Academic achievement is closely related to the mental health of adolescents. Failure for a teenager to actualize their academic potential is often an indication of underlying and possibly undiagnosed disorders such as anxiety, depression, ADD, learning disabilities, PTSD, spectrum disorders, or substance abuse. Environmental factors such as family discord, divorce, problematic teachers, problematic peer relationships, and bullying, can also correlate with academic underachievement.

Common academic problems include :

- Lack of motivation or disinterest in school

- Failure to recognize the value of education

- Difficulty visualizing personal academic success

- Refusal to accept personal responsibility for underachievement

- Confusion or misunderstanding of subject matter

- Excessive socializing

- Gravitation toward underachieving social groups

Treating Academic Problems —

Working with a therapist allows an adolescent the opportunity to explore their perceptions and motives, it can help expand and develop their value system, find motivation, and to organize their life better. Therapy can help students identify underlying internal or external obstacles that may be contributing to academic underachievement, and develop strategies to overcome those obstacles. A teen who experiences difficulty in school after a traumatic event, for example, may find his or her performance in the classroom improving once he or she can talk about and move past the trauma in therapy.

Adjustment disorders are the presence of a group of symptoms that correspond with a stressful event or events in a teen's life. Symptoms occur within 3-months of the triggering event(s) and are disruptive to social, educational, or other important areas of the teen's life.

Common events that may lead to adjustment disorder include :

- Divorce or family conflict

- Bullying or other social problems

- Injury or illness of self or loved one

- Death of a loved one

- Moving or changing schools

- Financial instability

- School problems

- Sexuality issues

- Unexpected catastrophes

- General life changes

Symptoms of adjustment disorder may include :

- Mood disturbance such as anxiety or depression

- Decreased distress tolerance

- Physical pain or discomfort with no indication of actual injury or illness

- Social withdrawal or avoidance

- Behavioral problems

- Academic problems

Adjustment Disorder Treatment —

Teens with adjustment disorders typically respond well to psychotherapy. Talking to a therapist provides an opportunity for the adolescents to discover and understand why the stressful event was so unsettling to them, to identify strategies to overcome and manage stress better, and to ultimately accept and learn and grow from difficult life events, and to be better prepared for the difficulties they will inevitably face in the future.

It is not uncommon for an adolescent to lose their temper occasionally. If however, a teen struggles with bouts of severe anger that significantly disrupts the teen's life and the lives of those around him or her, he or she may have intermittent explosive disorder (IED). IED is a condition identified by recurring episodes of intense verbal anger, aggression, and even physical violence. To the outside observer, these anger episodes seem irrational or disproportionate to the situation at hand. IED can cause significant distress and disruption, and negatively impact relationships, school, or work, and can even have legal and financial consequences.

Symptoms of Intermittent explosive disorder may include :

- Increasing irritability

- Ruminating or racing thoughts

- Building energy and physical tension

- Increased heart rate

- Chest tightness

- Loss of ability to think clearly

- Loss of ability to empathize with others

- Excessive arguing

- Yelling

- Threatening

- Damaging property

- Inciting violence

- Physical fights

- Assaulting pets

Intermittent Explosive Disorder Treatment —

Cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) are effective therapeutic modalities that can help teens overcome anger issues. As they work with a therapist, teens learn mindfulness and relaxation techniques. Teens are encouraged to explore and identify underlying fears and insecurities that are often fueling their anger. They practice how to pay attention to internal dialogues, to correct distortions, strategies to cool off, and to see situations differently. Rather than using anger and rage, teens begin to implement effective interpersonal communication and problem-solving skills, bringing peace back into thier homes and into their lives.

By nature adolescents are more prone to anxiety than adults. To a certain degree anxiety is normal and even helpful and necessary for a teenager to become and stay alert and to perform well in the world. If however, anxiety reaches a level of severity that significantly interferes with a teen's ability to function academically, athletically, or socially, a teen may have an anxiety disorder.

Anxiety disoder symptoms include :

- Restlessness

- Feeling keyed up or on edge

- Being easily fatigued

- Difficulty concentrating

- Academic problems

- Excessive irritability

- Muscle tension

- Sleep disturbance

- Overwhelming fear of rejection

- Frequent distress in social interactions

- Avoiding Social interactions

Anxiety Treatment —

Psychotherapy has shown to be very effective in helping individuals overcome anxiety disorders. In therapy, teens are encouraged to explore and identify in detail the causes of anxiety, correct any underlying cognitive distortions, and develop concrete skills to cope with anxiety including relaxation and reframing techniques. Teens are challenged to gain strength by practicing their new skills inside and outside of sessions through visualization exercises and even direct but tolerable levels of exposure to triggering stimuli. Most adolescents who suffer from anxiety show a reduction or even complete elimination of symptoms after several (or fewer) months of psychotherapy, and many patients notice improvement after just a few sessions.

