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What is Family Based Treatment for Adolescent Eating Disorders? Part 1

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.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Eating Disorder Treatment for Teens

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:

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Isolation at School

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:

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Your Teens Are Watching You- 3 Things You Must Model Well

Your teenagers learn what is valuable from your behavior. Photo Credit: imagerymajestic via freedigitalphotos.net

Your teenagers learn what is valuable from your behavior.
Photo Credit: imagerymajestic via freedigitalphotos.net

1. Faith in God: If faith is important to you, then you have to model it, not just say it.  It is easy to say something like, “I don’t want to force my kid to believe a certain thing.  I’ll let them decide when they grow up.”  In the meanwhile you don’t really expose them to your faith because you don’t want to be pushy.  Please just know that if this is the tack you take, you’re kids will probably grow up not believing in any kind of organized religion.  You need to model a strong faith in God if you want your kids to grow up with faith.  Your teenagers pay astute attention to whether you react with anxiety or prayer.  They notice whether you devote your spare time to helping others or doing what feels good for you.  They are watching to see if you turn to scripture or if you turn on the news for your hope in the future.  Every single day there are a hundred little choices we have to make to turn towards God versus turning towards ourselves, and your kids see almost every decision you make.  They copy you.  In their future they are more likely to choose a faith if they have been shown how by your example.

2. Finances: Do you buy things you can’t afford?  Do you pay for little extras like a daily cup of coffee and then dismiss the cost because “It’s just a few dollars?”  Do you get your hair done each month even though there really isn’t a college fund set up yet?  Your teenagers are paying attention.  They believe they can have anything they want right now it if that’s the example you set.  If you are intentional about saving up for things like vacations and a car when you need one, they will learn that behavior instead.  When they want something nice, if you help them map out how to work for it and save for it, they will start to really value what they have, and will start to think carefully about how they spend their money.  Your kids are also watching to see how you give and how you save.  If you invest wisely for the future, and talk about it a little all along the way, they will learn this is important.  When you prioritize giving to others, they will value giving.  You have a HUGE influence on your teens by your example with finances.

3. Humility:  Your teenagers learn an immense amount from you on how to behave in relation to other people.  If you are humble in your relationships, your teens will start to act with humility as well (Rick Warren explains humility to mean, “It’s not thinking less of yourself, it’s thinking of yourself less”).  I have a neighbor who is constantly doing small things to help out other people.  She makes food if you feel sick; she watches your kids for a few minutes if you have to get something done; she asks about that thing you complained about 5 weeks ago to see if it’s better.  She is constantly thinking of others.  She is subtle in how she does it, and it is certainly not so people will like her.  In fact, she isn’t thinking of herself at all.  She is simply the walking definition of humble.  As her kids have gotten older they have become more and more kind.  They are both incredibly sweet to the younger kids on the street.  They are polite.  They seem to automatically look for ways to serve someone in the smallest things.  When they were trick-or-treating last Halloween they both made sure other kids got their candy at the door before they put their hands out.  I don’t think they are even conscious of their kindness.  I think it’s something they are learning from their incredibly humble mother.  These children know how to behave in relation to others.  Imagine these two when they are teens.  Don’t you want your teenagers to be like that?  They are watching what you do, and they are learning.

This blog isn’t written to condemn you for all the things you’re not doing right.  It’s tough to be perfect.  We are all doing the best we can.  All I’m asking of you is to be intentional.  Make sure you are showing your children the kind of adult you hope they become.  Don’t raise your kids without intentionality, because the default is to let screens and peers raise your teens.  Instead, I want you and your values to the most significant influence in their lives.

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

5 More Things That Raise Your Teen’s Anxiety

Stress is tough on teens. Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net

Stress is tough on teens.
Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net

Teenagers these days are stressed out!  So are we all.  We’re short on sleep, overscheduled, and overstimulated.  Here are the top 5 stressors my teen clients talk about:

1. Looking good:  Teens don’t yet know what makes them unique and special.  They haven’t established a career or any specific knowledge that gives them an identity.  They’re receiving a general education in middle and high school, so there is very little that distinguishes them from their peers.  As a result, many teenagers spend an extraordinary about of emotional energy on wanting to be the best looking of their peer group.  Girls try to be thinner, and boys try to look stronger.  Pimples are akin to a nuclear crisis.  This is a regular source of stress for your teenager.

