Introduction

Teenage years! – I’m sure we all remember this time in our lives: swirling, intense and rapidly changing emotions; conflicts with parents; peer pressure; school demands, rules and temptations; romance and friendship challenges; drug and alcohol pressures; the quest for independence; and now social media! So much to accomplish – and so quickly! As you can imagine, most of my clinical experience and treatment of adolescents focuses on:

• Relieving moodiness, depression and anxiety; low motivation; withdrawal.
• Reducing the impact of trauma, stress, school and social demands.
• ADHD and school performance issues.
• Build self-esteem and self-confidence.
• Eliminating violent video game, internet and social media obsessions.
• Anger: Correcting disruptive, defiant and oppositional behaviors that cause poor family relationships and conflicts with rules at home, school and society.
• Restore-enhance parental influence.
• Ways to handle interpersonal conflicts with other adolescents (including bullying, cliques, social media and cell phone messaging).
• Drug and alcohol abuse.
• Compensating for intellectual and other developmental difficulties.
• Personality development disruptions.
• Self-harm behaviors and suicidality.
• Adaption to relocation, separation, divorce, adoption and family blending; illness and loss.

Therapeutic Approaches

I use a blend of problem-solving, mindfulness, skill acquisition, cognitive, and psychodynamic approaches to view and address adolescent problems from their perspective – while at the same time incorporating parental viewpoints and goals. I first focus on creating a secure, non-judgmental and empathetic relationship with your son or daughter. I try and make our meetings interesting, fun and self-affirmative for adolescents so we can address serious conflicts in a non-traumatizing and didactic way. Then, I work to increase coping and problem-solving capabilities. I strive to restore the opportunities of adolescence, to maximize acquisition of skills needed for adulthood and develop advantageous personality attributes. Finally, I re-establish parental involvement to enhance positive family dynamics where kids feel parents are their source of reassurance, advice and support. This may mean both individual and, eventually, some family sessions. An additional important goal is to extend improved parent-child relationships into the future.

Mood and Anxiety Problems

Emotional distress in adolescents are common and sometimes difficult to identify, particularly as symptoms are often masked by behavioral responses, such as anger and aggression, poor school performance, acting out, low self esteem, social withdrawal or self-harm. Problems may be magnified because of limited verbalization skills and emotion regulation capabilities. My therapy develops both skill sets to help adolescents recognize their emotional difficulties, link them to their specific causes and find healthy resolutions.

Behavioral Issues  – Anger Management

Behavior problems at home and in school evoke diagnoses such as ADHD, learning disabilities, bipolar disorder, opposition-defiant disorder and conduct disorder. Such diagnoses are generally descriptions of behaviors, and are not representative of an irreversible underlying ‘pathology’ or ‘disease’.  Without treatment, however, behavioral problems can increase in severity and extend into adulthood as severe disruptions in personality – a notoriously difficult feature to treat in later life. My goal is to help adolescents learn how to make healthy decisions when parents are not around to guide them. Some behaviors reflect underlying mood, trauma or interpersonal conflicts. These will be addressed. Problems can also reflect disrupted family dynamics, or a mismatch between parenting style, discipline strategies and adolescent responsiveness. Where needed, our therapy will identify and treat these issues in a caring and cooperative way in parental sessions.

Drug and Alcohol Abuse

Substance abuse and dependency are highly dangerous, particularly in adolescents, and can lead to serious harm, arrest or death. Substance abuse issues must be dealt with immediately and effectively.  I offer treatment in critical time windows of opportunity:

• In early or sustained stages of use – often discovered at school or home – before the need for inpatient treatment.
• After an arrest and legal problems.
• After court sentence – required treatment program.
• After inpatient treatment and return home to family and school.

Edgewater Psychotherapy provides both early and supportive treatment for substance abuse in adolescents.

Treatment modalities are derived from Dialectical Behavior Therapy as well as the Adolescent Community Reinforcement Approach. Emphasis is placed on psychoeducation, reinforcement of refusal skills, addressing drives to use (peer pressure, mood disorder, stress), as well as establishing a lifestyle away from substance use in cooperation with parents and family.

Peer-pressure and Relationship Conflicts

Poor interpersonal skills in combination with peer pressure, intense emotions, temptations and low self-esteem can lead to severe disruptions in social interactions with associated mood and behavior problems, including promiscuity, substance abuse, law-breaking, bullying and risk-taking. I focus therapy here on developing choice-making skills.