guides clients to identify and use their “wise mind,” which draws upon a middle ground of both emotional and rational thinking.

A person who activates their wise mind is able to acknowledge and respect the emotions they are feeling while viewing a situation logically, Fisher explains, which is really useful during conflict.

Emotion regulation and distress tolerance are core treatment targets in DBT, which can also help both teens and parents during times of stress and disagreement, Fisher notes. She says she often talks with parents and teens about the need to ride strong emotions like a wave, rather than reacting with impulsivity, and offers psychoeducation on how humans’ emotional reactions usually tend to recede within 30 minutes.

DBT also fosters skills that can help teens to rationally think through the urge to turn to negative coping mechanisms such as self-harm, Fisher adds. She equips teen clients with numerous age-appropriate mechanisms that they can use to take their minds off distress and invite calm, such as reciting Taylor Swift song lyrics or playing solitaire on their phone.

Observing family dynamics: Moore is trained in Gestalt therapy and pulls from that method to focus on communication with parents and teenage children who are in conflict. One exercise that Moore finds helpful involves inviting the entire family to a counseling session and having them sit in a circle facing each other. She gives them a discussion prompt and then sits outside of the circle as an observer. While the family discusses the prompt, Moore listens, observes the family’s dynamics and pauses the conversation to occasionally offer comments on some of the interactions and patterns she is noticing. The power in this technique, Moore says, is that it prompts the family to communicate naturally.

The goal, she continues, is to bring awareness to sticking points that the family may not be cognizant of and give them techniques and assignments to improve communication, which they first try in session and then later at home.

Moore used this method with a family she once worked with that had three adolescent children (one son and two daughters). While discussing the prompt, a disagreement arose, and the mother began to raise her voice. When that happened, the three children slumped down in their chairs and stopped talking, and the father started looking around the room, avoiding his family’s gaze, Moore recalls.

Moore paused the conversation and said, “I’m noticing that when conversations get a little heated, mom’s voice escalates and all three children slump down in their chairs, and dad is disconnected too.” Then she asked the group whether this is a usual pattern of communication in their home. The children immediately said “yes” and reported that when their mother starts to escalate, “there’s nothing we can say” to placate her.

This conversation helped the mother realize that she felt a need to “project dominance” and speak louder when she assumed her children were not listening to her. As a result, she was shutting down communication, Moore notes.

Moore had the family work on rerouting this pattern in session with her and as a homework assignment to try later at home. She asked the mother to work on being more aware of her body language, voice volume and the needs of her children during arguments. The children were challenged to try and empathize with why their mother felt she wasn’t being heard and find gentle ways to signal to their mother that she was becoming escalated during disagreements while remaining engaged.

Using humor: Counseling sessions may be the last place an adolescent wants to be, Fisher acknowledges. This can especially be the case if their parents told them they were going to counseling five minutes before the appointment to minimize complaints and disagreement from the teen.

She finds humor to be a great way to break the ice, build rapport with adolescent clients and make counseling “easier to digest,” as long as it’s appropriate and a good fit for the client. 

Recently, Fisher had an intake session with a family, and it soon became clear that the teen was completely turned off and “wasn’t having it.” She diffused the situation by naming what she was observing in a humorous way: “It seems like you don’t want to be here, and I’m just this weird person asking a bunch of questions today!” This statement validated what the teen was feeling and helped make the session seem less adversary, she recalls.

Fisher cautions counselors to be careful when using humor and know how to use it appropriately. “Don’t use it to minimize emotions that a client is feeling,” she says, “but humor can normalize discomfort and helps the counselor come across as nonthreatening.”

Coping with unhealthy dynamics 

When working with parents and teens who are at odds, counselors can be put in a difficult situation if the parents expect the practitioner to “fix” their child without doing their own work to change unhealthy dynamics in the home environment. The counselors interviewed for this article say this is a common scenario, so during intake (as well as whenever this issue becomes a challenge later in therapy), they make a point to talk with parents of teen clients about the need to be open to change themselves.

“It doesn’t matter how hard a kid is trying to make changes in their own life [via counseling] if change is not supported in their [home] environment. … I can do fabulous work with a child but sending them back into an unhealthy environment that hasn’t changed will be detrimental and they won’t make progress,” Solmonson says. “Unless you [the counselor] can make some changes to the child’s environment, you’re not going to be as successful as you can possibly be.”

