A Key to Success in Therapy

I want to share with you something that has helped many of my clients, teens and families, achieve positive changes in therapy. It may sound simple, even cliché, but learning to set clear goals and stay focused on them often makes the difference between success and long, drawn out struggles.

Often, when teens come in for therapy they have a strong sense that “something doesn’t feel right” or they “just want things to get better”. Parents often talk about their son’s low self-esteem, poor social skills, or lack of motivation.

I feel that these are all very legitimate reasons to seek help, and concerns like these are a good starting point for a conversation that helps clearly define what is going on in a child’s life and what can be done about it.

For example, let’s say that a 13 year-old boy comes in to talk about his struggles.

Marcus: So what’s going on? You look a little down today.

Teen: I just don’t like school anymore.

Marcus: Oh. Is there anything in particular you don’t like?

Teen: I don’t know. I just don’t like it.

Marcus: Maybe you can help me understand. Do you mean that you’re having trouble learning in your classes?

Teen: No, it’s not that. I just hate school.

Marcus: Well, I’m sure you’ve got good reasons for that. And I don’t know you that well yet; I’m just curious. If you had to pick one main thing that you hate about school, what would it be?

Teen: None of the kids even pay attention to me. They just act like I’m not even there.

Already, we’ve gone from the physical signs of sadness and discouragement to a much more specific problem, and instead of trying to convince this boy of all the reasons why he “should” like school or go to school, together we’ve uncovered that the issue isn’t really school at all, but insecurity around social relationships.

But that still isn’t specific enough. I would want to help this kid identify exactly what things make it hard for him to make connections with his peers. Maybe they really like him, but he lacks assertiveness to start conversations. Maybe they are mad at him for constantly interrupting when they do talk to him. Maybe he is on the receiving end of racial profiling or prejudice.

In other words, I can’t help him address his problem in any useful way until we have a really good idea of what the specific challenges are.

Let’s say he identifies that the other kids probably really like him, but he lacks the assertiveness he needs to start conversations with them. Now we’re getting close, but still not quite specific enough. Who does he want to talk to? Lots of new friends? Just a few established friends? A romantic interest? When we narrow down his focus into something like: “I want to be good enough friends with two guys on my soccer team that we can hang out at each other’s houses,” then we have something we can work with.

Breaking down his problems into manageable goals will likely help him feel less intimidated by vague feelings of powerlessness, sadness and worry. Also, he’ll know if he has been successful in a real and tangible way. If he agrees that meeting this goal is something he really wants to do, we can work together to find a way to get there.