The blog

You meet a new client in the waiting room for the first time and extend your hand, he just looks at you and doesn’t reciprocate. When you settle into the office and begin to talk he states, “all therapists suck, why should I trust you?”. Are you going to take the bait?

Those of us who work with teenagers occasionally experience the angry, hostile, provocative young person who seems determined to irritate us. Let’s look at what causes this behavior and the most effective way to respond.

Good treatment begins with an understanding of why challenging/maladaptive behaviors occur and what purpose they serve for the client. Why would a teen start an interaction in this way? Lots of reasons:

• Perhaps it’s true, maybe they have received treatment that was unhelpful in the past and they understandably have their guard up.
• A previous  therapist may have been threatening or disrespectful to them.
• They may be vulnerable and scared, and they don’t want us to see this.
• Previous interactions with inappropriate adults in other roles may have left them suspicious and defended.
• Lack of skill for effectively coping with an anxiety provoking interaction may be getting in the way.

Anger and hostility typically emerge when people perceive that their goals are being blocked, and it’s critical to acknowledge this and validate what’s true. The most humane and compassionate response is to give the young person the benefit of the doubt and assume that there is an understandable reason for this behavior even if it isn’t yet clear what it is.

We are youth professionals and it’s our obligation to step back from the emotion that these types of interactions activate in us and respond in a thoughtful and kind manner. Our responsibility is to provide a corrective emotional experience. How do we do it?

• Be patient. Stay in the present moment and see the human being in front of you – worthy of respect and compassion despite their behavior.
• Allow the teen to express the anger, show openness to it and acceptance of it.
• Agree with what’s true, “I don’t blame you for being upset given what you just told me about what happened to you.”
• Provide choice and control. Ask for permission, be humble, and drop any authoritarian urges you experience.
• Be real, show you are interested in their perspective and don’t argue!

In short, don’t take the bait! You have an opening to provide a new experience to the teenager sitting in front of you, and in doing so potentially changing a life. Please take the opportunity.

~Britt Rathbone, LCSW-C