It’s vital for practitioners who work with teens to tailor their counseling approach to be sensitive to this lack of autonomy, Sznewajs stresses. Even older teens who work, attend college or live away from home often remain financially dependent on their parents, she adds.

It can be a challenge when a client’s home environment remains problematic, Sznewajs says, but “it informs my therapy so much. I can see what the problems are at home and what my client needs to cope because change likely won’t happen.”

When a teenage client’s parents are resistant, unsuccessful or unable to make changes in family dynamics, Sznewajs often helps the client shift their focus from feeling frustrated and complaining about toxic patterns at home to finding ways to cope and build small pieces of autonomy within their situation. She guides the client to explore and identify aspects of their home life that they have to tolerate while finding ways to manage and be true to themselves without stoking conflict and increasing turmoil.

She uses acceptance and commitment therapy to prompt them to identify what they can and cannot control. Techniques that help teenage clients identify and explore their values, Sznewajs says, can also be helpful and give them things to focus on that are within their control.

Fisher uses DBT to help adolescent clients identify their core values. It can be helpful to have the client explore what they want in their life and what is missing as well as how their values might conflict with or be similar to ones their parents hold, she explains.

“A lot of this work is managing situations that aren’t ideal, which is good training for real [adult] life,” Sznewajs adds. “We are not always in situations that are what you want them to be.”

 

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Read an online companion piece to this article, “Curfew is when?! Helping parents and teens see eye to eye on boundaries and rules.” And search for articles with the tag “teenager” at ct.counseling.org for more on the nuances of counseling adolescent clients.

Motortion Films/Shutterstock.com

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The emotional and social health needs of Gen Z

By Lindsey Phillips January 10, 2022

kitzcorner/Shutterstock.com

Members of Generation Z — typically defined as those born from the mid-1990s to the early 2010s — have little to no memory of a life without smartphones or access to the internet, which is why they are often dubbed “digital natives.” They have also grown up in a world where social media, political polarization, racial unrest, school shootings and climate change are ever-present realities. 

All of that turmoil and uncertainty is affecting their mental health, with 70% of teenagers across genders, races and socioeconomic status reporting anxiety and depression as major problems among their peers, according to the Pew Research Center. A report by the American Psychological Association found that Generation Z is 27% more likely than previous generations to report their mental health as fair or poor. On a brighter note, they are also more likely than older generations to seek mental health therapy or counseling, with 37% of Gen Zers reporting having worked with a mental health professional.  

Roshelle Johnson, a licensed professional counselor (LPC) and clinical director at Light and Power Counseling in Phoenix, works with a number of Gen Z clients who are struggling with anxiety or depression. Recently, she received three calls from parents whose children had just attempted suicide. “That spoke to me about how hopeless our young people are feeling,” she says. 

Addressing anxiety

Nichole DeMoya, a licensed mental health counselor and qualified supervisor in Florida, finds that many of her clients are in a constant state of worry. Her teenage and college-age clients commonly voice concern about future careers, school shootings, financial security, climate change and societal unrest. These clients are “very worried about the future because things are so unstable for them right now,” DeMoya says. She doesn’t dismiss their concerns; instead, she helps them learn to shift their focus to the present and on what they can control. 

DeMoya also considers the individual client’s home and school environment to see if they are adding additional layers of stress. She recalls working with a 12-year-old girl who struggled with anxiety. During one session, the client revealed she was scared that a foreign country was going to bomb her city. In learning more about the client’s home environment, DeMoya discovered that the girl’s father watched the news around the clock, and this was contributing to her anxiety. 

“She was starting her day already in that fight-or-flight [mode], already in a heightened state of anxiety,” says DeMoya, a clinical director at River’s Edge Counseling, a group private practice in Jacksonville, Florida, that specializes in treating trauma. “And then she went to school where she didn’t feel safe because school shootings are an ever-present threat.” 

DeMoya wasn’t able to help the client challenge her anxious thoughts because everything the client was being inundated with told her she should be anxious. So, DeMoya spoke to the parents and explained how the news was negatively affecting their daughter’s mental health. The father had been oblivious to this and was supportive of helping ease that stressor in his daughter’s life by no longer watching the news around her. That simple change made a big difference, helping the girl to regulate her nervous system and start her day on a positive note, DeMoya says. 

