Adolescent & Youth Therapy at InPsyche Journeys
The Special Period of Adolescence and Youths
Adolescence, or the “teenage years” is a special period for adolescents and parents alike – a time of changes, adjustments, tension, discovery, turbulence and joy. Adolescents are transiting into puberty – a phase beyond childhood and yet, not quite adulthood. For a start, puberty is a time when adolescents experience significant hormonal changes within their bodies, including the brain, which can bring about a range of new experiences that adolescents go through and make sense of. Bodily changes, mood changes, new ways of viewing the world, their abilities (e.g. belief in their invincibility, trying out risky activities), trying out new things, testing boundaries and questioning the status quo as more sophisticated thinking patterns develop.
A time when friend groups are forged and dropped, self-boosting feelings of belongingness and bitter feelings of rejection are felt even more keenly, and a sense of identity is developed. A time when adolescents experience a new sense of independence, coming across as questioning authority, wanting more “freedom”, more time with peers and less time with their caregivers.
Caregivers themselves often find themselves adjusting to understand their adolescent (child) too. On one hand, caregivers may struggle to make sense of their adolescent children and yearn for the child whom they were used to. For example, caregivers try to seek the child who used to be more “obedient” than the adolescent who now questions authority, asserts his/her/their opinions, wants to make decisions. Caregivers sometimes face difficulties with communicating with their adolescent children, therefore have very little idea of what their adolescents are doing, thinking or going through. In the process, tension and conflicts may arise between adolescents and their caregivers due to differing perspectives, or “one-way street” interactions when adolescents withdraw and shut down. On the other hand, apart from the doom and gloom, adolesence can be a period of positivity. For example, parents and adolescents ride on the adolescents developing sense of independence and sophisticated thinking patterns, to foster new parenting styles which model negotiation and consequential thinking when making decisions with the adolescents, instead of a directive stance.
In the midst of these transitions, how do adolescents fare? International and local research studies have found that adolescents across the world are have a high chance of experiencing mental health issues. The World Health Organisation (2024) found that one in seven 10 to 19 year-olds globally experience a mental health disorder, with depression, anxiety and behavioural disorder being the main conditions, A study by the National University of Singapore (Seah & Ng, 2023) found that one in three adolescents experienced symtoms associated with depression, anxiety or loneliness, and one in six adolescents experienced symptoms associated with aggression, hyperactivity and rule-breaking. One in 10 adolescents were found to have at least one ongoing mental health condition. Contributing factors include striving for academic excellence, lack of mental health literacy by parents and the misperceived use of electronic devices by parents. Another study by the Institute of Mental Health (Teo, 2024) found that one in three youths aged 15 to 35 years old were likely to experience depression, anxiety and stress, with cyberbullying and body image issues to be contributing factors.
Seah, S. & Ng, D. (2023, April 27). Study finds 1 in 10 teens suffers from mental health disorder; professionals call for more support from parents. CNA. https://www.channelnewsasia.com/singapore/teens-youth-mental-health-disorder-nus-study-support-parents-resilience-3448571
World Health Organisation (2024, October 10). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Common Issues Adolescents Face
1. Mental Health
Conditions As mentioned earlier, mental health conditions such as depression and anxiety-related conditions, are commonly experienced by adolescents across the world. Depression and anxiety-related conditions typically develop as a result of an interaction of biological, individual (psychological) and environmental (e.g. school, family, peer and romantic relationships). I have listed some common situations that could contribute to mental health such as depression anxiety-related conditions.
2. Learning Difficulties & Developmental
Conditions Depression and anxiety often occur together with various other mental health condittions for people of different ages. Depression and anxiety-related conditions can also occur alongside individuals who have learning difficulties (e.g. reading, writing) and/or developmental conditions (e.g. Intellectual Disability or Giftedness, Autism Spectrum Disorder, Attention Deficit and/or Hyperactivity Disorder).