2. College:  There is an incredible amount of pressure on Orange County teenagers to achieve in high school so they can get into a great university.  The problem is, they really don’t have a concept of what makes a university great.  They tend to just assume schools with prestige and difficult admission requirements are what defines their entire adult future.  Please help your teenager avoid buying into this lie.  Different colleges excel at different things.  Your adolescent’s success in college has more to do with matching the right kind of school to their personality and values than anything else.  For example, I have one client who is achieving very high grades in high school, but his personality is such that he flourishes in an environment where he is one of the top students.  He would really struggle at a UCLA type school even though he could get in there.  He’s intentionally choosing a much smaller private school for this very reason.

3. Sports:  Playing sports is very good for teenagers.  It’s really beneficial for them to get exercise, be around friends, and learn discipline.  But, we have many teenagers who are forced to take sports a little too seriously.  They have multiple hours of practice per day, private coaches, weekends dominated by travel and tournaments, and constant pressure to play at a very elite level.  What is all this for?  These teens are training like professional athletes, often at great financial and emotional expense, just to make a college team?  It’s one thing if your teen is truly passionate about their sport, and you couldn’t keep them from practicing if you tried.  It’s completely another thing if you’re the one pushing and they only “like” the sport.  This kind of pressure ends up equating to stress.  In fact, many teenagers confide in me during a counseling session that they actually hate being an intense athlete.

4. Social media:  Without a doubt your teenager stresses about social media (if they use it).  Adolescents are truly bothered every time they logon to Instagram and see several of their friends in a photo without them.  They feel compelled to check their social media multiple times per day.  They are bolstered or discouraged by comments made on their posts.  They use social media as a means to compare themselves to others.

5. Homework:  This one won’t surprise you.  It likely caused you stress as a teenager too.  Teenagers are assigned a lot of homework.  It is stressful to be at school all day, and then have to come home and work on it for many more hours.  Now that adolescents feel they have to take harder and harder classes to stand out, their homework load has become extremely burdensome.

Stress in small doses actually motivates us.  It’s good to learn to manage stress.  When your teenager becomes overly stressed though, they can be irritable, frustrated and anxious.  Knowing some of the things that cause them anxiety can help you help them.  One of the big skills you have to teach your child before he/she flies the coop is how to keep life in balance.  Help your teenager know they simply cannot participate in, or be the best in everything.

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

California Sex Ed

Dear Parents, 

At Teen Therapy OC, we know how important it is to strive toward having open and honest conversations with your teens about uncomfortable topics like sex. We know that in the adolescent development stage, teens are often exposed to information about human sexuality at different rates. This means that some children are exposed to sexual material and information earlier than others and this discrepancy can lead to misinformation spread by their peers. Because of this, we hope parents have conversations with their children about human sexuality and how to set healthy boundaries for themselves.

The “California Healthy Youth Act” is the sex education curriculum for public schools. We thought it would be helpful to provide the information to you so that you can educate yourself of what your 8th graders will be learning to prepare you to have conversations about the things they may not understand or may not be aligned with your family’s beliefs. Depending on your own beliefs and your evaluation of your child’s readiness for this level of information, you may choose to opt out of this program. If after reading the material, you are concerned, call your child’s school for more information about this curriculum and your options as a parent.
 
Here are some tips for talking to your kids about sex: 
-Understand that they aren’t going to be thrilled to have this conversation with you. If you give them choices about when and where they have this conversation with you, they will feel they have some amount of control.
-Choose a time when there aren’t siblings or other people around to help foster a safe environment for sharing about what is likely embarrassing for them to talk about.
-Ask questions about what THEY think about what they learned. 
-Try to avoid talking more than they do in order to help them develop their own critical thinking skills. 
-Ask the teen what they think are healthy sexual boundaries for teens.
-Ask what reasons they have for choosing those particular boundaries around sex. 
-Be sure to stay calm and breathe slowly if their answers aren’t what you hoped they would be. This is a sign that their child brain is developing critical thinking skills, which is a sign of a maturing brain. You can still share what you think and why without making them “wrong or bad” for thinking what they think. 
-If your teen’s answers don’t align with what your boundaries are for them as their parent, try not to react negatively to their answer. Instead, validate that sexual desire is normal, but needs to be treated thoughtfully like any of our other human desires so that we behave responsibly.
– It is important to clearly define your expectations for their boundaries until they become an adult and have the freedom to choose their own boundaries. 
-If your family has particular beliefs that don’t align with something taught in the curriculum, try not to pass judgment on the curriculum itself as being “bad” or “wrong”, but instead calmly and thoughtfully explore the differences with your teen. 