Jayna Bonfini, an LPC at Associates in Counseling & Wellness in McMurray, Pennsylvania, works with several teenage girls who experience anxiety and have histories of self-injury. By engaging in self-injury, they are taking their emotional pain and distress and turning it into a physical act, Bonfini says, so she uses dialectical behavior therapy (DBT) techniques to help them learn how to better regulate their emotional distress.

“Sometimes clients will use negative coping skills to escape painful emotions because it feels like it’s the easiest way to handle them,” Bonfini says. She instead helps clients learn healthier coping strategies with DBT skills. If a client is sad, for instance, they may isolate themselves from others. Bonfini may have the client use the DBT skill “opposite action,” which encourages them to choose the exact opposite of what their emotions tell them to do. So, instead of isolating, the client would go out and engage with others or perhaps even address the situation that is causing them distress rather than avoiding it. This approach helps clients build mastery over their emotions, she adds. 

Lauren Bellenbaum specializes in working with youth ages 10-24. She ensures that her clients leave counseling with a few practical skills they can use when they have a panic attack or feel extremely anxious (such as when they have to give a speech in class). “This generation … really want[s] skills,” she says. “Talk therapy is great, and they do need that too, but they also want to come out of sessions with some practical skills … [and] practical, straightforward advice.”

Bellenbaum, an LPC, often discusses different sensory skills that clients can use to help ground themselves when they feel anxious. For example, intense sensory experiences, such as eating sour candy, smelling essential oils, using very cold water, doing high-intensity exercise or engaging in paced breathing, can decrease anxiety, she says. She often advises clients to keep grounding objects nearby in case they find themselves feeling anxious throughout the day. Other sensory skills clients may use to help decrease anxiety or stress include having a calming Pinterest board or pictures to look at, a soothing Spotify playlist to listen to or their favorite blanket or sweater to wear. 

Improving interpersonal relationships 

Many of Bonfini’s clients seek counseling for anxiety, and social anxiety in particular. It is common for many young people to dislike phone calls, but Bonfini once worked with a client whose phone phobia was so intense that it prevented her from making necessary calls, including to the financial aid office at her college. Bonfini built an entire session around preparing the client to make this call, including practicing what the client would say and engaging in some deep breathing and interpersonal effectiveness skills with her. And then they made the call together.

“They have this impending sense of doom if somebody says, ‘We need to talk,’” notes Bonfini, an associate professor of counseling at University of the Cumberlands. “It’s this whole anticipatory anxiety that they all get, [wondering,] ‘What’s coming? What’s coming?’” 

Bonfini, who presented on supporting Gen Z’s mental, emotional and social needs at the American Counseling Association’s 2021 Virtual Conference Experience, also finds that friendships are difficult for several of her Gen Z clients. They often make casual connections with people online or at work or school, but that is different from a deep, personal form of friendship, Bonfini says, and that is where they struggle. 

Online friendships further complicate their ability to make and maintain meaningful relationships. Many of Bonfini’s clients say they mainly socialize online while they are alone in their room, which can be lonely and isolating for them, she says. Some of her clients even prefer online relationships, she adds, because when they have a problem, it’s easy to block this “friend” or create a new avatar and move on.

Bonfini, co-editor of the second edition of Casebook for DSM-5: Diagnosis and Treatment Planning, observes that Generation Z as a whole lacks many of the social skills that previous generations learned through face-to-face interactions. She finds DBT techniques helpful for teaching these (and other) clients interpersonal effectiveness, conflict resolution skills and ways to communicate their needs. 

Bellenbaum, owner of Transform Youth and Family Counseling, a group counseling practice in Grants Pass, Oregon, also finds DBT useful in helping clients learn a variety of skills, including emotion regulation, distress tolerance, mindfulness and interpersonal effectiveness. These skills are important for this generation, she says, because they often struggle with healthy communication and conflict resolution. One DBT skill she often uses to help clients communicate more effectively is DEAR MAN, an acronym that stands for the behavioral strategy of Describe, Express, Assert, Reinforce, be Mindful, Appear confident and Negotiate. This strategy supports clients in expressing and getting their needs met and in telling others “no” in a respectful way, thereby increasing the likelihood of a positive outcome. 

