Therapeutic Approaches for Teens

If you are interested in therapeutic approaches, here’s a bit more information:

All therapeutic approaches have something called a theory of change. The theory of change is the way that this approach whole-heartedly believes healing, health, and positive change happen.

• Emotionally Focused Therapy/Emotionally Focused Family Therapy (EFT/EFFT)

  We like this therapeutic approach a lot here. The reason we like it a lot is because the foundational key concept is attachment. We all need good attachment. When we’re experiencing attachment as it’s meant to be experienced, we feel seen, heard, known, and understood in our relationships. We have a deep sense that the other will be there for us if we need them and that they have our backs. When we use EFT/EFFT in therapy with both individuals and families we are looking at ways to improve attachment as attachment is a creative, powerful way to experience healing and connection with one another.

Theory of change for EFT/EFFT: Shift happens via corrective emotional experience which is fostered through secure attachment in our most important relationships.

• Internal Family Systems (IFS)

  Most of us here have been trained with this model. There are an emerging number of therapeutic approaches that are proving (yes, in research studies) to be effective with resolving the physical and psychological effects of trauma. This is one of those approaches. This works with the idea that we form parts inside of us that have these main jobs: to manage our life, to soothe our feelings, and to hold our pain. Therapy follows a path of getting all of those parts known, understood and feeling better. We like this approach because if clients decide they like it and are willing to try it, we find the results to be effective, swift, deep, and lasting. Clients have told us that they’ve spent years in traditional therapy with some small wins only to try this and experience big wins in a short time.

  Theory of change for IFS: Shift happens through parts going through experiences of being seen and releasing burdens.

• Relational Psychotherapy

  This approach has a core value around caring about and paying attention to the relationship between therapist and client as a way to facilitate healing. When practising relational psychotherapy, there is a big emphasis on attunement and response. We really appreciate this approach as it does so well at validating everyone’s unique personhood and unique experiences.

  Theory of change for relational psychotherapy: The therapeutic connection and paying attention to what’s happening within that co-created connection facilitates experiences of validation, curiosity, insight, depth, and healing.

• Narrative Therapy

  This approach pays attention to the stories we are in, and the stories we tell ourselves about what we’re experiencing. Narrative therapy cares a lot about validating the experiences we have of the systemic structures we all encounter. We like this approach for what it offers around reframes and the possibility that we can change how we understand something, or someone, in a way that is freeing and empowering for us. Narrative therapy is also really great with an intervention called “externalizing”. This looks like making a struggle something that can be defined as separate from us and when we do that we can change our relationship with that struggle. Most of us will use tools and interventions from narrative therapy as they are effective and helpful.

Theory of change for narrative therapy: Change happens when working with details from your story that can change your relationship with that story/struggle – which can affect the trajectory of the story and can change your life for the better.

• Cognitive Behavioural Therapy (CBT)

  This is an interesting one to explore. It’s probably the most politicized of therapy approaches in the field. CBT is a manualized approach to therapy, which makes it highly attractive for researchers to study. For this reason, CBT is arguably over-represented among research findings – even over-shadowing other effective therapeutic approaches. The prominence of CBT in research findings is one of the guiding factors that inform medical practitioners to recommend it. This, in combination with the features that lend CBT well to ‘brief’ therapy and group work, boosted CBT’s popularity among doctors (through referrals, their own provision when trained, and offerings in hospital settings), and in agency settings, too. So we get a lot of referrals recommendations for CBT from doctors.

  Here’s how we in private practice feel about it: It’s good and we use it, especially if there’s a referral and it feels important to the family we’re receiving into the Centre here. If it’s important to you to have CBT for your teen, it’s important to us to offer CBT to your teen. Also, we know it’s not the only evidence-based model and we’re keenly aware of its limits.

  This approach works with the idea that we’re prone to stinking thinking which is really a variety of ways that our thoughts could go a bit off course and lead us astray. And if we can course correct our thoughts, our feelings and struggles will follow.

  Theory of change with CBT: Cognitive Behavior Therapy helps people identify how their thoughts, behaviour, and emotions are inter-connected. They notice distressing thoughts and evaluate how realistic the thoughts are. Then they learn to change their distorted thinking. When we think more realistically, and act with integrity, we feel better.

• Dialectical Behavioural Therapy (DBT)

  This is a method of therapy was primarily developed to treat Borderline Personality Disorder. DBT was originally presented as “under the CBT umbrella” and has come to be recognized as its own modality. Over the years, it has been shown to be effective for a variety of presenting concerns. This is very specialized therapy that clients usually seek out in a very specialized capacity that we don’t offer. Everyone here only offers a little bit of DBT and there are many lovely clinics in Toronto that do offer this.

For the sake of our conversation here, though, the theories of change with DBT are: Increased awareness and acceptance of emotion; increased attentional control; increased ability to modulate emotion; and increased use of adaptive coping skills.

• Family Based Therapy (FBT) for eating disorders

  In working with teens, we have found that it’s helpful for us to know how to come alongside families with teens that are struggling with eating disorders. FBT is a very structured approach that many of us have been trained on to help families help their teen with their relationship with eating. FBT is the approach used by hospitals with eating disorder clinics for youth.

  Theory of change with FBT: The whole family needs to be supported and empowered to change the client’s relationship with eating.

• Mindfulness

  We would likely think about this as a therapeutic tool rather than a therapy itself. But as it’s such an important tool and it has a distinct and important presence, we thought we should note it here. Mindfulness is a style of meditation that helps you be present to, and focus on, what you’re experiencing or feeling in a non-judgemental way. The invitation is to accept what you’re experiencing and, once you have, to just let it pass instead of engaging with it in a way that is self-defeating.

  Theory of change with Mindfulness: Meditation will bring regulation, awareness, and transcendence over disruptive thoughts, feelings, and experiences.

• Mindful Self-Compassion

  Mindful Self-Compassion is a systematic therapeutic approach where mindfulness is explored in a way that can increase our sense of self-compassion and where, in turn, that sense of self-compassion is applied in a way to nurture a supportive relationship with our own selves.

Theory of change with Mindful Self-Compassion: When we can show-up for ourselves in a good way that is honest and clear about how we’re feeling and what we’re experiencing, with kindness, we are in a better position to cope and flourish.

• Acceptance and Commitment Therapy (ACT)

  Acceptance and Commitment Therapy continues to be recognized “under the CBT umbrella” because it looks at thoughts and behaviour with the understanding that these are not us, but do affect us greatly, and when we change the way we relate to unhelpful thoughts and behaviours, the impact is significant. This approach is values-based and encourages people to articulate what is important to them so that values can serve as a source of direction for decision-making, and a source of motivation when we’re coming up against barriers to our reaching goals.

Theory of change with ACT: Awareness and even acceptance of the specific ways we struggle, in combination with a commitment to our values, can help us “do what matters, not matter what”.

• Exposure and Response Prevention (ERP)

  This is a method of therapy used for Obsessive Compulsive Disorder. No one here has been trained to use this. We put this here to help parents know what to search for when looking for help for their teen. There are a lot of places in Toronto that offer this really important approach to therapy.

Also for the sake of our conversation, the theory of change with ERP is: Compulsions can be managed by facing your fears and letting obsessive thoughts occur without ‘putting them right’ or ‘neutralizing’ them with compulsions.