As a therapist who offers counseling for teens and their families, I’ve become aware of some of the biggest issues facing young people today. While depression and anxiety remain two of the major reasons why parents seek my help, often these are not the first issues that drive them to consult a therapist about their child. Usually, it’s one of the “Big 3” teen issues of our day – Sex, Drugs and Body Image issues (which includes eating disorders and steroid use).
Understanding the Adolescent Brain
Adolescence seems to be a time when these 3 issues surface more commonly than at other ages. That is not by accident. From what we now know about the developing brain – and what we are continuing to discover – dramatic changes occur during adolescence. These changes include forming a sense of identity, acquiring the ability to think critically, testing judgments about risk and reward, conceptualizing the world in abstract ways and forming lasting social relationships, among others.
These are all critical skills that will prepare young people to become independent and autonomous adult individuals. However, these changes – and the rapid, sometimes “herky, jerky” pace at which they happen – also leave many teens vulnerable to the lure of unhealthy sexual activity, dangerous abuse of alcohol and other drugs, frightening problems with food and eating, as well as the use of steroids and other “body enhancers.”
Often, teens are expected (by both adults and their peers) to be able to handle life’s unpredictable events as an adult would, even though they have yet to fully master the skills necessary to do so. Therefore, when stressful, traumatic or depressing events occur – sometimes exacerbated by high performance expectations in school or athletics, physical or sexual abuse, loss of a loved one, problems with romantic relationships, etc. – teens often find the attraction of sex, drugs, steroids and other behaviors too good to ignore.
Drugs and alcohol can provide short-term feelings of comfort, confidence and euphoria. Sexual activity is often connected with an adolescent’s desperate search to connect on an intimate level with another person. And problems associated with body image, such as eating disorders, often are attempts to control at least one aspect of a teen’s life, especially when other dimensions feel out of control.
Constructing a Coping Plan
Whether an adolescent has only recently begun to dabble in one of these Big 3 issues, or whether he or she finds themselves in the throes of addiction, bulimia, steroid use and other alarming behaviors, one of the critical steps in either resisting or recovering from these problems involves constructing a solution-focused plan.
In my experience as a teen therapist in Pasadena, helping my clients to cope with Sex, Drugs and Body Image issues is not a “one-size-fits-all” process. Each adolescent, and their families, school situations and living conditions that surround them, is unique and different. So the best plan to coping with these problems usually involves consulting with an experienced therapist and constructing a plan that fits with the teen’s specific situation. That being said, I do tend to follow a general structure when I help teens and their families construct their own Coping Plan:
1) Naming It.
In order to break through the assumptions or silence that often accompanies drug use, sexually acting out and other issues, I invite teens and their families to specifically name what the problem is. Sometimes, they use a generally accepted name, like “Bulimia” or “Drug Use.” But other times, they come up with their own titles, like “Pretending that She Eats” or “The Pot Smoking Problem.” This naming process can be very helpful in getting everyone on the same page and focused on what the goal of counseling is going to be.
2) Describing It.
During this stage in the process, my clients and I usually go through a variety of different questions and scenarios. The goal is to paint as specific and detailed a picture of the problem – when it happens, how it shows up, what it interferes with, etc. Describing the problem and understanding its facets and dimensions really help my clients to clearly express what they are really dealing with.
3) Formulating a Goal.
This stage involves understanding how teens and their families would prefer to live in relation to the problem. Why do they want things to be different than they are right now? How would they prefer to deal with their problems? This can also be a time to discuss how they will define success. For example, “If you finally have control over drinking, what will you be doing differently?” Or, “How will you know when you’re doing better?” This is very helpful in measuring success.
4) Finding Exceptions & Strengths.
During this part of the process, it can be helpful to start identifying and describing ways in which the Problem doesn’t influence you. When does it not seem to be as big? When you are able to say “no” to drugs? How are you able to do that? What things or people seem to help? I often invite teens and their families to identify strengths and resources that can help, including activities that don’t involve their specific problems. I believe that every teen has strengths that can be useful in building their coping skills.
5) Writing a Contract.
Often, I find that teens and parents can more easily experience success when they put down on paper how they will work to overcome the problem. This contract can look several different ways, but it seems to be best when all members of the family are involved on the same team against the problem. For example, when everyone has a role to play in battling an Eating Disorder, it tends to become overwhelmed, rather than your teen.
6) Doing the Plan.
During this phase, my teen client and their team members will start acting against the problem. Success tends to increase even more when they can find other sources of support – from groups like AA or OA, social or church groups or other types of gatherings that don’t tolerate the problem or are vigilant against it.
7) Monitoring and Adjusting.
Once a teen and his or her family start seeing some initial success in their plan against a specific problem, it’s vitally important that this progress is noted and monitored. Often we think that it is the job of the parents to monitor how the teen is doing, but I’ve found that the Coping Plan is even more successful when every member of the team has a role in monitoring the other members. Once again, it keeps everyone on the same page and working towards the same goal. This is also the time to keep track of things that are not working and discard them, while identifying and starting to do more of the things that do seem to help.
This 7-step plan is meant to be general, so it may be difficult to implement after merely reading this article. But it should give you ideas of possible ways to help a teen and their family to cope with problems involving Sex, Drugs and Body Image issues. A good therapist can help implement such a plan and open more possibilities.
© Copyright 2009 by Tom Badzey, MA, MFT, therapist in Pasadena, California. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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