Bellenbaum also makes use of role-plays in session to help with interpersonal issues. A client may be having conflict with a friend, for instance, and isn’t sure how to address or handle this difficult situation. So, Bellenbaum has them act it out in session. She would play the role of the friend and have the client practice using their skills to approach the friend and have a conversation about their conflict. This makes it easier for the client to have the actual conversation later in person.

Johnson, a licensed independent substance abuse counselor, and Amber Samson, a licensed clinical professional counselor in Maryland, have both found that members of Generation Z sometimes have trouble differentiating between friends and acquaintances (terms that are often conflated because of social media) or recognizing healthy versus unhealthy relationships. There can be an expectation for this population to be “friends” with everyone they talk to online or in person, notes Johnson, who runs an anxiety management group for teens. They have followers on Instagram and friends on Facebook, she says, and this can lead to them being hurt when some of these acquaintances fail to meet their expectations or aren’t there for them. 

When a client refers to someone as a “friend,” Johnson asks the client to tell her more about the relationship. If, for instance, she learns that this friend is someone the client met online and plays video games with, she explores with the client what friendship means and how not every acquaintance is a friend. 

Johnson explains the concept of friendship using a dartboard illustration, with the inner target in the shape of a heart. She points out how the dartboard has different rings, which represent different levels of friendship, and how not everyone in the client’s life can fit in the inner circle or bull’s-eye — that area is reserved only for close, personal relationships. She finds this exercise particularly helpful with teenage clients, who are typically still figuring out these relationship dynamics.

Johnson encourages clients who are struggling with social anxiety after returning to in-person education to find a club or group that caters to their strengths. One client she worked with enjoys watching indie movies, so they joined a movie club at college. The group isn’t large — just four or five other students — but it’s a great way to meet others with similar interests and safely practice social skills, Johnson says. 

Relationships can be hard enough without adding in the complications of social media. One negative social media post can sometimes ruin a person’s day, so Bellenbaum often teaches clients how to cope and handle distress when things are outside their control. 

If someone made a rude comment about the client on social media that caused them to have an automatic negative thought such as “It’s true; I am a horrible person,” then Bellenbaum would use cognitive behavior therapy (CBT) to help the client identify, challenge and replace the negative thought with a healthier, more realistic one. But if the client is upset, angry and embarrassed about the mean comment, then Bellenbaum might teach them distress tolerance and distracting skills using DBT. This strategy allows them to tolerate difficult emotions and feelings so they can get through the rest of their day until they are in a space where they can get help or process their feelings. 

Samson, a therapist at Choice Clinical Services in College Park, Maryland, works with Gen Zers, millennials and people of color. She observes that members of Gen Z often struggle with interpersonal boundaries, largely because they have grown up in a digital world where they are constantly connected and expected to communicate with others. She advises her clients to take breaks from social media and engage in activities they find relaxing. Samson has noticed that if her clients dedicate some of their day to relaxing by themselves, then they typically feel better and have the energy to be available and interact with others. 

Some Gen Z clients may find it difficult to start a conversation with their counselor, Samson adds. They may not know how to explain or even identify what they are feeling, so she goes back to the basics and helps educate her clients on identifying feelings by using the feelings wheel. The wheel contains words identifying basic emotions in its middle and branches out to more complicated aspects of these feelings on the outer perimeter of the wheel.

Being authentic 

DeMoya, a certified child and adolescent trauma professional, stresses the importance of being authentic with this generation. “As therapists, we have to move away — as I think we are — from the disconnected, Freudian approach where we just put on our glasses, have our clipboards … and don’t engage in a more relational way,” she says. “You have to be willing to put the clipboard down.” Although there is nothing inherently wrong with taking notes in session, DeMoya says, it can sometimes be a barrier to developing a closer connection with Gen Z clients. 

This generation often wants to know more about the counselor they are working with, and as Bonfini points out, they are likely to have Googled the clinician before the first session. Bonfini recalls being taught as a counseling graduate student not to self-disclose with clients, but she has learned that some limited disclosure helps build rapport with this population. Her clients often ask if her high school or college experience was similar to theirs. She shares with them the ways it was different, such as not having a smartphone and having to make sure that she showed up on time to meet friends or else she would miss them. But she also normalizes and validates common adolescent experiences such as feeling uncomfortable in one’s own body, navigating romantic relationships and being unsure of what’s next after graduation. 

