Sex, Drugs and Body Image: A Coping Plan for Teens & Parents

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. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Barbara

    March 16th, 2009 at 10:51 AM

    Adolescence is such a difficult time. I remember being a teenager and being faced with so many hard choices and very frequently making the wrong decisions simply because I did not yet have the mechanisms in place that I needed to be able to make wise and studied choices. I am very fortunate that none of the choices that I made have had a detrimental effect on my life, but it is a wonder! I have a very hard time with parents who seem to have forgotten everything that they did as a teen and who then hold their own children up to very unrealistic expectations. I hope that in your therapy sessions you work with the whole family to discover what is going on in this young life and helping them all to explore all of the underlying issues and the things they can do as a family to facilitate a better and stronger environment for everyone.

  • carrol

    March 17th, 2009 at 12:21 PM

    All teens just need to have something that they feel in control of and this is but one of the many ways that this need manifests itself.

  • Yancey

    March 18th, 2009 at 12:49 AM

    I really like the look of the Coping Plan. I agree with carrol, we as parents need to remember what it was like when we were in School and were teenagers. I used to be a teenager and I do remember, vaguely how it was.

  • Sage

    March 18th, 2009 at 3:21 AM

    I like number #1, putting a name on it. I think the idea of the family coming up with their own language for the problem is a great way to get everyone engaged in trying to understand what’s going on, and to put it in a context that feels true and right. It can be hard for people to find meaning in clinical terms, and those terms don’t always capture everything that the family members need to have included in their official designation of what the problem is.

  • Melissa

    March 18th, 2009 at 3:28 AM

    I think teenagers need a friend more than anything. Being a friend to your child doesnt mean you have to smoke pot with them but being involved in their lives and making them THE priority. If you havent done it in their pre-teen years make a start atleast in the last years they live under your roof and your rules. I think its cool if a dad and son take up kick boxing together or if a mom and daughter have a day at the spa together. Teenagers do know the right from wrong and lecturing them is not going to help.

  • Dale

    March 18th, 2009 at 6:50 AM

    Then they need to be given more things at home and at school that they can do and feel in control of and good about, not just thinking of the things they can do with their bodies. Whatever happened to teaching them about being proud of things they accomplish at home such as improvement projects or being proud of the things that they do at school. This is more than enough proof that we are all focusing on the wrong things in life and teaching teens and even younger children to think about them too. Give them responsibilities to live up to at home, and when they do a good job praise them for it. Do not make their lives so that the only things they receive praise on is how emaciated they look or how drunk they got the night before. Peer praise can steer them in the wrong direction- we as adults have to step in and do more for them.

  • Becks

    March 20th, 2009 at 4:33 AM

    Maybe if children had heathier role models everywhere they turned instead of those who always seem to be on the path to destruction we would not have a lot of these problems.

  • Hilman

    March 22nd, 2009 at 8:32 PM

    I caught a kid I know smoking pot recently. He told me that he was fed up of the noise in his life. His mom and dad are divorced and neither is a responsible person to take care of him. His friends taunt him and tease him for being a loser. Noone cares whether he exists. I definitely agree with the role model thing. Even if you are not a white collared parent atleast be there for your kids and show them that you are doing the best you can to make their life worth living. I am sure that goes a long way.

  • Dorothy

    March 23rd, 2009 at 3:41 AM

    As the parent of two girls I am constantly shocked at just how far parents and the media are allowing their own young girls to take things these days. The clothes are ridiculously trampy and they are encouraged to be sexy from a very early age. What is going on here? This is crazy. I feel like I have to do more and more every day to take matters into my own hands- I am even looking for schools that require uniforms because I think that takes a lot of pressure off of girls of all ages. We try to do what we can to monitor the images that our kids are exposed to but it is not enough. Many messages that they receive depict drug use and starvation as cool, not as real problems. Not only does this need to be talked about at school, but also in the home, everywhere the kids are to make it loud and clear that this type of behavior is scary and dangerous, and completely not cool.

  • Kylie

    March 24th, 2009 at 2:01 AM

    When being a hobo is cool and smoking pot is child’s play, I am not surprised we need so much of help from counsellors and psychologists. Substance abuse amongst young people is the most sickening thing happening with society these days.

  • Felix

    March 30th, 2009 at 4:19 AM

    Sex, guns and rock and roll used to be hot in my times. I think the only thing that’s changed is the music is now hip hop. Love changes a lot of things. Sometimes children turn into parasites and parents into need givers. We need to change that to be able to make a dent into the mind and heart of our own children.

  • Ollie

    June 10th, 2009 at 2:09 PM

    Its awful when you’re in that hole with depression, but I believe you can climb out of it, its a long journey but boy is it worth it, as the suffering and the experience in the long term becomes an asset. Would you agree?

  • eva

    February 2nd, 2011 at 8:46 PM

    I’m a mother of three teens 1 boy and 2 girls. as per my observation they were curious of everything. i let them to explore with a proper guidance of course and so far it doing good. i treat them as my best friends and i don’t think they have the reason to hide at me. so far they all have clean living lifestyle. but if ever i would definitely follow the 7 steps that you suggest.

Leave a Comment

By commenting you acknowledge acceptance of's Terms and Conditions of Use.

* Indicates required field.

GoodTherapy uses cookies to personalize content and ads to provide better services for our users and to analyze our traffic. By continuing to use this site you consent to our cookies.