It is noteworthy to pay attention to adolescents who have learning difficulties and/or a developmental condition. At a time when academic excellence and belonging with the “in” group are two important tasks for adolescents, adolescents with learning difficulties and/or developmental conditions may sometimes exhibit behavioural, emotional or academic difficulties that are different from their peers. This may give rise to comparisons between themselves and their peers, and in turn may contrbiute to anxiety, perceptions of inadequacy and depressive symptoms (e.g. withdrawing from peers, low mood).
3. Peer Relationships
Peers are the people that adolescents spend increasingly more time with as they move through their teenage years. Peers are commonly the “mirror” that adolescents look at to get feedback – accurate or inaccurate, about themselves
a) In-groups & Out-groups: Acceptance, Belongingness, Rejection & Abandonment
The identity of adolescents is actively being developed in their teenage years. Belonging to in-groups or being cast out is sometimes taken by adolescents as a key indicator of their worth, popularity and whether they are “good enough”. Unfortunately, being left out of friend groups for various reasons – often through no fault of targeted adolecents – can range from neutral reasons (e.g. differing interests) through to sinister ones (e.g. rallying fellow peers to isolate targeted adolescents) which adolescents find themselves in.
Understandably, the social “mirror” might inaccurately amplify feelings of rejection and abandonment experieced by the targeted adolescents. In turn, these unaddressed perceptions could feed into the development of longer-term, negative views adolescents have of themselves (e.g. poor self-worth, low self-esteem, feeling “not good enough”), giving rise to symptoms of anxiety and depression in their daily interactions with others.
b) Bullying & Cyberbullying
Peers sometimes intentionally rally others to turn against and isolate targeted adolescents. This is an example of bullying which exerts emotional distress on the targeted adolescents. Similarly, name-calling, making threats, ambushing targeted individuals, exerting physical violence are examples of bullying which can cause emotional distress, apart from physical hurt in the case of physical violence.
Similarly, given the widespread use of social media, the online platform can be used as a shield in which cyberbullying can take place easily. Name-calling, hate comments and sinister posts are some examples of cyberbullying which can be hidden behind faceless perpetrators, while real-time netizen comments can be easily accessed on any devices anywhere. The relentless exposure and absence of clear perpetrators can result in intense emotional distress, comparable to conventional forms of bullying
Prolonged exposure to bullying can greatly affect the emotional health of targeted individuals and possibly give rise to mental health conditions if unresolved.
4. Academic Excellence
Academic excellence is a significant defining factor of the identity of most adolescents, especially in academically-driven Singapore. Adolescents and parents alike can contribute towards the high-pressure cooker associated with striving for academic excellence. Sometimes, adolescents and their caregivers can have different levels of motivation in striving for academic excellence, which can result in tension, conflicts and high levels of stress experienced by the adolescents or within the family.
Adolescent & Youth Therapy: My Approach at InPsyche Journeys
Adolescents are often brought by their caregivers to seek professional help, and identified as the “problem” to be “fixed”. In these situations, adolescents often come for sessions against their will and often appear quiet and unwilling to speak. Yet, underneath their silence, lie important clues about their perspectives of the issues at hand that need to be heard together with their caregivers’ perspectives.
Therefore working with adolescents involves a systemic approach – working with the adolescents alongside their caregivers, and understanding their relationships and interactional patterns.
Some approaches that I commonly draw from:
Adolescents might first come into youth therapy being quiet, clammed up and protecting themselves. Some might be ready to jump in and start working. I respect the adolescents who remain quiet and clammed up, while taking their cue to pace the sessions. Sitting with the silence is one thing I sometimes utilise. I also tap on resources that allow for non-verbal engagement to facilitate interactions. For example, Expressive Therapy modalities, such as the Squiggly game, Symbol or games, are some resources I tap on.
Other Approaches I Commonly Draw From When Working with Adolescents:
– Include but are not limited to Cognitive Behaviour Therapy, Schema Therapy, Mindfulness-based activities.
– Working with Adolescents and Their Families: Working effectively with adolescents can’t do without working with their families, relationships and interactional patterns. I use techniques drawn from the Systemic Approach to address the “systems” and dynamics within the family in order to increase awareness of unhealthy interactional patterns and to increase healthy ones.