1

Adolescent counseling
Adolescent counseling (or therapy) is designed specifically for children and teens who need
help with their mental health. Child and adolescent counseling is beneficial to truly any
young person. But for those who suffer, it’s critical. Mental health therapy can prevent
adolescents from experiencing mental health crises and also help those in need of extra
mental health support.
Adolescent counseling is essential for an adolescent who is dealing with anxiety, depression,
or trauma. Substance use in adolescents is a serious issue that needs to be addressed in
adolescent counseling. Moreover, children and adolescents who are discovering their sexual
orientation or experiencing gender dysphoria can benefit from child or teen therapy.
For the purposes of this article, we will use “counseling” and “therapy” as well as
“counselor” and “therapist” interchangeably, although they are different. Read on to learn
what adolescent counseling is, the benefits of teen counseling, the different types of
counseling, and how Newport Academy supports adolescents who require mental health
treatment. We’ll also answer the question “How do I know if my teenager needs counseling?”
Key Takeaways
 Adolescent counseling should always be provided by a licensed, professional
counselor.
 There are many different types of teen therapy that include individual, group, family,
trauma, and experiential modalities.
 Benefits of teen counseling include better emotion regulation, stronger family
relationships, and higher self-esteem.
 The main difference between counseling and therapy is that counseling typically
addresses a specific issue while therapy is a more in-depth approach to heal
underlying trauma.
Why Is Child and Adolescent Counseling Important?
Child and adolescent counseling gives kids and teens a safe place to work through mental
health challenges. If mental health issues go untreated, adolescents could end up in crisis.
Counseling can avert crises. Teenage counseling can also support the well-being of children
who aren’t in crisis but could benefit from additional support.
Adolescence is an intense stage of life. As they move through the stages of adolescence,
hormonal changes and puberty can wreak havoc on teens’ physical and emotional well-being.
There are many external factors disrupting the mental health of today’s teens, including social
media, constant stimulation, fear about world events and climate change. In addition,
adolescents deal with perennial issues like peer pressure, self-esteem issues, and bullying.
Counseling for teens helps adolescents learn healthy coping skills and set realistic goals.
Clinical mental health counseling provides a safe space for teens to explore distressing
thoughts and emotions, work through childhood trauma, and build stronger connections with
family members.
 2

Teen Counseling vs. Therapy: What’s the Difference?

The main difference between counseling and therapy is that counseling tends to be short term
and focused on a specific goal, while therapy is usually a more in-depth and longer process
that helps clients work through past experiences.
However, therapy and counseling are often used interchangeably. Moreover, counselors and
therapists are both licensed and trained professionals. And both can use talk therapy as well
as other adolescent counseling modalities.
Adolescent Counselors
Teen counselors are typically focused on the present. They tend to be goal oriented and focus
on each client’s strengths. Counselors help clients relieve distressing mental health symptoms
and help their clients feel better.
Teen Therapists
Adolescent therapists help clients work through underlying trauma in order to live more fully
in the present and work towards a better future. Therapists help clients process thoughts and
feelings, both past and present, that are influencing their behaviors and the way they navigate
the world.
The Benefits of Child and Adolescent Counseling
We’ve already established that child and adolescent counseling is beneficial to both the child
and their family members. Here are some of the specific ways teenage counseling helps kids
become happier, healthier, and more resilient.
Building Emotional Regulation
Learning to regulate their emotions is important for teens as they grow into young adults.
Emotion regulation can be difficult for teens with developmental disabilities, mood disorders,
personality disorders, eating disorders, and addictions.
Healing from Trauma
Adolescence is a time in which teens’ brains are still forming. Without treatment, acute or
chronic trauma can stunt brain development and put adolescents at a disadvantage as they
grow up, negatively impacting them for the rest of their lives. Symptoms of trauma and
PTSD include flashbacks, nightmares, dissociation, feelings of terror, and physical pain.
Growing Self-Worth and Self-Compassion
It’s important for teens to develop a greater sense of self-worth. Many adolescents have low
self-esteem which could lead to depression and suicidal thoughts. Learning self-compassion
can help adolescents be kinder to themselves and develop a greater sense of self.
Repairing Family Relationships
Teen therapy is particularly impactful when family is involved. Family therapy tailored
toward adolescents, such as Attachment-Based Family Therapy, can restore ruptures between
parents and children. These ruptures might be the result of early childhood trauma or may
have developed during the teen years while the adolescent was struggling with mental health
issues.
 3