Thank you for having the hard conversations. Being a parent isn’t for wimps!

Helping teens grow and families improve connections,
Lauren Goodman, MS, MFT

Absolute Truth in an Emotional World

“What is truth?” Pilate’s famous words echo in today’s culture in a way that is devastating our teenagers. Each teen is now subtly learning they get to define their own truth. They are being told they are so incredibly entitled to their own view that the world needs to adjust to and accept their version of truth.

Is it any wonder I see so many teenagers confused and upset about the world? They are being taught they are whatever they think they are; then they are hit with the harsh reality that the world is not inclining itself to their every belief. They end up feeling frustrated and more confused than ever.

Parents, you can’t immediately change what the world is doing or the messages it gives your children. However, you can help what culture you create at home. Allow absolute truth to exist in the home. Have rules, limits, boundaries, and discussions about what is what. As a counselor to this generation’s adolescents, my heart aches with the desire to see your kids thrive and be self-assured. You can help them on their way to this by sticking to what is right and true.

If you create a world with boundaries, unalterable truth, and rules, your teenagers can push against these walls. This is a vital part of adolescent development. It is like a butterfly fighting its way out of a cocoon. If you open a cocoon for a butterfly, it will die because it cannot develop the wing strength it needs. If you let your teenager pass easily through adolescence allowing their emotional state of the day to dictate their version of truth, they will die in their spirit because their intellect will be too weak to survive in this world. They will never have to wrestle with learning to accept or change things they don’t like. Instead your teenager will become one of those adults who expects the world to adjust to them. People who think that way flounder and have very little grit.

So please, while I am not asking you to be rigid and stubborn, do not take on the current cultural trend of cowing to every emotional identity your adolescent says is their current truth. Help them stay grounded in what is actually real. You will strengthen them by allowing them to struggle through.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Does My Teenager Actually Need Therapy?

I want to call a therapist and ask about what’s going on with my kid, but I’m not sure my kid really needs therapy. I don’t want to get talked into bringing them in if it isn’t necessary. I don’t want to start spending a lot of money and having my child get attached to a therapist if they don’t actually need to be there.

This is the thought process many parents go through when deciding if they should call. I understand it. I feel like that when I call the pediatrician’s office to see if one of my kids needs to come in. I wish they’d just tell me if it’s not necessary.

I’m writing all this because I want you to feel at ease to call. I personally return almost every phone call about counseling that comes our way. I do this because I don’t want you to bring your teenager in unless it’s necessary. Of course I can’t always tell that on the phone, but I do regularly tell people it’s not yet time to start counseling. I promise you the same courtesy.

I had a call last week from a couple of concerned parents. It was hard for them to witness their daughter struggling with friends at school. She was feeling isolated and left out. Once we talked for a little while on the phone, it seemed to me this problem might resolve itself if given a little bit of time. I asked the parents to wait a few weeks and see whether things improved for their daughter. If not, there might be something worth digging through in therapy. For many though, a little bit of time salves a lot of wounds.

This is not an uncommon story when you call to talk to us. You also might hear from me that nobody on our team is the right fit for your situation. It doesn’t help your teen if he or she is paired with a therapist who doesn’t have the right training/experience for your issue. We usually have good outcomes for our clients because we are very picky on the front end about who we see. That is why people in the community trust us and trust is the MOST important ingredient in a successful counseling experience.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Parenting Teens with Loving Authority

Let’s face it, as parents we all struggle to balance authority and love. When our kids are being respectful and obedient, it’s much easier for us to be kind, patient, and giving. When our teenagers are argumentative, rude, and ungrateful, we find ourselves wanting to exercise our authority. Watch this quick video to learn a little bit how you can balance the two for maximum effect. HINT: It’s all about going slowly.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

3 Signs of Depression in Teens

Depression can be devastating to those who suffer its insidious greed for life, engagement, and joy. Teens who are depressed feel lackluster about their world, their future, and themselves. Often slogging through each day without hope, depressed teens contemplate suicide as a means of relief from the relentless blandness of a life without color.

Watch this short video for three signs your teenager may be afflicted with depression:

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Why Working is Good for Teens

Parents and teens, one of the best things you can do to alleviate depression, anxiety, and a struggle with identity and purpose is get a job. I know it adds stress in a certain way, but in my observations, teens who work have several things:
1. Increased confidence.
2. A better understanding of money.
3. Can talk to people with good eye contact.
4. Lower anxiety.
5. More friends.
6. A place where they belong outside school and home.
7. Discipline that isn’t coming from parents or teachers.
8. More realistic ambitions and goals.
9. A better sense of marketable skills when they choose a college major.
10. More purpose, which leads to lower anxiety and depression overall.