Occasional obstinance and mischief are typical characteristics of the adolescent experience. If however, a teen has a persistent pattern of defiance and acting-out, he or she may be struggling with a disruptive, impulse-control, or conduct disorder.

Different than other mental health conditions, such as anxiety or depression where the adolescent’s distress is focused inward, with conduct disorders the distress is focused outward. These behaviors usually have not only a significant negative effect on the teenager, but on those within the teen’s social circle as well.

Symptoms of disruptive, impulse-control, or conduct disorders may vary in presence and in intensity, and may include :

- Frequent irritability or being easily annoyed

- Being excessively critical of others

- Frequent anger and resentfulness

- Often argues with adults or people in authority

- Often actively defies rules or refuses to comply with adults

- Often deliberately annoys or upsets others

- Has difficulty being accountable, often blames others for his or her mistakes or misbehavior

- Often spiteful or vindictive

- Bullying, threatening, or intimidating others

- Initiating physical fights

- Using a weapon

- Physical cruelty to people or animals

- Sexual misbehavior

- Frequent dishonesty

- Stealing, shoplifting

- Destruction of property

- Deliberate fire setting

- Academic problems

- Frequent truancy

- Running away

Disruptive, impulse-control, and conduct disorder treatment —

Psychotherapy can be instrumental in curbing a teenager’s pattern of problematic behavior by helping the teen make a clearer connection between problematic behavior and negative consequences, and helping them gain a greater sense of personal control and responsibility. In therapy, teens are intstructed and encouraged to increase awareness of physical sensations and thoughts that underlay impulsivity, anger and aggression. Teens receive skills training in distress tolerance, emotional regulation, and interpersonal effectiveness, with an emphasis on empathy and effective communication. Treatment often involves family therapy to improve communication, problem-solving skills, parenting skills, family connectedness, and heal from wounds from the past.

Bullying is the uninvited, aggressive behavior of an individual or individuals with the intent to cause emotional or physical harm or discomfort to another, and involves a real or perceived imbalance of power. Victims (as well as the perpetrators) of bullying may have serious, long-lasting problems as a result.

Bullying can take many forms including :

- Teasing

- Taunting

- Name-calling

- Physical threatening or intimidation

- Hitting, kicking, pinching, spitting, tripping, pushing

- Taking or damaging another’s property

- Inappropriate sexual comments

- Spreading rumors

- Embarrassing another in public

- Malicious social exclusion

- Sending, posting, or sharing personal or private, negative, harmful, or false information with the intent to cause embarrassment or humiliation

Symptoms that may indicate a teen is being bullied include :

- A sudden decline in academic performance

- Resistance or refusal to go to school

- Abrupt change in mood

- Changes in sleep patterns

- Unexplained weight loss or weight gain

- Social isolation

Treating Bullying Problems —

Psychotherapy can help victims of bullying identify, express and manage perceptions and emotions about being mistreated. In therapy teens learn important new skills including ways to bolster self-worth and self-respect, to communicate assertively, to maintain healthy boundaries, to devise a plan for stopping the abuse, and how and when to ask for help. Outcome of therapy include feeling stronger, more confident, less like a victim, feeling more in control of life, and feeling more optimistic about the future.

While a certain amount of moodiness is to be expected during the adolescent years, for teens with major depression the frequency, intensity and duration of depressive symptoms go beyond the occasional melancholy mood.

Symptoms of major depression in teens may include :

- Feelings of sadness, which may include crying spells for no apparent reason

- Feelings of frustration or anger over small matters

- Feeling empty or hopeless

- Easily irritated or annoyed

- Loss of interest in usual activities once found pleasurable

- Disconnection or frequent conflict with, family and friends

- Feelings of worthlessness or irrational guilt

- Rumination on past failures or exaggerated self-blame or self-criticism

- Overly sensitive to rejection or failure

- Memory problems, difficulty thinking, concentrating, and making decisions

- Academic problems

- Pervasive belief that life and the future are grim and bleak

- Reoccureing thoughts of death, dying or suicidal ideation

Treating Depression —

Psychotherapy helps teenagers understand themselves and the nature of their depression. In therapy teens learn to better tolerate distress, solve problems, change negative thinking patterns, and regulate emotions. Psychotherapy helps teens regain a sense of happiness, control, and hope for the future.

