Teenagers are Trying to be Their Friend’s Therapist during the Pandemic

Teenagers are Trying to be Their Friend’s Therapist during the Pandemic

There is an issue I have encountered many times working with teenagers in psychotherapy that is seldom talked about. The issue is teenager’s trying to act as a therapist to the friends or girl/boy friend. This issue is increasing due to the pandemic and quarantine. Many teenagers are experiencing more anxiety (CDC) and boredom due to being at home more and no school. There have been many times that a teen will tell me their girlfriend is suicidal and ask me what they should do to help her? Often a teen will ask could they just bring their girlfriend into one of their sessions. They argue since I am helping them, I can help their girlfriend. At this point we need to have a conversation about how therapy works and the situation that they are in at that point.

In terms of me just seeing the girlfriend, I explain I need parental consent because she is under 18 years old. I also explain if she is suicidal the parents should be involved. Sometimes the teen explains their girlfriend is living in an abusive household and the parents would never agree to psychotherapy. In these situations, I provide the suicide crises number and tell the teen to have the girlfriend call the crises line and they will get her help. Some teens will exaggerate a situation just so I will see the girlfriend. Therefore, it may be a normal argument between a teenager and parent that I may be entering. Therefore, I provide the crises line and 911 so the situation can be assessed. If the girl does need help, I don’t want to ruin the chances of her getting psychotherapy by acting too fast. I also need to be careful how I handle the situation with my patient. If he is wanting me to see his girlfriend, I have established a therapeutic relationship and trust with him and I do not want to spoil that bond.

The other part of this situation and the more important part is the teen trying to act like their friend’s psychotherapist. Many teens feel since they have been coming to therapy and making progress, if I give them some advice they can help their friend. I explain that they do not having the training needed to be a therapist. I also point out they are not emotionally ready to be a psychotherapist. Many teens feel a very close bond to their friends and girlfriends because they have shared a lot of very personal information and have been open emotionally. While this may be true, it is not the same as psychotherapy.

Why is it important to discuss this issue? What if a teen tries to be their friend’s therapist and the friend commits suicide. They teen will be emotionally devastated and blame themselves. The parent of the teen who committed suicide may blame the teen too. Maybe they were not handling the situation correctly and the teen might have been saved if they had been hospitalized. However, the teen was never hospitalized because their friend was acting as the therapist. The teen could be in a lot of trouble. I have seen this happen. I have had parents come in for grief therapy because their child committed suicide and their child’s friend was acting as therapist and keeping everything a secret. This is a very sad and tragic situation for all involved.

Any time I have a teen asking me about a friend I explore the situation to determine if they are acting as therapist. If they are I explain to the teen why this is inappropriate. I acknowledge how close they are to their friend and how much they care about their friend. I then point out because they care so much they want to do what is best for their friend. I ask them how they would feel if their friend committed suicide? I point out that they are in a very difficult situation that they are not emotionally prepared for or professionally trained for. We discuss that this doesn’t mean anything negative about them. We discuss how they are expecting too much of themselves. I explain if they really want to help their friend, they will encourage their friend to seek help or they may need to tell someone such as the school counselor or their friend’s parents. Sometimes they say, “but I promised to keep it a secret.” I explain sometimes you may need to break a promise to help someone. I also point out their friend may initially be mad but if they truly care they need to do what is best for their friend.

Teenage suicide is an epidemic. The CDC just moved suicide from the third leading cause of death to the second leading cause of death for teenagers. Also the CDC has noted there has been an increase in anxiety, depression and suicides since the beginning of the pandemic. Additionally, teenagers are turning to cutting more often to deal with their feelings about life and the pandemic. Therefore, at this time in our history, this issue has become a bigger issue and needs to be addressed. The situation where friends try to act like the therapist happens more often than people realize. I had a situation occur this week. After explaining the situation to the teen, they spoke to their friend and their friend is now in therapy. This was a good ending. I would estimate 1 out of 3 teens ask me about their friends and are trying to be the therapist to their friend. Besides teens feeling they can handle this situation because they feel so close to their friend, I believe this occurs due to our views on mental health.

Because of the mental health stigma many teens are reluctant to go to therapy. They don’t want to be labeled as “crazy” or “weird.” Furthermore, it is not easy for teens to get therapy. Many psychotherapist prefer not to work with this age group for various reasons. Also many families cannot afford psychotherapy and many insurance companies do not cover psychotherapy. As a result, teenagers tend to turn to each other when they are encountering emotional issues. Research indicates that teens turn to their friend first when they encounter emotional issues. If we want to stop teenagers from acting like psychotherapist and if we want teenagers to get appropriate mental health care, we need to talk to teenagers about why they can’t act as a friend’s therapist and we need to increase access for teenagers to mental health care and remove the mental health stigma.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. For more information regarding his work visit his website http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3

How To Improve Your Relationship with Your Teenager During the Pandemic

How To Improve Your Relationship with Your Teenager During the Pandemic

Many parents worry because their teenager talks more to their friends than to them. Often many parents feel like a failure because their teenager is spending more time with friends than them. However, with the quarantine many teenagers have not been able to hang out with friends. They have maintained contact by texting, FaceTime, Zoom and gaming. Some parents have seen this as an opportunity to increase the amount of time they spend with their teenagers and as an opportunity to improve their relationship with their teenagers. This is an excellent idea. Unfortunately some parents who are concerned that their teen spending too much time with friends may result in their teen becoming involved with drugs or other issues. They feel they can use this extra time to pry into their lives and find out what their teenager is really doing. Unfortunately, this idea eliminates the opportunity of improving your relationship with your teenager. By improving your relationship with your teenager, you increase the probability that your teenager will open up to you if they are in trouble. Unfortunately many parents tell me they have decided they way to resolve this issue is that, “”I am going to be my teenager’s best friend” as a way prevent these problems or finding out about them. Unfortunately, many of these parents do not understand that it is normal developmentally for teens to spend more time with their friends.