Gaining Healthy Coping Skills

Learning healthy coping skills to navigate challenges and discomfort is another benefit of
adolescent counseling. Clinical mental health counselors can help adolescents find new,
healthy ways to manage difficult family dynamics, depression, anxiety, and other challenges
and triggers.
Supporting Teens’ Growth and Development
Counseling for children and teens also supports adolescent development. There are different
developmental milestones that adolescents need to reach in order to move on to the next stage
of the teen years. Counseling can help teens meet their developmental goals by working
through each stage of development and its effects on social, behavioral, and emotional
development.
Risk-taking: an important phase of growing up
A crucial stage of individuation involves teenagers experimenting with new social roles,
behaviours and situations. This exploration is integral to establishing their adult identity,
distinct from their childhood self. Decades of research suggest that the dramatic hormonal
changes and rapid brain development that occur throughout adolescence commonly result in
lowered impulse control, coupled with heightened risk-taking behaviours. Problematic
behaviour may manifest externally (anger, aggression and family conflict), or your adolescent
may internalise their feelings about transitioning into adulthood (anxiety, depression and
family withdrawal).
Counselling for adolescents is an invaluable opportunity that helps adolescents make sense of
themselves, their behaviours and interactions with others during this critical time of
development.

Problems faced by adolescents

Emotional Turbulence During Adolescence
Adolescents and teens experience a large range of emotions – often very quickly – during
times of stress. During adolescence and early adulthood, our ability to regulate emotions
becomes more developed. Learning this skill through teen online counselling services can be
very beneficial.
Some very important findings from research in terms of decision making and emotion
regulation during adolescence:
 Teens and youth may be more sensitive to feedback in social situations. Although this
can be helpful in terms of adaptation to different social settings, it can also enhance
feelings of rejection and exclusion.
 Peers are of utmost importance during adolescence. Having friends who accept you is
essential when we are in our teens. This can sometimes lead adolescents to make
impulsive or high risk decisions when emotions are running high. It will also lead to
teens supporting their friends in challenging situations automatically and without
debate. This can be important for teen friendships.
 Later on in our teens and into early adulthood, we are more able to understand the
perspective of those around them and think in a more sophisticated manner.
 4

Development of this skill can also be highly effective during CBT therapy techniques
when teens learn about cognitive reframing and perspective taking.
Learning emotion regulation skills during adolescent counseling is highly effective. When
teens are faced with difficult situations, we want to help them develop skills to tolerate that
distress and develop the ability to self soothe during times of stress. How can we help our
teens during this time?
Imagine that your teen is trying to work on a difficult presentation but they are unable to get
started. How could a parent help? You might sit with them and walk them through the plan
for the paper or even start writing the first sentence or two. And then you might try and walk
away so they can work on this on their own. This can allow your teen to figure out how to
tolerate distress, without it being overwhelming for them. In doing these behaviours, the
parent is also modelling and encouraging behaviours that you want your teen to eventually do
on their own using a process called scaffolding.
Adolescents can learn many different emotion regulation skills through online counseling.
Working with a therapist through an online counseling platform can be accessible and flexible
for teens and parents with busy schedules. At FTPS, we recognize how challenging it can be
to try and be at an in-person therapy appointment after a busy day of school. That is why we
offer online therapy services in Ontario, Nova Scotia, British Columbia and New Brunswick.
Academic Stress During Adolescence
Adolescence is often a time of significant academic stress. A recent systematic review by
synthesized the relationship between academic pressure and the connection with adolescent
depression, anxiety, harm to self and suicidal behaviour. The article refers to two large
surveys that were completed and demonstrated how adolescents indicate academic pressure
as being a top influencing factor on the state of their mental health. Teachers and parents also
cite concerns about academic pressure often rising and the negative impact it can have on
teens’ mental health issues.
These are significant issues faced by adolescents. How can adolescent counseling help?
The best anxiety treatment for teens will take a holistic approach and help individuals learn
ways to manage stress. In terms of academic pressure, it is always important to ensure that
teens have support to manage their workloads and space out assignments and studying over
time. This can help decrease feelings of being overwhelmed and allow the work and pressure
to be handled in small manageable chunks. Mental health therapists can help adolescents
learn this very important skill of chunking and breaking assignments down.
Teens can also engage in CBT therapy online and learn a variety of skills that can help
manage academic stress. These skills would include:
 Tracking mood and behaviours to better understand when anxiety levels are high
 Understanding how our thoughts can influence our behaviours and emotions
 Creating distance from our thoughts, using skills such as cognitive reframing and the
tool of the thought record
 Learning about thinking traps and how those can impact teen’s moods, thoughts and
behaviours
 5

