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Steven Clemens, MS, LPC
36O DEGREE HEALTH
, PLLC

401 Meadowlands Drive, #102
Hillsborough NC 27278
Telephone: (919) 296-8750

Steven M. Clemens has a Master’s Degree in School Administration and Educational Leadership from UNC-Chapel Hill, and a Master’s in Education in Clinical Mental Health Counseling from NC State University. He is a National Certified Counselor and Licensed Professional Counselor in North Carolina. He previously held licensure as a Teacher of Exceptional Children (K-12) and Principal (K-12) in North Carolina.

He currently works as a therapist at 360 Degree Health, PLLC, in Hillsborough, NC and is accepting new clients. His services include individual, group, and family counseling for children, adolescents, and adults.

Critical Environments:
Establishing a Therapeutic Alliance
with the Resistant Teenager

By Steven Clemens, MS, LPC

Today, counseling encompasses theories and techniques as varied and diverse as the counselors and clients who use them. Nevertheless, in order to be successful, these theories are dependent on a strong therapeutic alliance with the client. It is my belief that for effective therapy with the resistant teenager, the right therapeutic environment is critically important—an environment created by communicating a deep sense of understanding prior to investing in problem-solving interventions.

Steven Clemens, MS, LPC

IA basic goal of therapy is to create a safe psychological and emotional climate so that young clients will not feel threatened and will be able to drop their pretenses and defenses. As a counselor, I attempt to understand my clients’ subjective world view and help them discover a new awareness of their options in life. I do this by facilitating an atmosphere that respects the client’s dignity and self-worth, recognizes their freedom in determining their own values and goals, and encourages them to pursue their own lifestyle.

Since 1997, I have extensively counseled children, adolescents, adults, and families. And, in my experience, it is rare that teenagers report feeling better due to a singular technique or intervention. Instead teens often mention that feeling heard, understood, and valued are reasons for improvement.

Prescribed Options?

I believe counselors are often too quick to introduce a prescribed treatment regimen without listening to the teenager’s true concerns and goals. This can damage the opportunity to develop a healthy therapeutic relationship and often leads to resistance—which arises in situations where the teen does not feel psychologically or emotionally safe. Resistance can be characterized by a teenager’s unwillingness to work on their problems and/or cooperate in the therapeutic process; it can occur for a multitude of reasons ranging from extreme shyness to desire for power and control. Thus, counselors must be aware of both their own behaviors and their client’s disposition.

Validation and acceptance are also necessary parts of any therapeutic intervention, regardless of the client population. I attempt to demystify therapy by including the client as an active partner in the assessment and treatment process. Simply asking questions such as, “Was this session helpful?” or “Was there anything we didn’t cover today?” gives teens the chance to express themselves, while conveying the message that their reactions—positive or negative—will be heard and respected.

Resistant Behavior

Most of the kids I have worked with have suffered repeated emotional challenges in their lives. So understanding that resistant behavior is often a sign that the client is hurting or protecting themselves from further pain is an important first step. Children are very adept in testing the limits of adult patience—a skill that allows them to recognize which adults are worthy of their attention. This understanding is critical for adult caregivers or counselors. Instead of letting myself get “bent out of shape” by a resistant reaction, I accept what the client is doing as a healthy and understandable personal protective measure.

Counselors who react in an authoritarian way to such resistance quickly lose credibility with their clients. Counselors who make every effort to understand the feelings of confusion, anger, insecurity, and loneliness beneath these defiant displays have a chance to reach their clients. In fact, I’ve learned that if you let most clients vent, maintain a supportive stance, listen for the true feelings underlying the spit and venom, eventually most of them will come around. They will see that you are not there to enforce your will, that you are able to listen, and that you are truly not going to give up easily—and they will let you in.

In short, a counselor’s authentic desire and determination to connect with the young client, along with validation, patience, acceptance, empathy, and an unconditional positive regard are all critical keys to the development of a safe and successful therapeutic alliance.