Being authentic also includes working collaboratively with this population to determine their treatment plans and therapeutic goals. Bonfini likes to use motivational interviewing to build rapport and let her clients know that she is working in partnership with them. She often requests that they rank and rate various mental health issues they may want to work on in session. And she asks them, “When will you know therapy is over? What does that look like for you?” This process not only lets the client know that counseling is a partnership but also provides her with useful information about the client’s core issues and treatment goals. 

Today’s counselors must also be willing to learn more about the world these digital natives inhabit. “If you want to be an effective therapist and connect with youth, you have to know social media,” Bellenbaum asserts. Bellenbaum familiarizes herself with current social media trends and has Instagram, YouTube, TikTok and Facebook accounts to help her better understand this culture and what her clients reference. She doesn’t play the video game Minecraft or games such as Dungeons & Dragons or Magic: The Gathering, but she’s aware of what the games are because younger populations often play them. Knowing about current social media trends will help clinicians better understand the challenges this generation faces, she says. 

But counselors don’t necessarily have to be familiar with all the latest trends to build rapport with this population. It’s great if you are, DeMoya says, but what’s more important is showing up authentically in session. 

Making counseling more friendly for Gen Z 

Counselors can also adjust their clinical environment to make it more welcoming for Gen Z individuals. One simple change is to offer electronic communication options for making initial contact with the counselor or setting up an appointment. Bonfini has found that Gen Z clients are less likely to reach out via phone, and when they do call, they don’t say much beyond “I want to make an appointment” or “Call me back.” Secure messaging platforms, text messaging and online forms allow clients to go into more detail and explain why they are seeking counseling, their current schedule and the best way to get in touch with them, she says. 

Bellenbaum uses the app Talkroute, a virtual phone system, for her business because it allows clients to call and text her business line for scheduling purposes. Bellenbaum can also access this app on her laptop or phone, which makes it convenient for her as well. In her client intake packet, she stresses that texting is only for scheduling issues because she cannot guarantee confidentiality through text, but she likes having this option because she knows Gen Z clients are more likely to text than to call. 

Bellenbaum mentions the importance of counselors having office décor that clients can relate to. She has tailored her space to the Gen Z age group by having modern décor with comfortable chairs, blankets, pillows and inviting colors. She also keeps fidgets and snacks in her office in case clients want them. Bellenbaum says her clients often notice and comment on how they like her wall color or décor.

DeMoya’s goal is to create a therapeutic environment that feels like two friends hanging out in a living room. She invites clients to bring in their own coffee or snacks, and she also keeps drinks and snacks in her office. She tells clients to sit where they feel most comfortable — whether that’s on the couch with their feet up or on the floor — and DeMoya will join them in sitting on the floor if they ask her to. 

Bellenbaum also knows that, as digital natives, Gen Z clients prefer electronic forms over paper ones, so she has made all her paperwork electronic and uses an electronic health record. In fact, she doesn’t even keep a filing cabinet in her office. “A big piece of working with Gen Z [is using] … what works for them,” Bellenbaum says. 

If clinicians use a lot of paper worksheets and homework assignments, there is a good chance the forms will be lost or not filled out, Bellenbaum says, so she finds electronic copies more useful. She also suggests counselors get creative in how they incorporate electronic therapeutic techniques. For example, she may ask clients to keep a thought journal on a note app on their phone, and she often recommends that they use apps such as Calm or Headspace when they are working on mindfulness techniques. When she has assignments for clients, Bellenbaum may give them an electronic worksheet, have them take a picture of a worksheet on their phone or email them a link to a counseling exercise because she says they are more likely to engage with the activity if it can be accessed electronically. 

Samson also uses therapeutic apps with her clients. For instance, she sometimes recommends that clients who are struggling with obsessive-compulsive disorder use the GG OCD app, which converts CBT techniques into short games that challenge intrusive thoughts and promote positive self-talk. 

DeMoya has learned that many Gen Z clients prefer counseling approaches such as mindfulness and eye movement desensitization and reprocessing (EMDR) that allow them to be in the moment targeting specific issues. When doing bilateral stimulation as part of EMDR, DeMoya gets creative to keep these clients engaged. For example, she gives clients who are musically inclined drumsticks, sets a metronome and has them drum to the beat, or she may have a client use boxing gloves and punch left and right for bilateral simulation.

