When the house has gone quiet, or stopped being quiet altogether

The work

The person with the symptom is not always the person with the problem

Families usually arrive with one identified patient. The teenager who will not get out of bed. The one who is angry. The one whose school has rung again. And often that young person is genuinely having a hard time and genuinely needs support.

But families are systems, and a system under strain tends to put the pressure through its weakest joint. Fixing the joint without looking at the load is temporary at best. So while I will absolutely work with your teenager, I will also want to understand what is happening around them.

That is not an accusation, and it is not about finding a parent to blame. Almost every parent I meet is doing their best with an unfamiliar situation and very little sleep.

Working with teenagers

Teenagers can usually tell within about ten minutes whether an adult is genuinely interested or is running a script on behalf of their parents. If they decide it is the second one, you will get politeness and nothing else, and everybody will waste their money.

So I am straight with them about what I am there for. I tell them what is confidential and what is not, honestly, at the start. Within the limits of safety, what they say to me stays with them, and I will not be feeding a weekly report back to the kitchen. Parents sometimes find that uncomfortable, and it is the thing that makes the work possible.

• Anxiety, including school refusal and the anxiety hiding underneath the refusal
• Low mood, withdrawal and losing interest in things that used to matter
• Anger that has become the only available setting
• Family conflict, and conflict that has hardened into permanent stalemate
• Separation and divorce, and being asked to carry messages between two people
• Bullying, friendships and the specific exhaustion of being visible online at all times
• Early substance use, handled without theatrics

Working with parents

Sometimes the most useful sessions have no teenager in them at all. If your child will not come, that is common, and there is still a great deal to work with. How you respond to the door slamming genuinely changes what happens next, and that is workable even when your child has no interest in changing anything.

A note on younger children. I work with teenagers and with families as a whole. I do not offer individual therapy for young children. If that is what you need, tell me on the call and I will point you toward services that do it well.