It is also important to talk about the role of parents and educators when it comes to
adolescence and academic pressure. What can parents or teachers do? A few of the ways in
which educators and parents can help adolescents include:
 Providing mental health support through education for both parents and students.
Talking about mental health can help to destigmatize it and allow teens to speak to
their teachers and parents when they are not doing well
 Providing adolescents with wellness spaces for breaks throughout the day. These
spaces can be used for studying quietly or simply taking a break from the hustle and
bustle of the classroom
 Teachers can provide formative relationships to adolescents during their development.
Teachers can always check in on students should they notice significant changes in
their mood and behaviour.
 Some students might benefit from writing tests in a quiet space if they experience
significant test anxiety or difficulties with focus and attention. This can be discussed
with the teen as well as with any mental health therapists involved in their care
Academic stress is a very significant issue for adolescents and youth. It can contribute to
elevated stress and mental health issues. However, through mental health therapy and
school support, individuals can be better supported throughout their academic journey.
Peer Issues and Social Anxiety During Adolescence
Peer pressure can certainly emerge throughout adolescence. Mental health therapy can
provide teens with the skills they need to set boundaries and be able to say “no” when they
are feeling uncomfortable. Learning healthy assertiveness skills can also be an important
focus during online therapy sessions.
However, adolescents may also experience symptoms of social anxiety that are different from
grappling with peer pressure. If your teen is experiencing excessive fear of judgement from
others to the point where they are avoiding social situations, they might be experiencing
social anxiety. If you notice your teen is avoiding different social situations and they speak
about high levels of anxiety in these situations, it would be very beneficial to reach out to a
professional, such as a psychologist or psychiatrist, to better understand what they are
experiencing.
Social anxiety treatment can be highly beneficial when this happens. CBT and ACT
interventions are often used during social anxiety treatment. Teens will learn a variety of
skills during this type of anxiety treatment, including:
 Learning to decrease avoidance in social situations is a graduated manner, using
exposure therapy
 Recognize the role of anxiety and how to better manage and tolerate it during times of
anxiety
 Focus on values and what is important to you, as opposed to avoidance which can
increase anxiety levels in the long run
 Engage in social situations and pay attention to the experience of them and how one is
able to make space for difficult thoughts and feelings during anxiety-provoking
situations
 6

Working with a therapist during social anxiety treatment can be very effective. Social anxiety
can be extremely disruptive and it is important to provide teens and adolescents with skills
they can use to decrease their avoidance and engage in more social interactions.
Family Dynamics and Adolescent Mental Health
Family dynamics are often complex and certain family stressors can heighten emotions and
challenges during adolescence. For example, parental stress and divorce can have a negative
impact on teens. Of course, these types of family situations are not preventable and are not
anyone’s fault. Nevertheless, family therapy may play an important role in helping teens
navigate the emotions and reactions they might experience during times of familial stress.
Parents may also benefit by speaking with a therapist to allow more positive interactions to
take place within the family environment, even during times of stress and separation.
Parents may also have difficulty navigating their teens’ emotions and feel at a loss to be able
to help them. Parents also have their own emotional baggage and might find they are bringing
these stressors into the relationship with their teens. For all these reasons, parent coaching can
also be highly advantageous to help navigate challenging family dynamics and allow for
much more positive relationships amongst the entire family.
It is always important to include family members during teen online counselling, with the
consent of the adolescent of course. This allows for parents to learn important updates about
how their teen is doing. It also allows mental health therapists to deliver important skills to
parents that they can use in between therapy sessions.
Violence
Adolescence is a time for developing independence. Typically, adolescents exercise their
independence by questioning or challenging their parents' (or guardians') rules, which at
times leads to rule breaking. Parents and health care practitioners must distinguish occasional
errors of judgment, which are typical and expected, from a degree of misbehavior that
requires professional intervention. The severity and frequency of infractions are guides. For
example, recurrent binge drinking and engaging in recurrent truancy or theft are much more
significant than isolated episodes of the same activities. Warning signs that suggest a
disruptive behavior disorder is impairing functioning include deterioration of performance at
school and running away from home. Of particular concern are adolescents who cause serious
injury to themselves or others or who use a weapon in a fight.
Because adolescents are much more independent and mobile than they were as children, they
are often out of the direct physical control of adults. In these circumstances, adolescents'
determine their own behavior, which may be influenced by maturity and executive
functioning. Parents guide rather than directly control their children's actions. Taking risks,
engaging in extreme behaviors, and testing abilities are all normal actions during
adolescence. Adolescents who feel warmth and support from their parents are less likely to
develop serious problems, as are those whose parents convey clear expectations regarding
their children's behavior and show consistent limit setting and monitoring.
Many factors contribute to an increased risk of violence for adolescents, including
 Developmental problems
 Gang membership
 Access to firearms
 7

