Therapy for Teens

The teen years are an important period of development. Experts suggest that mental health struggles are not uncommon during these years, with one in three high school students reporting symptoms of depression such as sadness and hopelessness. Just as with adults, therapy can be a helpful resource for teens to address some of these common concerns.

There are many different types of therapy that may be useful for treating adolescents. In order to choose which type of therapy is right for your teen, it can be helpful to learn more about your options and how each one works.

This article discusses some of the types of therapy that are common for teenagers. It also covers how these therapies work, the benefits of each, and what you can expect during treatment.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, often referred to as CBT, is a type of psychotherapy that focuses on making connections between thoughts, behaviors, and feelings. Psychotherapists who use CBT help people identify and change dysfunctional patterns.

Basic Principles

CBT is based on the idea that there is a clear link between thoughts, behaviors, and feelings. A teen who thinks they are socially awkward, for example, may then experience anxiety and avoid social interactions. CBT works by helping teens learn to identify their automatic negative thoughts and replace them with more helpful, realistic ones.

How It Works

Teens often develop distorted core beliefs about themselves. CBT helps confront and modify those distortions. A psychotherapist using CBT would help a teen identify those unhealthy thought patterns that contribute to mental health problems. A therapist may ask a series of questions and ask the person to keep a thought record to help identify dysfunctional thoughts.

Benefits of CBT

CBT helps teens learn how to interpret their environment differently. Compared to other therapeutic approaches CBT is generally short-term. Sometimes, only a handful of sessions are needed.

The approach is also very problem-focused which means it deals with issues in the present. Treatment providers aren't likely to rehash a teen's childhood or look for hidden meaning in their behavior. Instead, sessions focus on helping the teen with problems going on now. 

This type of therapy can provide benefits such as:

• Change negative thought patterns
• Identify positive responses to stress
• Improve communication with others
• Improve self-esteem
• Interrupt thoughts that lead to addictive or other self-destructive behaviors
• Reduce fears and phobias

What to Expect

During CBT, your teen will work on identifying negative thoughts, which can be a challenging process. Their therapist will work with them to develop new ways of thinking and learn new coping skills.

Your teen may be assigned "homework" to do outside of their therapy sessions, which may involve practicing many of the skills they are working on during therapy. CBT tends to be highly structured, which can be helpful for teens who want to be able to clearly understand goals and expectations.

Family Therapy

Family therapy is an approach that helps teens by addressing the interpersonal and family issues that affect their mental well-being. For teens who are dealing with problems with the home environment or family conflicts, this type of therapy can help both the child and the family as a whole.

Basic Principles

Family therapy works by improving emotional awareness and understanding their role in the family. By working with their therapist and with the rest of the family, individuals are able to learn more effective ways of communicating with one another. It can also help parents and caregivers learn strategies such as listening to and validating their teen's emotions.

How It Works

Family therapists utilize a number of techniques in order to help teens and their families. Their approach may include behavioral strategies such as role-playing and modeling effective communication, psychodynamic strategies such as talking about experiences in order to gain insight, and structural strategies to address how family routines and dynamics play a role in how each member of the family functions.

Benefits of Family Therapy

This type of therapy can help teens and families in a variety of ways. Some of these benefits include:

• Improving communication
• Reducing conflict
• Improving the home environment
• Creating empathy
• Building family cohesion 
• Developing healthy boundaries

This approach can be helpful in addressing behavioral issues and coping with life changes such as moving, divorce, or the death of a loved one. 

What to Expect

Family therapy can be short-term or last longer depending on the situation a teen or family is facing. Some sessions may focus only on your teen, but in most cases, it will involve all of the members of the family.

During your sessions, you will talk about the issues you are facing and explore other factors that may also contribute to issues including peer influences, stress, trauma, or underlying mental health conditions.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy, often referred to as ACT, is an approach that can help teens learn to identify, understand, and accept their emotions. Teens commonly face challenging or strong emotions, so gaining an understanding of these feelings can help them find ways to manage them effectively.

Basic Principles

The basic principle underlying this approach is that learning how to accept emotions can help improve psychological flexibility. This skill involves being able to regulate emotions in the short term and set aside feelings until you are able to address them in an effective and acceptable way.

