The Perils of Parental Involvement in the Treatment of Adolescents

Is the psychotherapy treatment of adolescents any different from other psychotherapy treatments? Over the past 20 years, clinicians (Meeks, 1986; Spiegel, 1989; Levy-Warren, 1996) throughout the psychoanalytic field have demonstrated that indeed, the field of adolescent psychotherapy involves and requires therapeutic stances that are more flexible than those employed with adults and that “adolescent psychotherapy” has merged in the consulting room with a variety of therapeutic approaches and disciplines. Most experts agree on the need to maintain family involvement in the therapeutic process, with particular attention to delicate issues such as autonomy, trust, and confidentiality. But what happens when the family becomes the obstacle to the proper development of the adolescent? When parental violations threaten the well-being of the adolescent? When these violations are so subtle as to be nonreportable; yet they are, nonetheless, emotionally traumatic? I believe that in these times of “evolving domains,” it is imperative that as clinicians we question our long-established ways of working with adolescents and their families. As we witness a new century of psychoanalytic thinking and practice beginning to take shape, we must evaluate and adapt our work to the often confusing dynamics of individuals and their families who are themselves struggling to cope with a rapidly changing world.