Parent sessions as a catalyst for change in teen therapy
Many parents are surprised when I explain that at a minimum, I expect to see them half as often as I see their children. This means that if I see the child weekly, I expect to see the parent every two weeks. These are full-length sessions, not quick check-ins. These are paid sessions, not free phone calls. Some parents welcome and appreciate this idea because they see me as an outlet for some of their own issues. Other parents may resist, either because of time or finances, or because they don't see what use it is for me to see them when it's the child who is my primary patient. My hope is to help parents understand why their kid's therapist will want to meet with them for parent sessions.
To illustrate my thinking here, I'm going to use a highly simplistic example of a child leaving a bowl of cereal in the sink.
*I will use the terms "parent" and "caregiver" interchangeably in this article. I do recognize that in many cases, the primary caregiver may be a grandparent, aunt, uncle, sibling, family friend, etc. I'm talking about both bio and non-bio parents in this article.
**I will also use the terms "child" and "teen" interchangeably. This is very much on purpose, because we often forget that teens are still children.
Your child’s perspective is one side of the story
Serving children and families has been my craft for many years at this point. One of my top five lessons has been this: each perspective of what happened is important. Part of my work as your child's therapist is to help bridge the multiple perspectives of what is going on. Let's use the bowl of cereal as an example here. The parent sees the rebellious teen leave a bowl of cereal in the sink and walk away. House rules are that dishes go straight to the dishwasher. From the parent's perspective, this child may be entitled, irresponsible, and disrespectful.
Let's flip the script here. The child, fraught with worries about...well anything (grades, college admissions, a friend contemplating suicide, a friend having risky sex) leaves their bowl of cereal in the sink, intending to come back and wash it after they've attended to whatever they're perceiving as a crisis. The teen may be thinking "I'm leaving this in the sink and not on the table because in this house, we care about cleanliness."
I'm offering a simplistic example here, but I've seen this play out over and over again in circumstances that were much more serious. My job is to bridge these perspectives and that simply never happens in the 2 minutes I spend greeting parents in the waiting room, or during the 5 minute check in calls I make to discuss appointment scheduling. It happens somewhere around minutes 17-20 during a parent session. It happens after we've cleared the small talk. It happens after we've talked about the weather. It happens after we've discussed your child's grades.
I cannot tell you how many times a parent has started off saying "Everything is fine!" during the first fifteen minutes of a meeting before opening up about a concerning event that they really need to process. And the process takes--in my experience--a minimum of 10 minutes, and ideally 20-30 minutes to really delve into the conversation enough for it to be meaningful. This time is an investment in your family's well being. In the cereal bowl example, there may be a deeper issue, such as the parent remembering how their own parent would harshly punish them for leaving dishes in the sink. This information matters.
The good news here is that in most cases, the more I've met with parents, the easier it becomes to get to the core issues. As we get to know each other, the pressure to make small talk will dissipate and we'll likely get down to business by minute 10. But this almost always happens slowly, over time.
Being a parent is hard work
To put it frankly, a child's emotional well-being will only be as good as that of their primary caregiver. Children feed off of the psychological state of their caregiver, so getting to know the caregiver is just as important as getting to know the child.
Without getting too much into the nerdy shenanigans from my graduate training, there is a wealth of evidence that supports the idea that even the most far-removed events--say, an argument between a parent and their coworker--has the potential to create a ripple effect and impact the child. Allow me to illustrate:
Parent goes into work. Parent has argument with officemate about the noise level. This argument leads to the parent working late because they've fallen behind on their work. Parent arrives home late, tired, irritable, and watches their teen leave a dirty bowl of cereal in the sink and walk away. Parent is upset because they work so hard to provide for their child and this child can't be bothered to rinse the bowl and place it in the dishwasher. Parent yells at the teen for being a lazy slob. Both are left feeling angry at each other.
I've offered you a truly simplistic example here. That's on purpose, because the stories I hear regularly are deeply saddening. Part of our work in parent sessions is to offer the parent support in managing their everyday stressors. Maybe it's work-related. Maybe there's family drama. Maybe there's road construction near the home and the parent isn't sleeping enough. The possibilities are endless here. Parents have to deal not only with their own emotional baggage, but also that of their children. It's my firm belief that every parent should have access to a therapist. Parents are often reluctant to discuss these stressors with me because their child is my client, not them. They're not wrong about this. And in some cases, I provide referrals for parents to see their own therapist. But there's still plenty of room for us to collaborate and figure out how your stress as a parent is impacting your child's wellbeing.
Healing is a family endeavor
Raising a child who has mental health concerns can be an exhausting experience. Time and time again, I find myself working with parents who have already endured years of strain from emotional meltdowns, physical aggression, delayed development, poor academic performance, and guilt. These experiences do not occur in a vacuum, they affect everyone in the household.
Shared insight between parents and their child's therapist can help kick off the collective healing that needs to take place in order for a child's behavior to improve. This might be as simple as making sure everyone is on the same page about how to respond to the next meltdown. Or it may be as complicated as supporting a sibling who has repeatedly fallen victim to the primary client's aggressive outbursts. Either way, these are emotionally intensive processes that simply cannot be accomplished in a ten-minute phone call, or during a quick greeting in the waiting room. Taking the time to meet with your child's therapist is a unique opportunity to optimize treatment.
Note: This blog post was originally published on September 9, 2020 and re-published with minor revisions on April 9, 2021