How It Works

This type of therapy utilizes six key strategies to help teens understand their emotions:

• Acceptance: Instead of avoiding negative emotions, teens are encouraged to observe and accept them without trying to change or deny them.
• Cognitive defusion: The focus of this step is to change how they react to their feelings or thoughts. By changing this reaction, the emotion then has less power over them.
• Being present: This strategy focuses on being mindful and aware of what is happening without judging or trying to change the experience.
• Self as context: The focus of this technique is to help see their thoughts as something separate from their behaviors. 
• Values: ACT works to help teens identify the values that are important to them.
• Committed action: This type of therapy also helps teens find ways to commit to behaviors that will help them stick to their values and achieve their goals.

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Benefits of ACT

ACT can be beneficial for treating a number of conditions. Research suggests that ACT can be an effective tool for helping reduce symptoms of conditions such as anxiety and depression.

What to Expect

During ACT sessions, teens work with their therapist to assess issues in their life that may be creating emotional challenges including relationships, negative self-talk, and stressful events. Sessions often focus on addressing immediate challenges in a teen's life and then move on to addressing past issues and developing new skills.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy, also known as DBT, is a form of CBT that was originally developed to treat borderline personality disorder (BPD). It has since been adapted to treat other mental health conditions including attention-deficit/hyperactivity disorder (ADHD), depression, eating disorders, post-traumatic stress disorder (PTSD), and suicidal behaviors.

Basic Principles

The key strategies used in DBT include:

• Mindfulness, which involves learning how to focus on the present moment without worrying about the past or future
• Distress tolerance, which involves using techniques such as distraction or self-soothing to better tolerate distressing emotions or situations
• Interpersonal effectiveness, which focuses on helping teens develop positive, healthy relationships
• Emotional regulation, which helps teens identify and label emotions and explore ways to cope with their feelings effectively

How It Works

Teens who are treated with DBT learn behavioral skills in group therapy settings. They also receive individual therapy where they address personal challenges in their life and adapt and practice the new skills they have learned. During treatment, teens can also receive phone coaching from their therapist when they are facing challenges in their daily life.

Benefits of DBT

DBT can help teens achieve greater self-acceptance, gain new skills, and learn to better tolerate distress. Research suggests that DBT can be helpful for treating a range of conditions in both adults and children.

What to Expect

During treatment, teens attend individual sessions as well as group therapy sessions where they receive skills training. During skills training, teens learn new skills, practice these skills in the group, share their experience, and gain support from other group members. Homework to be completed outside of these sessions is also common. 

Interpersonal Therapy (IPT)

Interpersonal therapy is an approach to treatment that focuses on how interpersonal relationships and social interactions affect mental health and well-being. One form of this therapy, known as interpersonal psychotherapy for adolescents (IPT-A) has been specifically adapted to treat depression in teens between the ages of 12 and 18.

Basic Principles

The key idea behind IPT is that improving relationships can help relieve symptoms of depression. It helps with difficulties in relationships by addressing interpersonal deficits that make it difficult for teens to form and maintain quality relationships.

How It Works

Proponents of IPT suggest that social and interpersonal factors play an important role in both the onset and maintenance of depression. By addressing problems with loneliness, grief, trauma, transitions, and unhelpful relationships, IPT works to relieve the distress that people feel.

Benefits of IPT

Studies have shown that IPT-A can be effective as a treatment for depression in adolescents. During treatment, teens learn to recognize their feelings about relationships, improve their communication skills, and decrease relationship-related stress.

What to Expect

In IPT-A, teens meet with their therapist once a week for a 12- to 16-week period. Each session has a specific focus, including exploring how relationships influence mood, identifying problem areas, developing new problem-solving strategies, and practicing new interpersonal skills.

A Word From Verywell

According to the Centers for Disease Control and Prevention (CDC), getting an early diagnosis and intervention is essential for the well-being of children with mental health conditions. If your teen is struggling with a mental health problem or a behavioral issue, talk to their doctor. A physician can rule out any possible medical issues that may be contributing to the issue can refer you to a therapist.

A mental health professional will likely want to interview you and your teen to gain a better understanding of the current issue. Then, sessions may include your teen only or the therapist may want you or other family members to attend as well. Online therapy is another treatment option that can also be effective for teens.