Events such as the death of a loved one, death of a pet, divorcing parents, a major move, a break-up in a peer relationship, or any significant change or loss in an adolescent's life that is beyond their control can trigger deep, debilitating pain and sorrow. While not all teens become disabled by the loss of something they value, for some, the experience can be excruciatingly difficult, and their grieving can profoundly interfere with their ability to function as they once did.

Symptoms of debilitating grief may include :

- Acute sorrow and pain

- Rumination or difficulty focusing on anything other than what was lost

- Intense and persistent longing or pining for what was lost

- Obsession with, or avoidance of tokens or reminders of what was lost

- Feelings of numbness or detachment

- Denial

- Bitterness or resentment

- Feeling life is meaningless or purposeless

- Lack of trust in others

- Inability to enjoy life or think back on positive experiences before the loss

- Regression to a previous developmental state

- Difficulty engaging in normal routine

- Changes in hygiene, eating, or sleeping habits

- Frequent nightmares

- Psychosomatic ailments

- Difficulty focusing

- Academic problems

- Isolation or withdrawal from others or from social activities

- Guilt or self-blame

Treating Grief and Loss —

Psychotherapy can be an invaluable resource in helping adolescents heal from loss and move past their grief. In therapy, teens are provided needed support, guidance, in a confidential, non-judgmental space. They are patiently, compassionately encouraged to talk and sort out the complex thoughts and emotions they are experiencing that may be difficult to process with friends or family. Working with a trusted therapist, teens are better able to identify, express, and process their feelings of sadness, anger, uncertainty, and even guilt. Therapy increases the likelihood a teen will not only overcome their current challenges, but they will emerge from the experience stronger, more emotionally intelligent, with a deeper well of understanding and self-efficacy that they can draw from when confronted with adversities they will inevitably face in the future.

The process of becoming a psychologically healthy adult requires a child to leave behind the safety of what is familiar to take on a more mature role and identity. And so, by nature, adolescence is a period of uncertainty, experimentation, and transformation. In addition to dramatic physiological changes, the transition to adulthood is further complicated by conflicting drives to feel a sense of belonging to the group, while at the same time desiring individuality and autonomy. As their capacity to think abstractly awakens, and they begin to struggle with the questions “who am I?” and “who am I to become?”, it is normal and natural for teens to experience a measure of perplexity and awkwardness.

For some teenagers, however, this critical developmental process of “belonging and becoming” can be particularly difficult and distressing, especially for those who are having trouble forming just the basics of a congruous sense of self. Teens who have been unable to form an adequate internal foundation from which to continue to build their identity can easily become lost, confused, and misguided.

Signs of identity problems include :

- Distorted or unrealistic perceptions of self

- Frequently shifting, disparate, and shallow displays of personality

- Inconsistent expressions of values and behaviors in different social settings

- Suggestible (easily influenced by others)

- Unstable mood

- Dramatic or out of context displays of emotions and behavior

- Promiscuity

- Self deprecation

- Low self-worth

- Painful shyness or introversion

- Excessively criticizing others

- Detachment from family

- Shallow peer relationships

- Frequent changes in peer groups

- Academic problems

- Rapidly shifting interests or hobbies

Treating Identity Problems —

In a private, nonjudgemental environment, psychotherapy provides teenagers the opportunity to carefully examine their lives, to discover who they really are and who they want to become. Teens learn to be introspective, to hear their own inner voice, to see and understand themselves more clearly and more deeply. They learn to recognize and correct distorted self-concepts, and to accept and properly value their own unique characteristics. In therapy teens are encouraged to identify and further develop their individual values and goals authentically, in a space free from distraction and outside social influences. As their self-identity becomes more defined, stable and secure, teens begin to experience more peace and confidence, they are more able to withstand social pressures, and are better situated to pursue their own authentic path of self-discovery, growth and maturity.

Stable child-parent relationships are crucial for the proper psychological development of children, for the health of the family, and even for the health of society. Relational issues between parents and children can occur at any time while the child grows and develops, but are particularly common during adolescence as teens naturally begin to form an identity independent of the family. Today’s families are particularly vulnerable to problems and conflict due to our fast-paced culture, demanding social pressures, and other modern environmental influences including technology and social media that can interfere in the development of adequate love and connection between teens and parents. While occasional arguments and discord are a normal and natural part of life with teens, parents and teenagers often find themselves stuck in a continual pattern of resentment and conflict that, if gone unaddressed, can have long-term detrimental effects.

