Autonomy in the Therapeutic Process: Balancing your Wishes for your Teen with Concrete Goals in Therapy

Imagine playing a recreational sport where half of your teammates were joining the team to connect with others and get a bit of exercise, and the other half of your teammates were trying to be serious competitors. 

This situation likely wouldn’t be able to last for long. The competitive teammates would get upset at the others for not wanting to practice as much throughout the week, and the social teammates would be upset with the ones who were pushing the team too hard and taking the sport too seriously. 

While neither side would be in the wrong here- it’s not problematic to want to join a laidback social group, and there’s nothing wrong with wanting to win- they likely wouldn’t be able to see eye to eye, leading to frustration and resentment.

This is exactly what happens when teens, therapists, and parents are not on the same page when it comes to goals of therapy treatment. However, this scenario still happens far too often.

Parents want what is best for their teens. You might label certain behaviors as problematic if you know they will be an obstacle to your teen’s success. For instance, if they aren’t cleaning their room regularly, they spend a lot of time away from school, or they are constantly on their phone, you might feel like these behaviors should be addressed in therapy.

Your teen might feel differently. They might not see any of the behaviors above as problems, and they might want to focus on other issues that they feel are more consequential. They might have problems with a specific student at school or anxiety about performing well in their sport, and as a result, they believe working on these issues is how their time in therapy should be spent.

This can lead to frustration on both of your parts when the issues each of you value the most aren’t addressed in therapy. If you are hoping your therapist will help your teen avoid using profane language, you will be disappointed if you hear your teen continue to swear after multiple sessions. If your teen is hoping their therapist will help them learn how to get better grades in school, they will feel let down if they continue to bring home grades that are less than satisfactory.

The best way to prevent you and your teen from feeling frustrated with the treatment process is to align your goals with those set by your teen’s therapist. As a parent, this means balancing your wishes and hopes for your teens with concrete goals that your teen’s therapist might suggest.

It’s important to remember that your teen’s therapist will also have a desired course of action. Therapists who specialize in Dialectical Behavior Therapy (DBT) will set treatment goals that are measurable so that they can be effectively tracked and your teen’s progress can be monitored. 

Instead of working to eliminate profanity from your teen’s vocabulary, a therapist might focus on helping your teen regulate their anger and how they respond when upset. Instead of focusing on lowering your teen’s phone use, they might work toward helping your teen manage their anxiety so that they don’t have to be reliant on their phone in social situations.

Oftentimes your teen’s therapist will use surveys and DBT cards to help monitor and track your teen’s progress. When you, your teen, and your teen’s therapist all have the same goals, seeing this progress will be encouraging. Instead of feeling disappointed, you and your teen will know that their treatment is effective.

It is also important to realize that many of the goals set by your teen’s therapist will be determined by the actions and words of your teen. If your teen communicates a specific struggle that they are having trouble trying to cope with in their life, their therapist might deem it important enough to shape one of their treatment goals. While this goal might not seem as important as the goals you have for your teen, it is important for you to allow your teen to have autonomy in their treatment and to respect the therapist’s judgment.

Approach this process with an open-mind and be willing to adjust your own hopes for your teen’s treatment to align with the goals set by their therapist.