Hooray! We now have in-person group therapy! This has been a long time coming. Many teens benefit from hearing what their peers have to say (when an adult is present to moderate). This is such a nice option to offer for your families because some teens have things to work on in a more social setting, the cost of therapy is lower for group therapy, and sometimes it’s easier to learn from listening to someone else walk through a struggle than to be on the spot about your own struggles.
Last month CE4Less.com was kind enough to offer a free class on treatment for PTSD in veterans in honor of Veteran’s Day. I learned so much from this class that I’ve changed my strategy in dealing with trauma in general. While we rarely work with veterans at Teen Therapy OC, it has been easy to apply the techniques to adolescent and young adult clients.
The class introduced Cognitive Processing Therapy. This is a prescripted, step by step process of working through trauma that has led to nightmares, flashbacks, intrusive thoughts, hypervigilence, fear, anxiety, insomnia, and/or the depression associated with PTSD. So far my clients with PTSD have responded positively to this protocol.
I think in the case of my clients who are in the middle of the CPT treatment, they feel better because CPT doesn’t require them to talk directly about the events that occurred. It instead allows the client to explore how the events are affecting them today. It lets them find out what internalized messages related to trust, relationships, self-governance, and boundaries have come out of the trauma. Many clients don’t realize they are living by a set of “rules” they created for themselves as a result of their trauma. These rules are almost always self-protective in a way that doesn’t adapt well to their current life.
Here’s an example modified to keep complete confidentiality for my clients: When Jane was 16 she got drunk at a high school party. She was not so drunk that she blacked out the experience. She remembers making out with a guy who nobody else seemed to really know at the party. He convinced her to go out to his car. When they were there, Jane was assaulted by this guy and it really scared her. She got home safely, but Jane didn’t tell anyone what happened. A few months later she began to have nightmares. She became jumpy when friends at school tried to hug her. She started to feel withdrawn, fearful, and powerless. She also felt paranoid each time she saw a black SUV drive by that it could be this guy in his car. Six months after the assault, Jane felt like she’d lost herself to a prison of anxiety, flashbacks, and a sense that the world could not be trusted.
Jane came to counseling and was diagnosed with PTSD. She was relieved to know there was an explanation, but she didn’t know what to do to get her life back. She didn’t feel ready to share details of the event because that felt too overwhelming. She was thankful she could start CPT without going into detail about her trauma. She was able to complete the first steps (impact statement and stuck points) and already see there was a light at the end of the tunnel.
In no way do I profess to be an expert at the administration of CPT just because I took one class. There are therapists with more training in this treatment protocol. I do have extensive experience with teenagers though, and some begin therapy to talk about what they think is bothering them only to discover their symptoms are in response to a trauma. I’m incredibly grateful to have this tool available to help. It seems to be working well. I’m also grateful to the Dept. of Veteran’s Affairs for making these tools free to clinicians so they can guide their clients through this process.
Family based treatment (aka Maudsley Method) empowers parents to act as a critical part of the treatment team when healing a teenager from an eating disorder. This is done in consult with a therapist, dietician, and medical doctor. Parents follow the advice of their treatment team to get the adolescent’s caloric intake back on track so health can be restored. This is a very emotionally taxing process, but it also hopefully keeps the teenager out of the hospital. Many parents have lost their authority to the eating disorder over the course of the last several months or even years. When they are not only given permission, but required to take back that authority, there are often encouraging results.
Eating disorders are so nasty! They are cruel, unkind, and abusive to their victims. They take over a person’s relationships, personality, ambitions, and dreams until you find your teen is a shell of her former self. I should know…I had one for 7 years. Now I help parents fight back against the eating disorder monster. Here are some thoughts on the process:
I have heard more isolation stories from clients starting school last week than in all my previous years of practice (14). One teen told me how she plans to sit in the library for lunch. Another told me he is never invited to anything with his so-called “friends.” A third talked about how she feels like all the friend groups are already formed and she has no way to get into one. In every single case, their hearts are broken and they don’t know how to fix it. I feel their internal anguish as I listen to them give me the details about their worlds. They feel as though they are looking in on a world where everyone is smiling, but that they are stuck outside. They so desperately long for even just one person to show the interest, love, and compassion that they see other teens so effortlessly get.
What gives? Why are some outsiders despite every effort and others insiders even without trying?
1) Charisma: A few people have a lot of this character quality. Most have some. Then there are those who have almost none. You know the type: They just can’t seem to say the right thing at the right time. They make others feels awkward with their awkwardness. It is easy to pick up on the fact that they are not entirely comfortable with themselves.
2) Social Awareness: There are people who lack this very important character trait. They talk too loudly, they don’t know when to drop a discussion topic, they stand too close to people…they just cannot seem to read a room. Teenagers are very socially aware and they often reject the child who has not figured out social awareness.
3) Projected Confidence: Teenagers who walk with their heads up and scanning for eye contacts project more confidence. This is attractive to others. When eye contact is made, these confident teens will wave or smile. People reflexively smile and wave back, which makes everyone like each other more. Think about all that is missed for the teen who walks with eyes downcast.
4) Respect: Adolescents who know where they stand on an issue and are not swayed by the crowd’s opinion are more respected. Have other respect you translates into them being more inclusive.
5) Going Where You’re Wanted: This is the #1 most important thing teens do who fit in. They do not try to force themselves in where they are not obviously included. Teenagers who go with the other teens that already like them are happier. This is likely a life attitude of being content with what you have.
Here are some other thoughts on the struggle for an adolescent wanting to fit somewhere:
Hello, I’m Lauren! If you notice your teen struggling, you might be feeling helpless, hopeless, frustrated or concerned as a parent. Try to remember, there is hope. I want to help your adolescent feel better. My hope is for them to enjoy their life again. I want them to feel confident they can handle whatever situations arise.