 Substance use
 Poverty
There is little evidence to suggest a relationship between violence and genetic defects or
chromosomal abnormalities.
Obesity in Adolescents
Obesity is now twice as common among adolescents than it was 30 years ago and is one of
the most common reasons for visits to adolescent clinics. Although fewer than one third of
adults with obesity were obese as adolescents, most adolescents with obesity remain obese in
adulthood.
Despite many therapeutic approaches, obesity is one of the most difficult problems to treat,
and long-term success rates remain low.
Although most of the complications of obesity occur in adulthood, adolescents with obesity
are more likely than their peers to have high blood pressure. Type 2 diabetes mellitus is
occurring with increasing frequency in adolescents due to insulin resistance related to obesity.
Because of society’s stigma against obesity, many adolescents with obesity have a poor self-
image and become increasingly sedentary and socially isolated.
Physical Problems in Adolescents
Although adolescents are susceptible to the same kinds of illness that afflict younger children,
generally they are a healthy group. Adolescents should continue to receive vaccinations
according to the recommended schedule ( see Table: Childhood Vaccination Schedules).
Acne is extremely common and needs to be addressed because of its impact on self-esteem.
Trauma is very common among adolescents, with sports and motor vehicle injuries most
frequent. Motor vehicle crashes, other unintentional injuries, homicide, and suicide are the 4
leading causes of mortality in the adolescent age group.
Disorders that are common among all adolescents include
 Infectious mononucleosis
 Sexually transmitted infections
 Endocrine disorders (particularly thyroid disorders)
Disorders that are common among adolescent girls include
 Urinary tract infections
 Menstrual abnormalities
 Iron deficiency
Pregnancy must be kept in mind when treating adolescent girls.
Although not common, neoplastic diseases such as leukemia, lymphoma, bone cancers, and
brain tumors also occur.
 8

Therapies for Adolescents

Therapy for teens can come in different types that can treat a range of concerns that
adolescents might experience. Ultimately, the goal is to help teens cope with the problems
they may be experiencing and function better in different areas of their lives.
The teen years are an essential period of development. Experts suggest that mental health
struggles are not uncommon during these years, with one in three high school students
reporting symptoms of depression such as sadness and hopelessness.1 Just as with adults,
therapy can be a helpful resource for teens to address some of these common concerns.
There are many types of therapy for teens, so it's important to learn more about your options
and how each works. Common types of therapy for teens include:
 Cognitive behavioral therapy (CBT)
 Family therapy
 Acceptance and commitment therapy (ACT)
 Dialectical behavior therapy (DBT)
 Interpersonal therapy (IPT)

1. Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, often referred to as CBT, is a type of psychotherapy that
focuses on making connections between thoughts, behaviors, and feelings. Psychotherapists
who use CBT help people identify and change dysfunctional patterns.2
CBT is often used with adolescents. It can be effective in treating a wide range of issues
including eating disorders, substance use, anxiety, and depression.3
Basic Principles
CBT is based on the idea that there is a clear link between thoughts, behaviors, and feelings.4
A teen who thinks they are socially awkward, for example, may then experience anxiety and
avoid social interactions.
CBT works by helping teens learn to identify their automatic negative thoughts and replace
them with more helpful, realistic ones.5
How It Works
Teens often develop distorted core beliefs about themselves. CBT helps confront and modify
those distortions.6 A psychotherapist using CBT would:
 Help a teen identify those unhealthy thought patterns that contribute to mental health
problems
 Ask a series of questions about such thoughts
 Ask the person to keep a thought record to help identify dysfunctional thoughts7
 9

Benefits of CBT
CBT helps teens learn how to interpret their environment differently. Compared to other
therapeutic approaches CBT is generally short-term. Sometimes, only a handful of sessions
are needed.8
The approach is also very problem-focused which means it deals with issues in the present.
Treatment providers aren't likely to rehash a teen's childhood or look for hidden meaning in
their behavior. Instead, sessions focus on helping the teen with problems going on now.9
This type of therapy can provide benefits such as:
 Change negative thought patterns
 Identify positive responses to stress
 Improve communication with others
 Improve self-esteem
 Interrupt thoughts that lead to addictive or other self-destructive behaviors
 Reduce fears and phobias10
What to Expect
During CBT, your teen will work on identifying negative thoughts, which can be a
challenging process. Their therapist will work with them to develop new ways of thinking
and learn new coping skills.
Your teen may be assigned "homework" to do outside of their therapy sessions, which may
involve practicing many of the skills they are working on during therapy. CBT tends to be
highly structured, which can be helpful for teens who want to be able to clearly understand
goals and expectations.
Recap
CBT often involves homework assignments. Getting parents involved in supporting a teen's
efforts to complete the homework can be key to getting better. Be sure to talk to the therapist
about how you can best support your teen's treatment.
Family Therapy
Family therapy is an approach that helps teens by addressing the interpersonal and family
issues that affect their mental well-being. For teens who are dealing with problems with the
home environment or family conflicts, this type of therapy can help both the child and the
family as a whole.
Basic Principles
Family therapy works by improving emotional awareness and understanding their role in the
family. By working with their therapist and with the rest of the family, individuals are able to
learn more effective ways of communicating with one another.11
 10

It can also help parents and caregivers learn strategies such as listening to and validating their
teen's emotions.
How It Works
Family therapists utilize a number of techniques in order to help teens and their families.
Their approach may include:
 Behavioral strategies such as role-playing and modeling effective communication
 Psychodynamic strategies such as talking about experiences to gain insight
 Structural strategies to address how family routines and dynamics play a role in how
each member of the family functions
Benefits of Family Therapy
This type of therapy can help teens and families in a variety of ways. Some of these benefits
include:
 Improving communication
 Reducing conflict
 Improving the home environment
 Creating empathy
 Building family cohesion
 Developing healthy boundaries12
Family participation and support can also help improve treatment outcomes. Research has
also found that teens with families that participate in family therapy are less likely to drop out
of treatment.13
This approach can be helpful in addressing behavioral issues and coping with life changes
such as moving, divorce, or the death of a loved one.
What to Expect
Family therapy can be short-term or last longer depending on the situation a teen or family is
facing. Some sessions may focus only on your teen, but in most cases, it will involve all of
the members of the family.
During your sessions, you will talk about the issues you are facing and explore other factors
that may also contribute to issues including peer influences, stress, trauma, or underlying
mental health conditions.
Recap
Family therapy can be effective for teens who are dealing with behavioral problems or family
issues that affect their well-being.12 It may involve some individual sessions, but usually
requires the participation of all members of the family unit.
 11

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy, often referred to as ACT, is an approach that can help
teens learn to identify, understand, and accept their emotions. Teens commonly face
challenging or strong emotions, so gaining an understanding of these feelings can help them
find ways to manage them effectively.
Basic Principles
The basic principle underlying this approach is that learning how to accept emotions can help
improve psychological flexibility.14 This skill involves being able to regulate emotions in the
short term and set aside feelings until you can address them in an effective and acceptable
way.
How It Works
This type of therapy utilizes six key strategies to help teens understand their emotions:15
 Acceptance: Instead of avoiding negative emotions, teens are encouraged to observe
and accept them without trying to change or deny them.
 Cognitive defusion: The focus of this step is to change how they react to their
feelings or thoughts. By changing this reaction, the emotion then has less power over
them.
 Being present: This strategy focuses on being mindful and aware of what is
happening without judging or trying to change the experience.
 Self as context: The focus of this technique is to help see their thoughts as something
separate from their behaviors.
 Values: ACT works to help teens identify the values that are important to them.
 Committed action: This type of therapy also helps teens find ways to commit to
behaviors that will help them stick to their values and achieve their goals.
Benefits of ACT
ACT can be beneficial for treating a number of conditions. Research suggests that ACT can
be an effective tool for helping reduce symptoms of conditions such as anxiety and
depression.15
What to Expect
During ACT sessions, teens work with their therapist to assess issues in their life that may be
creating emotional challenges including relationships, negative self-talk, and stressful events.
Sessions often focus on addressing immediate challenges in a teen's life and then move on to
addressing past issues and developing new skills.
Recap
ACT can be a helpful treatment for teens who are struggling with emotional challenges. By
understanding and accepting their emotions without judgment, teens are able to better
regulate and manage their feelings.
 12

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy, also known as DBT, is a form of CBT that was originally
developed to treat borderline personality disorder (BPD). It has since been adapted to treat
other mental health conditions including attention-deficit/hyperactivity disorder (ADHD),
depression, eating disorders, post-traumatic stress disorder (PTSD), and suicidal behaviors.16
Basic Principles
The key strategies used in DBT include:
 Mindfulness, which involves learning how to focus on the present moment without
worrying about the past or future
 Distress tolerance, which involves using techniques such as distraction or self-
soothing to better tolerate distressing emotions or situations
 Interpersonal effectiveness, which focuses on helping teens develop positive,
healthy relationships
 Emotional regulation, which helps teens identify and label emotions and explore
ways to cope with their feelings effectively
How It Works
Teens who are treated with DBT learn behavioral skills in group therapy settings. They also
receive individual therapy where they address personal challenges in their life and adapt and
practice the new skills they have learned.
During treatment, teens can also receive phone coaching from their therapist when they are
facing challenges in their daily life.17
Benefits of DBT
DBT can help teens achieve greater self-acceptance, gain new skills, and learn to better
tolerate distress. Research suggests that DBT can be helpful for treating a range of conditions
in both adults and children.18
A 2020 study published in JAMA Psychiatry found that DBT was an effective treatment for
reducing suicide attempts among teens who were at a high risk for suicide.19
What to Expect
During treatment, teens attend individual sessions as well as group therapy sessions where
they receive skills training. During skills training, teens learn new skills, practice these skills
in the group, share their experience, and gain support from other group members. Homework
to be completed outside of these sessions is also common.
Recap
DBT is a form of CBT that can effectively treat a range of mental health conditions that can
affect teens. It incorporates mindfulness practices and helps teens develop skills to
communicate in relationships, handle emotional discomfort, and regulate their emotions.
Interpersonal Therapy (IPT)
 13

Interpersonal therapy is an approach to treatment that focuses on how interpersonal

relationships and social interactions affect mental health and well-being. One form of this
therapy, known as interpersonal psychotherapy for adolescents (IPT-A) has been specifically
adapted to treat depression in teens between the ages of 12 and 18.20
Basic Principles
The key idea behind IPT is that improving relationships can help relieve symptoms of
depression. It helps with difficulties in relationships by addressing interpersonal deficits that
make it difficult for teens to form and maintain quality relationships.
How It Works
Proponents of IPT suggest that social and interpersonal factors play an important role in both
the onset and maintenance of depression. By addressing problems with loneliness, grief,
trauma, transitions, and unhelpful relationships, IPT works to relieve the distress that people
feel.
Benefits of IPT
Studies have shown that IPT-A can be effective as a treatment for depression in
adolescents.20 During treatment, teens learn to recognize their feelings about relationships,
improve their communication skills, and decrease relationship-related stress.
What to Expect
In IPT-A, teens meet with their therapist once a week for a 12- to 16-week period. Each
session has a specific focus, including exploring how relationships influence mood,
identifying problem areas, developing new problem-solving strategies, and practicing new
interpersonal skills.