Counseling Adolescents in Crisis

Adolescence: A Critical Stage of Development

According to the developmental theorist Erik Erikson, the fifth stage of human development is that of adolescence: identity versus role confusion. During this critical phase, adolescents must define who they are as people. They may wrestle with the pressures of academic success, personal priorities, and which peer groups to identify with in school. This period may include a substantial period of so-called acting out on the adolescent’s part (Erikson’s eight stages of development, 2018). Culturally speaking, within Western culture, there is often a great deal of leeway granted to adolescents during this period. A certain amount of rebellion and acting out is normal.

Adolescents have their own distinct culture, music, and critical, defining milestones such as going to high school, the prom, and away to college. Because of the need to define a separate identity and the social pressures of this stage, adolescents may be vulnerable to anxiety and depression. Erikson believed that if any stage’s essential conflict remained unresolved, then it was impossible for the individual to move on to the next phase of development.

Given the extent to which certain critical choices regarding sexuality, career, and educational choices occur at this phase, this makes adolescence particularly difficult. Some adolescents my struggle with defining an independent identity, because of conflicts about sexuality, peer or parental pressure, or unresolved mental health issues that come to the forefront as the adolescent becomes more independent. Adolescents may feel pressure to conform to certain peer group pressures to use drugs, not study, or to excel in sports, versus parental pressures to focus on schoolwork, postpone sexual activity, or to conform to specific gendered norms.

Because of the fraught nature of this period of life, many adolescents may benefit from counseling. But counselors, even experienced ones, may face challenges when dealing with adolescents. One common concern is the question of how much the counselor can keep confidential from the adolescent’s parents. Technically, minors do not have the same rights to confidentiality as do adult clients. However, an honest and productive relationship with a minor client requires a certain level of openness and trust. In fact, individuals in this stage of life may even have a heightened desire for privacy, which the therapist should accept as normal, particularly within our current cultural context (Brooks et al., 2011). Adolescents from cultures where parents feel they have a right to greater influence over their children may experience greater anxiety if they are struggling with their sexuality or are engaging in prohibited (but not dangerous) behaviors. The therapist must weigh the adolescent’s right to privacy versus the parent’s right to know what their child is doing on a situational basis.

On a state-by-state basis, there is often some leeway regarding minor confidentiality and additional rights that older, otherwise mentally competent minors may make regarding treatment. For example, in Colorado, minors over the age of 15 may consent to counseling, even without the consent of a parent or guardian (Brooks et al., 2011). This takes into consideration the fact that an adolescent does not have the same needs as, say, a child of 9, although there are many instances where confidentiality may need to be broached, such as in cases of sexual abuse, threats of suicide, eating disorder, or dangerous substance abuse.

Overall, the therapist has an important role in enabling the adolescent to resolve the conflicts which come to the forefront of this stage. Such stages may include cognitive strategies to replace black-and-white thinking (such as “I’m worthless”) with more positive thought patterns, or offering positive rather than unhealthy coping mechanisms to deal with stress and peer pressure. The therapist should also be cognizant of different situational factors which may influence development, such as the social distancing which isolated many teens during the pandemic. Overall, the therapist must be aware this is a unique stage of development and adolescents are neither children nor fully fledged adults.