Until recently, the vast majority of my work has been with adults. I have been providing therapeutic services primarily to people 18 and over since the early 1980’s. Granted, I’ve worked extensively with families, and do bring children in from time to time when working with couples, although that tends to be the exception rather than the rule. And with over twenty five years of experience working with people with addictive disorders, I am painfully aware of the impact that addiction has on the children of addicts. I’m not at all unaware of the issues that adolescents face, or effective techniques for treating young people. But basically, I have chosen not to develop a specialty on treatment specifically with adolescents. Recently that’s changed.
It’s redundant and obvious to say that children and adolescents are the adults of the future. They are the ones who will make the decisions about everything that is vital to society; and perhaps even more importantly, pass on key values to their own children; and so the cycle goes. How the children and adolescents of today adjust, adapt and form relationships is fundamental to the quality of their lives for tomorrow. How they learn to cope with the inevitable losses and separations that are such a painful part of adolescence will mold their abilities to manage grief for the remainder of their lives. How well they perform in school and other organized activities impacts the development and evolution of their self esteem, and that in turn affects everything in society from the crime rate to the degree of addiction in society, to the productivity and economic performance of the country.
I have decided to take an active role in this process. I believe that working with adolescents on their psychological issues in a supportive, encouraging and challenging environment provides young people opportunities to understand themselves, thus enabling them to make better and more informed choices in their lives — before they are made impulsively and prematurely. When a young person has the chance to work through psychological issues with a skilled and understanding therapist, one who can form and sustain a trusting alliance with the youth — much can be averted. Likewise, much can be changed and instilled. The therapeutic opportunities are very substantial when the work is done right.
At this point, I have dedicated approximately forty percent of my practice to working with adolescents and youth. I have been impressed and exhilarated by the commitment to treatment young people cultivate in an amazingly brief period of time. And while I expected kids to have a higher “no-show” and drop out rate than adults, I am instead finding almost the opposite. When a strong and trusting therapeutic alliance is established, I feel a “hunger” to do the work on the part of the youth. It is indeed a privilege to participate in therapeutic work with young people; one that also offers me an expanded sense of purpose than that of a “counselor.” Indeed, the opportunity to serve as a mentor of sorts is arguably the highest of callings.
Structure of Treatment with Adolescents
The structure of my work with youth and adolescents is similar to my work with adults but with a few caveats worth noting. First, I am unable to work with children who are not cognitively developed to participate in “talk therapy.” For the most part, this means no one under 10 is suitable (there are referrals available to treat this population, and you may contact me for more information).
Secondly, I strongly suggest that guardians permit essential confidentiality between the youth and the therapist with minimal exceptions, which would be discussed at the onset of treatment. This is necessary to provide a trusting environment for the youth to address and work through sensitive issues.
Next, typically, although not always, I have intermittent meetings with the youth’s immediate family, as the family of origin plays a critical role in the youth’s development. A willingness for the family to participate and engage in periodic meetings is requested.
Sessions are normally conducted in a similar fashion as with adults — they are usually either weekly or bi-weekly, for about fifty minutes, and cancellation policies are the same.
I understand the importance of proper coordination of care between providers and other professionals, particularly with youth and adolescents. Therefore, I am happy to communicate with school or other representatives when that is clinically appropriate.
If we determine that the youth may benefit from a psychiatric evaluation, please note that I have access to several excellent board certified child psychiatrists in Sacramento. I have been working with these physicians for years, and have developed an excellent care coordination system with them.
Please remember that if you choose to use your health insurance to cover the cost of services that the same types of issues remain in place: In order to be reimbursed, I will need to generate a psychiatric diagnosis and provide it to the insurance company, often along with additional clinical information, which I would be glad to review with you. If you wish to avoid a “paper trail,” you may wish to consider paying privately.
Thank you for taking time to learn about my Out Patient Adolescent Treatment Program. Please feel free to contact me with any questions or referrals.