Symptoms Parent-Child Relational Problems

- A pervasive sense of unhappiness or disconnection in the relationship

- Inability to communicate, collaborate or problem-solve

- Frequent arguments

- A pervasive pattern of withdrawal from conversation that impedes conflict resolution

- A pervasive lack of positive interaction (e.g., sharing thoughts, feelings, activities; affection)

- A pervasive pattern of perceiving the other negatively

- Intense and persistent levels of interpersonal anger and resentment

- Verbal aggression

- Physical abuse

Treating Parent/Teen Relational Issues —

When a pattern of conflict has developed between teens and parents, all are encouraged to participate in psychotherapy. At an individual level, family members are encouraged to be emotionally mindful, introspective, to explore and recognize clearly their individual needs, desires, and fears that inevitably underly the anger and frustration in the relationship. When individuals can see and understand themselves better they are in a position to better see and understand others. In individual therapy, teens and parents are encouraged to review and become familiar with principles of empathy, of effective listening, and healthy communication. They are then brought together to practice their new skill in session and encouraged to practice their skills at home. Most families who struggle with relational problems and who stay committed to the therapeutic process experience significant improvement in communication and ability to problem solve, as well as an increase in respect, love and connection.

Screens and technology characterize the modern world. As teens face this unique and unprecedented challenge they can easily become dependent on electronics which can damage relationships and cause psychological, and even physical harm. Screen/technology dependency issues may include addiction to cell phones, television, video games, social networking, and the internet. Addiction to electronics and drug addiction have a similar neurological footprint and share some of the same symptomatology.

Symptoms of screen/technology addiction include :

- Preoccupation or obsession with electronic devices

- Sadness, anxiety, restlessness, and/or irritability when separated from electronic devices or denied internet access

- Loss of interest in non-electronic activities previously enjoyed such as spending time with friends, sports, and hobbies

- Relying on technology to relieve stress or self-soothe negative moods

- Lying or deceiving others about electronics use

- Avoiding responsibilities such as homework, chores, or after-school job in favor of using electronics

- Academic problems related to electronics use

- Personal hygiene issues, eating problems, changes in sleeping habits related to electronics use

- Social isolation, or preferring virtual relationships over direct social connection

- Difficulty stopping or purposely continuing to use electronics excessively despite knowing the problems it causes

Treating Screen/Technology Addiction -

Psychotherapy provides teens struggling with technology addiction a space to unplug. In therapy teens are encouraged to look closely at their lives, to understand themselves better, to discover and clearly identify their values and goals. Therapy helps teens recognize areas where they have lost balance, the consequences of those imbalances, and effective ways to straighten things out. Teens are taught and practice in session being more mindful of internal thoughts, emotions and impulses that lead to unhealthy external behavior. They learn strategies to cope and tolerate distress, to regulate mood, to connect and attend properly to relationships. Therapy for addiction typically involves parents and family who learn effective ways to support the teenager, to love and communicate better, to trust each other better, to compassionately hold boundaries and hold each other accountable. Outcomes of therapy include greater self-awareness and self-control, an increase in confidence and self-efficacy, improved mood, improved relationships, and an ability to be present and cope with stress without resorting to the distraction of screens.

Sexual maturation is a complex process that involves both physiological changes and the development of beliefs, values, and principles that govern natural and normal human desires for connectedness and intimacy. In addition to innate physical influences, adolescent sexual attitudes and behaviors are affected by social variables including parent's values and family culture, peer relationships, and societal ideologies. Like never before in human history, today’s adolescents are regularly exposed to an extraordinarily broad array of explicit, hyper-sexualized messages, and imagery, along with conflicting moral ideologies, which can confuse and distort developing values and perceptions of sexuality. Difficult experiences such as sexual assault and other traumatizing sexual events can disrupt the psycho-sexual developmental process. While many are able to navigate the difficult and ofttimes awkward challenges of adolescent sexual development, and emerge from adolescence with few if any lasting signs of problems or distress, some teens struggle to develop a healthy framework of understanding and managing sexual identity, interests, and behaviors.

Sexual developmental/behavioral issues may include :