I know this isn’t a foolproof solution to every problem. However, it has made a huge positive difference in the lives of many of my clients. I think it’s worth a try.



Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

What Do I Do With A Sneaky Kid?

Teens who sneak are often unhappy about the mistrust their parents have for them. Image courtesy of Stuart Miles / FreeDigitalPhotos.net

Teens who sneak are often unhappy about the mistrust their parents have for them.
Image courtesy of Stuart Miles / FreeDigitalPhotos.net

What do you do if you’re one of the unlucky parents who has a sneaky teen?  You put very clear rules in place, but your teenager continues to do the wrong thing?  A lot of the time you’d even say yes if they’d simply ask, but they sneak anyhow.  This is incredibly frustrating for a parent.  It’s not that you want to control your teenager- you don’t.  You just want a trusting relationship between the two of you.  You want them to trust that you will say yes when it’s appropriate, and you want to trust they are doing what they tell you they’re doing.

 

The first thing you need to ask yourself is why they are sneaking.  You may or may not be able to answer this question.  If you believe they are sneaking because they are using drugs, having sex, or doing something otherwise dangerous they know you’d put a stop to, address this immediately.  For those of you that are pretty certain your adolescent isn’t doing anything dangerous, but is sneaking for some other reason, read on.

 

Perhaps one reason your teenager is sneaking is because you say no too often.  They feel confident you won’t give them any space if they ask for it.  They think the only way to have a little room to explore who they are is to go without permission.  I once worked with a teen boy who kept saying, “It’s easier to get forgiveness than ask permission.”  In his case, he was right.  He learned this very quickly and realized it was the only way he was ever going to date, try going to a party, or even get into minor mischief like toilet papering a friend’s house.

 

Another reason an adolescent could be sneaking is they are engaging in certain activities you wouldn’t approve of.  One way that many, many teenagers sneak is with their phones.  A lot of teens have smart phones now, and a great number of them download apps you would not like if you only knew they were there.  They know you’d make them take the apps off, and they don’t want to.

 

Whatever the reason(s) your teenager is being sneaky, here are a few ideas you can try to minimize this behavior.  The first thing to try is a heartfelt heart to heart chat.  This isn’t the situation where you punish them or get angry with them for what they’ve been doing.  Instead you talk about how it hurts you not to feel like you can trust your own child.  You ask them how they’ve been feeling when you keep getting frustrated with them as you catch them in their lies.  You and the teenager put your heads together to come up with a plan that will change this.

 

If this doesn’t work, you may have to try a less collaborative approach.  Warn your teenager this is coming if they don’t start being much, much more honest.  Then, outline very clear consequences that will occur if they are caught lying/sneaking.  Do this with a lot of love.  You don’t need to yell or even have a stern voice.  The only thing that is very important is you follow through on whatever consequence you’ve promised to give.  Be extremely consistent.  Reward them for honesty too.

 

Your final option is to make their world really small so it’s hard to sneak anything.  However, if you do this take care to make sure they don’t start resenting you.  You want all consequences you administer to children to make them think about how their action caused this result.  You don’t want them thinking, “My parents are such unfair jerks.”  They won’t learn anything that way.

 

Sneakiness is a really challenging character struggle to contend with and correct.  You are not alone in your aggravation.  Any parent who has dealt with a sneaky teenager feels angry, sometimes scared, and occasionally hopeless.  Just try your best to work on what you need to work on, keep loving them well, and be patient as you help them course correct.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

What Does Christian Therapy Look Like at Teen Therapy OC?

We provide an option for clients to see Christian therapists on our staff if they prefer it. I am often asked by Christian families what counseling looks like when it’s Christ-centered. The most important thing to understand is that we are not theologians or pastors so we do not give any biblical interpretation or religious advice. The way we most often see faith-based counseling play out is us encouraging clients to engage more fully with their religious community. For someone with social anxiety, there is an opportunity to face a lot of the fear while attending youth group. There can be collaboration with the youth pastor to make this a more comfortable step. For clients with an eating disorder there might be a discussion about what God really wants for their life and whether He sees them as beautiful even if they aren’t the “perfect” weight. For families there could be an encouragement to pray together or start attending church together. The bottom line is that Christian-based counseling means the therapist and client are operating from a paradigm that believes the client’s connection to God is an essential part of healing.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT