Overview
A parent called us last month and described, with the helplessness many parents recognize, what had been happening with their fifteen-year-old. She used to talk to me about everything. Now she barely speaks at home. She is in her room most of the time. Her grades have dropped. She seems flat — not sad in a way I can name, just gone somewhere I cannot reach. I do not know if this is normal teenage stuff or something I should worry about.
She refuses to talk to me about it. This is one of the most common entry points for adolescent therapy. The parent recognizes that something is happening but cannot tell whether it requires intervention. The teen will not talk to the parent.
Evidence summary
The relationship between parent and teen has become strained. And the parent is left guessing about how to respond. This article is for parents considering therapy for their adolescent, and for teens themselves who may have come across this article wondering whether therapy could help them.
) What's actually normal in adolescence A great deal of what concerns parents about their teenagers is, on examination, normal adolescent development: Increased privacy and emotional withdrawal from parents. Adolescence is a developmental period of differentiation from family of origin.
Care considerations
Teens turning inward is not failure of the parent- child relationship; it is appropriate developmental work. Mood lability. Hormonal change, brain development (the prefrontal cortex is still developing through the mid-twenties), and the cognitive work of forming identity all produce mood that is more variable than younger children's or adults'. Identity exploration including experimentation with appearance, peer group, and ideology.
This is the developmental task of adolescence. Most of the experimentation is temporary and serves identity formation. Conflict with parents about autonomy. The negotiation of independence is ordinary developmental work. Some friction is expected.
Next steps
Strong emotional engagement with peer relationships, often more than with family. Peer relationships are developmentally primary in adolescence in ways that change in young adulthood. This is normal. Sleep changes. Adolescent biological clocks shift later. Most teens are wired for later sleep and later waking than adult schedules accommodate.
) or any references to suicide
Overview 5
- Substance use that is becoming concerning