Concurrent Work with Parents of Adolescent Patients

Abstract

Over the last ten years we have seen an increasing acceptance of the general idea of working with parents of child patients. What remains, however, as an area of controversy, conflict, and resistance, is the question of whether and how much therapists should or can work with the parents of adolescent patients. Questions cluster around how to maintain confidentiality and lead to the even larger issue of conceptualizing the developmental goals of the phase of adolescence. We see the major developmental tasks for both parents and adolescents as involving transformation of the self and the relationship, in the context of separateness rather than separation. If adolescent therapists work from the assumption that the goal of adolescence is transformation, concurrent work with parents and adolescents will move them all into a new level of relationship. Without concomitant change in parents, it is doubly hard for adolescents to progress into adulthood. In this paper we offer clinical material from five older adolescents and their parents to illustrate the techniques that follow from our model of dynamic concurrent parent work throughout the phases of treatment. Using the tasks of the therapeutic alliance as a conceptual framework, we describe working toward the dual goals of restoration to the path of progressive development and restoration of the parent-child relationship. We pay particular attention to the unfolding of conflicts between closed-system omnipotent functioning and open-system reality mastery, and the role offathers in late-adolescent development.

“You can’t really have a relationship with them because they just ask you questions”: understanding adolescent dropout – an empirical single case study

“…Morgan’s numerous challenges, coupled with the absence of parental support for treatment—both indirect (such as endorsing therapy) and direct involvement—seemed to create substantial additional obstacles in the therapy process, especially when Morgan herself was struggling to engage. This aligns with an expanding body of research that underscores the importance of establishing a parental alliance when working with adolescents, particularly in complex cases ( Novick and Novick, 2013 ; Forsberg et al, 2014 ; Feder and Diamond, 2016 ; Malberg, 2021 ). This approach can be instrumental in navigating external challenges and highlights the criticality of not only addressing internal psychological factors, especially issues in the therapeutic relationship, but also engaging with and leveraging external support systems to provide a comprehensive and effective therapeutic approach for adolescents struggling with complex mental health needs.…”