- Obsessive sexual thoughts

- Preoccupation with pornography

- Excessive or compulsive self-touch or self-stimulation

- Promiscuity

- Excessive use of offensive sexualized language

- “Sexting” or inappropriate online sexual behavior

- Voyeurism

- Coercive sexual behavior

- Gender identity issues

- Sexual identity, orientation, and preference issues

- Feelings of shame or depression

- Social withdrawal

Treating sexual developmental/behavioral issues —

In therapy, teens are provided needed support and guidance, in a confidential, non-stigmatizing space. They are patiently, compassionately encouraged to explore and talk about the complex thoughts and emotions they may be experiencing about their sexuality that may be difficult to process with friends, family, or religious leaders. Working with a trusted psychotherapist, teens are often better able to identify, express, and process the feelings of confusion, uncertainty, and guilt that often accompany problems with sexual behavior, as well as address frequently co-occurring issues such as anxiety and depression. In therapy teens have the opportunity to receive personalized education about healthy intimacy and reproductive health. Teens are invited to seek out and identify not only their values and beliefs about sex, but who they are as individuals beyond their sexuality, and encouraged to live more congruent to their values and broader identity. As teens gain greater self-awareness, they become less compulsive, more aware of physical influences, subconscious influences, and social influences, more cognizant of both the freedom and responsibility they have regarding their sexuality. Therapy increases the likelihood a teen will not only overcome their sexual developmental issues, but they will emerge from the experience more knowledgeable, more self-aware, and more resilient.

The choice to use mood-altering substances is a challenge all kids and teens will inevitably face. Childhood and adolescence is a time of exploration and experimentation, and if a teen has tried drugs it doesn't necessarily mean they will become addicted. Unfortunately, too many teens do become dependent, damaging relationships, and causing physical and psychological harm. Because the adolescent brain is still developing teen drug abuse can have significant long-term cognitive and behavioral effects, and teens that abuse drugs may have a greater risk of developing an addiction when they are adults. Recognition and intervention can end an emerging substance use problem before it becomes severe.

Some common signs of teen drug abuse include :

- Academic problems

- Social withdrawal

- Bloodshot eyes

- Unusual changes in mood

- Changes in personality

- Irrational behavior

- Missing curfew

- Loss of interest in activities previously enjoyed

- Changes in diet

- Changes in sleeping habits

- Personal hygiene issues

- Social withdrawal

-Avoiding eye contact

-Unusual odors on breath or clothes

-Secretive behavior

-Dishonesty

Treating Teen Substance Abuse -

In therapy, with empathy and compassion, teens are encouraged to examine thier lives and to think critically about the benifits and risks of using, to make a clearer connection between their substance abuse and negative consequences, helping them gain a greater sense of personal control and responsibility. They learn to recognize and understand underlying vulnerabilities that make them more susceptible to substance abuse. They learn to recognize internal and external triggers and strategies to cope and tolerate distress, to regulate mood without drugs or alcohol. Therapy for addiction typically involves parents and family who also learn to communicate better, to connect and support the teenager, to compassionately yet firmly hold boundaries, and to create a healthier, happier, and sober home environment.

Young people who experience traumatic events usually have difficulty adjusting and coping in the weeks and months following the event. For some, the struggle gets worse, lasting for many months or even years. Post-traumatic stress disorder (PTSD) or other stress-related disorders can develop from experiencing a number different harmful, frightening, or life-threatening events including:

-Automobile accidents

-Being severely injured or diagnosed with a major illness

-Being harassed, bullied, or physically assaulted

-Being raped or sexually assaulted

-Being kidnapped, held hostage, or any life-threatening event

-Witnessing others who are deathly ill, injured, or killed

-Surviving a major disaster, such as fire, flood, earthquake, or epidemic

-Losing a loved one in particularly upsetting circumstances

Symptoms of PTSD or stress-related disorders may include:

-Acute sorrow and pain

-Recurrent, unwanted distressing memories of the traumatic event

-"flashbacks" or feeling as if the traumatic event is happening again

-Recurrent dreams or nightmares about the traumatic event

-Avoiding thinking or talking about the traumatic event

-Avoiding places, activities or people that are a reminder of the traumatic event

-Severe emotional distress or physical reactions to people, places, or things that are a reminder of the traumatic event

-Hopelessness about the future

-Memory problems

-Strained relationships

-Difficulty experiencing positive emotions

-Lack of interest in activities once enjoyed

-Being easily startled or frightened

-Always being on guard for danger

-Self-destructive behavior, such as drinking too much or driving too fast

-Irritability, angry outbursts or aggressive behavior

-Feelings of numbness or detachment

-Denial

-Bitterness or resentment

-Feeling life is meaningless or purposeless

-Lack of trust in others

-Regression to a previous developmental state

-Difficulty engaging in normal routine

-Changes in hygiene, eating, or sleeping habits

-Psychosomatic ailments

-Difficulty focusing

-Academic problems

-Isolation or withdrawal from others or from social activities

-Guilt or self-blame

Trauma-Focused therapy consists of carefully and safely exploring the client's experience of the painful life event. Teens are taught to identify and change thoughts or beliefs about the trauma that are distorted or untrue. Therapy progresses at the teen's own pace. As they become more comfortable with talking and even writing about the event, their emotional strength increases, they are more able to find peace, to relax, to think clearly and accurately about the event, and to tolerate, accept, integrate, and move on with their lives.