The solution that you are going to be your teen’s best friend is wrong!! You do not want to be your teen’s friend. You need to be your teen’s parent. Your teen has enough friends. Your teen doesn’t need another friend, they need a parent. They need someone to educate them about life and how to make decisions.

Remember, as a parent it is your responsibility to help guide your teen to be successful as an adult and in life as a productive member of society. This means at times you will have to set firm boundaries, educate them about life and sometimes tell your teen no. It is important to remember being a parent is not a popularity contest. You must set appropriate limits for your teen which means at times they will be mad at you. It is okay if they are mad at you. This is part of the process a teenager experiences as they are maturing into an adult.

Despite what they say, most teens want and like boundaries. At times they can be very helpful to your teen. They may be faced with a great deal of peer pressure to do something that they do not want to do and they can use you as the excuse why they cannot do it. Some may say this is immature because the teen is using their parent as an excuse, but we put our teens in a very, very difficult world so I think they are allowed some extra help now and then.

Another reason why should you not be your teen’s friend because your word and rules will mean nothing to your teen, if you are their friend. A friend is defined as a close associate. In other words, teenagers see their friends as equals. Now think about what this implies, if you are equals, you are on the same level as your teen. Therefore, they think they know as much as you do and since you are equals they can choose to follow your rules or ignore them as they see fit.

I run into this problem daily in my office. A parent will say “we have always been best friends, I talk to my teen and their friends about everything and we have good times together hanging out. I don’t understand why they disregard my authority as their parent.”

The answer is simple: you eliminated your authority as the parent and made yourself an equal as a friend. If you want your teen to respect your authority as the parent, you must remain the parent and not be the friend.

Consider the decisions these teens have to make every day. They are faced with issues regarding alcohol, drugs, sex, gangs and decisions about careers in their future. Teens live in a very difficult and complex world today. They need parents to help set appropriate boundaries and guide them so they make the best choices for themselves and avoid a great deal of trouble. You can only do this as a parent. Remember, as a parent you are not in a popularity contest. You have a responsibility to help guide your teen. If you want to help them survive high school then be the parent and make the tough, unpopular decisions that are in your child’s best interest. This will help your teen to respect you and the rules you made earlier you can enforce. If you set yourself as friend and equal, your teen loses respect for you, your advice and your rules. You find yourself powerless and you leave your teen on their own to decide what is appropriate behavior.

This is a difficult time for you and your teenager, but if you maintain your role as parent and your teen maintains their role as child you both will survive high school easier. Of course there will be difficult moments, but nowhere near as difficult if you blur the relationship boundaries.

Dr Michael Rubino has over 20 years experience working with teenagers and their parents. He is well respected in the community. To learn more about his work or private practice, visit his website at http://www.rcs-ca.com or http://www.RubinoCounseling.com. You can also visit his Facebook page http://www.Facebook.com/drrubino3. You can also email him from this website, if you have questions.

Helping Children Cope with Anxiety during the Pandemic

Helping Children Cope with Anxiety during the Pandemic

Anxiety is a common issue for children especially during the quarantine and having to attend school from home. Remember children’s imaginations are very active. During the last few months we have had little to no information about how the Coronavirus works. Therefore, there has not been a lot to explain to children and they have heard a lot on the news. Many parents tell me they have limited the access to news but with their IPads, phones and friends, they hear more than we are aware of. Also don’t forget, prior to the pandemic the children were dealing with mass shootings on a daily basis. Therefore, there is a lot going on to cause anxiety in children.

According to the CDC and what I have seen in my office, anxiety is at epidemic levels for children. The most common reason children are coming into therapy right now is anxiety or depression. Many parents want to know what they can do in between therapy sessions to help their child with their anxiety. I ran across an acronym by Lori Lite that is designed to help children who are anxious. The acronym is ASSURE. I will explain what is stand for and how to use it below.

A – Align with your child
 with their body language
 with their tone and volume of speech
 validate their feelings
S – Share your experience
your feelings in stressful moments
mistakes you’ve made and how you emerged from them
how you cope with stress in day-to-day situation
perspective you’ve gained from seeing “this too shall pass”
S – Skills-training
give them words for feelings and worries
get them involved in appropriate exercise and activities to release stress
teach and model coping strategies like visualization, deep breathing, positive imagery
U – Uncover stress-related signs and symptoms
body aches – head, stomach
irritability and mood change
appetite change
sleep changes
R – Reassure them
that they’ll come through
that you’re there for them
that you’re proud of the effort they’re investing in calming and coping
things will normalize – recall examples
E – Engage the topic when they’re calm
listen to what they say and don’t say
respect their process in overcoming stress and worry
brainstorm options while they’re calm, since that’s when the “thinking” part of the brain is turned on.
This may not eliminate their anxiety all together, but it should help reduce their anxiety. Also remember if their anxiety is severe also seek psychotherapy for your child with a therapist who specializes in treating children. Psychotherapy can now be done via telemedicine so there is no risk of exposing them to the virus. Between the mass shootings and the pandemic caused by the Coronavirus, our children are living through historic times. We have never experienced events like we currently are experiencing so there should be no surprise that children may need psychotherapy at this time.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. His practice does offer telemedicine. For more information regarding his work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.