“Generation Z is all about experiences,” DeMoya says. “If you can make the counseling [process] … something that touches all of their core senses — sight, sound, touch, taste, smell — and you can create something that is an experience in the counseling room, that’s how you’re going to get a whole lot of momentum from them.”

“They’re so stimulated in every area of their life,” she adds. So, “the counseling session has to be something that engages them in multiple, different levels.”

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Considering developmental and generational factors

Counselors know Erik Erikson’s stages of psychosocial development well, and they often think about how a client’s life stage (say as a teenager or emerging adult) might be affecting their mental health. But should counselors also consider the generation that a client belongs to? 

Amber Samson, a licensed clinical professional counselor in College Park, Maryland, thinks counselors should consider both. From a life-stage approach, counselors can reflect on what it was like to be an adolescent and emerging adult and how they are thinking about issues socially, she says. And from a generational perspective, counselors “can see the unique challenges that Gen Z clients face with communication and the constant access they have to their peers, which heightens the judgment and pressure they feel at this age.” 

Jayna Bonfini, a licensed professional counselor in McMurray, Pennsylvania, and a counselor educator, agrees that it’s important for counselors to be aware of how generational factors affect clients’ mental health and development. Drawing from psychologist Urie Bronfenbrenner’s bioecological theory of development, which argues that human development is a transactional process in which surrounding environmental context shapes an individual’s development, she points out that one’s sociopolitical time influences one’s development. Every generation faces different environmental and societal factors, and Bonfini argues that with increasing technology and climate change, Gen Z is dealing with a lot of issues and crises that previous generations didn’t have to think about in the same way.

At the same time, counselors must guard against pigeonholing clients based on “membership” in any particular generation. “A big hurdle that we can all get into as humans is looking at the next generation and automatically putting them in boxes [e.g., boomers are selfish, millennials are entitled, Gen Z is antisocial], and it [often] comes into the counseling session,” says Nichole DeMoya, a licensed mental health counselor in Jacksonville, Florida.

DeMoya encourages clinicians to be aware of their generational biases and to make sure that they do not intrude on their work with clients. It’s easy to criticize, blame and label, she notes, so Gen Z clients often want to know if they have credibility with their counselor and if their worries and concerns are going to be taken seriously.

 

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Lindsey Phillips is the senior editor for Counseling Today. Contact her at lphillips@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Addressing sexual violence among teens

By Leontyne Evans October 13, 2021

Intimate partner violence is increasing at an overwhelming rate among teens and young adults. Because of this, sexual violence is also increasing. Due to the lack of education and awareness in this area, it often goes unreported to authorities.

To better understand the topic, we first have to define it. Sexual violence involves forcing or attempting to force a partner to take part in a sex act or sexual touching when the partner does not or cannot consent. It also includes nonphysical sexual behaviors such as posting or sharing sexual pictures of a partner without their consent or sexting someone without their consent.

While facilitating groups and programs with young people in Omaha, Nebraska, I found that 3 of 10 participants were victims of sexual assault by a partner and didn’t know it. They were unaware that the actions of their partner were classified as abuse.

This has been consistent with all groups, classes and programs that I have facilitated. It is important to bring awareness to how under-reported this issue is among youth. In many cases, it’s not only those who have been victimized who are unaware they have experienced sexual violence. Believe it or not, the perpetrators of such abuse can lack awareness that they are using abusive tactics such as manipulation and coercion.

The need to talk about sex

A lack of education in this area exists in part because it is typically seen as taboo to talk about sex and consent with youth. Among those who are victims of sexual violence, physical violence or stalking by an intimate partner, 26% of women and 15% of men report that the abuse or other forms of violence took place before age 18.

Many parents think that talking about sex will encourage their children to engage in sexual activity before they are ready, despite there being no solid research to support this belief. So, because parents aren’t teaching it at home and because the sex education being taught in schools is pretty much limited to “have sex and you’ll get pregnant or catch a sexually transmitted infection,” many youth don’t have a proper understanding of what consent actually is.

Some victims believe they have to have sex with someone because it’s their “job” as a partner. The urban proverb of “what you won’t do, someone else will” reigns in the heads of our youth, making them believe they must have sex to keep a person’s interest. There are also young people who have not been taught to accept the word “no,” so when their partner says it, they don’t believe it or accept it. They either continue to try until their partner gives in or they become aggressive because they feel “disrespected.” This is the behavior we must bring attention to as counseling professionals. But to do that, we must figure out where it starts, how it starts and why.

Overall, youth who offend are more likely than youth who do not offend to have backgrounds involving fetal alcohol spectrum disorders, substance abuse, childhood victimization, academic difficulties or instability in the living environment. Studies performed on youth offenders show that youth who have been faced with adversity are at a higher risk to offend. These studies seem to be suggesting that these problems are rooted in familial dysfunction.

The message of entitlement

My work with youth has exposed several issues with parenting when it comes to young people understanding and accepting the word “no.” Many parent do not seem to grasp that every decision they make will have an impact on their children one way or another. Raising entitled children may not seem like such a big deal when they are younger, but those small, cute children have to grow up someday.

Not telling a child “no” to avoid hurting their feelings or hearing them cry is common. We want to protect our children from the harsh realities of the world and try to soften the blow by giving them the things that make them happy. But what happens when that child turns into a teenager and can’t accept the concept of “no” because they literally don’t know how. What happens when that sweet baby grows up learning that “no” doesn’t really mean no? That if they keep asking, become aggressive, act intimidating or annoy someone enough, that “no” can turn into a “yes”?

Kids who can’t accept no for an answer or perceive rejection as a form of disrespect take these behaviors into adulthood and are more likely to abuse. Once again, it may not be intentional. They may not even see themselves as abusers. This has simply become their norm, a learned behavior that has been accepted rather than corrected, leading them to believe that the person saying no is the one with the problem — not them.

Working together

In the counseling profession, we not only have the ability to work with youth victims and perpetrators; we can also offer support to the adults in their lives. We can speak to the importance of supporting the development of healthy, respectful and nonviolent relationships. It is critical that we take advantage of our access and give parents tips on how to navigate through these tough situations.

During the preteen and teen years, it is critical for youth to begin learning the skills needed to create and maintain healthy relationships. These skills include knowing how to manage feelings and how to communicate in a healthy way.

We can all work together to end the cycle of teen dating violence and teen sexual violence by encouraging adults to create safe and brave spaces for our youth. This involves creating spaces at home and school where youth feel safe to come to an adult to have open and honest conversations. It should be a place of trust and support, not judgment and anger.

Youth also need examples of healthy relationships. If children have been subjected to unhealthy relationships, parents should consider seeking professional help for their children to process their feelings toward what they have witnessed.

We often focus on making sure that adults involved in domestic violence situations are connected to programs and services, but we tend to forget about how children are affected by the abuse. As we encourage adults to seek counseling, we should encourage them to seek therapy for their children as well. Second-hand violence is just as impactful as firsthand violence.

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Being willing to be uncomfortable

In working with youth, we need to get used to the idea of introducing the concept of consent and safe sex at an early age. Contrary to popular belief, this will not encourage youth to have sex. It will, however, ensure that they are properly educated and prepared when they do decide to engage in sexual activity.

We also have to start having the same conversations with boys and girls. We can’t teach our girls about consent and not our boys. We can’t see only our girls as having the potential to be victims and not our boys. All children should be provided with the same knowledge, skills and tools to combat abuse.

Finally, we must create the possibility for prevention. Sex education should include more than discussions about pregnancy and sexually transmitted infections. Safe sex should refer not only to using condoms and contraceptives but also to discussing actual safety. Safety includes consent, mental and emotional safety, physical safety, the environment, etc. Using a condom does not make sex safe.

I had a client say that she hadn’t been raped because she didn’t scream and he used protection. We must change the narrative of what rape looks like in our society. We have to educate our youth in all things concerning sex, not just the parts that are comfortable to discuss. Then and only then can we begin to end the cycle of teen dating violence and sexual violence.

 

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Leontyne Evans works as the survivor engagement specialist for Survivors Rising, where she helps to empower and uplift survivors by providing education and resources that encourage survivor voice and self-sufficiency. She is a published author of two books, Princeton Pike Road and Relationships, Friendships and Situationships: 90 Days of Inspiration to Keep Your Ships From Sinking, both of which support her mission of ending the cycle of unhealthy relationships. Contact her at leontynesurvivorsrising@gmail.com.

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