Teen and Adolescent Therapy

Adolescence Is a Significant and Vulnerable Period

The teenage years are not just a phase to get through. They are the period when a person's sense of self, patterns of relating to others, and ways of managing difficulty begin to take shape in lasting ways. Identity formation, social pressure, academic stress, the neurological changes of the developing brain, and the increasing complexity of family relationships all converge during adolescence — and many teenagers navigate that convergence without adequate support because the adults around them are not sure what to do, and the teenagers themselves do not have the language or the trust to ask for help. Therapy offers both. At The Smith Counseling Group in Chevy Chase, we work with teenagers in a way that respects their intelligence, protects their privacy, and meets them where they actually are rather than where the adults in their lives think they should be. Book a free consultation for your teenager. Telehealth is available throughout Maryland.


What Brings Teenagers to Therapy

Teenagers come to therapy for many different reasons, and many of those reasons do not look like what adults expect mental health struggles to look like. Common presentations include:

If your teenager is struggling and you are not sure whether what you are seeing rises to the level of professional support, a free consultation is the right first step. We will talk through what you are observing and whether our practice is a good fit. Contact us here.

  • Anxiety about school performance, college applications, or the pressure to meet high expectations that the teenager may or may not have chosen for themselves

  • Social anxiety or difficulty with belonging — the fear of being excluded, misunderstood, or not good enough in the peer relationships that matter most during these years

  • Depression that looks like irritability, withdrawal, or a loss of interest in things that used to matter, rather than sadness that adults can easily recognize

  • Family conflict — including the specific tension that develops when a teenager's need for autonomy and a parent's need to feel connected and informed pull against each other

  • Identity questions around gender, sexuality, values, and who they are becoming, in the context of families and communities that may have complicated feelings about some of those questions

  • Grief — the loss of a person, a relationship, a version of their life, or a future they had imagined

  • The general experience of feeling overwhelmed, not knowing why, and not feeling able to say so to anyone who might actually understand

What Teen Therapy Is and What It Is Not

Teen therapy at The Smith Counseling Group is a space for the teenager. It is not a place where a parent's concerns are validated against the adolescent, where the therapist serves as an extension of parental authority, or where the therapist routinely reports session content back to parents. Teenagers who know their therapist will tell their parents what they say may be less likely to say what they actually need to say. That is not a useful therapeutic relationship. A key element of effective therapy for teenagers is often the experience of being genuinely heard by a trusted adult who is not part of their family system — someone who holds their confidence, responds without judgment, and helps them understand their own experience without an agenda about what they should feel or do. For parents, this can feel uncomfortable.

Trusting a professional to work with your child in a space you do not have access to requires a real act of faith. This is the right structure for the work, and we navigate it carefully. The confidentiality conversation — what stays in the room and what does not, and how we communicate with parents in ways that support the work — happens explicitly at the beginning so both parents and teenagers know what to expect. Telehealth is available for teenagers who have access to an appropriate private space for sessions. Reach out to discuss whether our approach fits your family.


Our Approach to Working With Teenagers

Therapy with teenagers looks different from therapy with adults, and it should. Adolescents are not small adults — they are people in the middle of a distinct developmental process, with a particular relationship to authority, privacy, autonomy, and the question of whether any adult is actually trustworthy. Effective teen therapy respects that. At The Smith Counseling Group, we work with teenagers using approaches calibrated to their developmental stage. Internal Family Systems therapy helps teenagers understand their internal experience—the different parts of themselves that want different things, the parts that carry shame or fear, and the parts that try to protect them in ways that sometimes cause more problems than they solve.

Cognitive behavioral approaches help with anxiety, intrusive thoughts, and the thought patterns that keep teenagers stuck in loops of worry or self-criticism. We do not assume that a teenager reluctant to be in therapy is resistant to help—often they are simply waiting to see whether the therapist will treat them like an intelligent person with a real inner life. We work from the assumption that they are.


How Parents Are Involved

Parent involvement in teen therapy is not a yes-or-no question. It depends on the teenager's age, the nature of what they are working on, and what the family system needs. At The Smith Counseling Group, we include parents in ways that support the therapeutic work without compromising the teenager's sense that their therapist is on their side.

This might mean periodic check-ins with parents, structured to give them useful information without revealing confidential session content. It might mean family sessions at particular points in the work when the relationship between parent and teenager needs to shift. It might mean very limited parental involvement for older teenagers who are working on concerns that are primarily about their own internal experience. The specific structure is discussed at the outset and revisited as the work develops. If you have questions about what parent involvement looks like in practice, a free consultation is the place to ask them.


If Your Teenager Is Struggling, Early Support Can Help Rather Than Waiting

Adolescence is not a temporary inconvenience that teenagers simply need to survive. The patterns and experiences of these years matter, and the support teenagers receive during this period shapes how they relate to their own inner life for a long time afterward. If you are watching your teenager struggle and not knowing what to do, that uncertainty is worth acting on rather than waiting it out. At The Smith Counseling Group, we offer a free consultation for families who are trying to figure out whether and how therapy might help. We work with teenagers in Chevy Chase and throughout Maryland via telehealth. Book a free consultation here — for your teenager or for yourself as a parent trying to figure out how to help.


Frequently Asked Questions

  • If you are noticing persistent changes in your teenager's mood, behavior, relationships, or functioning — things that have lasted more than a few weeks and seem like more than a temporary rough patch — that is a reasonable basis for a conversation with a professional. You don't need to be certain something is wrong. A free consultation is designed for exactly the situation. Reach out here.


  • This is one of the most common situations parents face. A teenager who is reluctant to start therapy is not automatically a teenager who will not benefit from it — often the reluctance is about not knowing what to expect, not wanting to be told what to do, or not trusting that a therapist will actually understand them. A free consultation that includes the teenager can help them see what the practice is actually like before committing to anything. In some cases, starting with a parent consultation first — to help parents understand how to talk about therapy in a way that reduces resistance — is the most useful first step. Contact us to discuss the best approach for your situation.

  • Many teenagers prefer telehealth because it offers privacy — they can connect from their own room rather than sitting in a waiting room and then having to explain where they have been. The Smith Counseling Group conducts telehealth sessions over a secure, HIPAA-compliant platform. Telehealth is available throughout Maryland. Ask about telehealth when you contact us.


  • Confidentiality is one of the most important things to clarify before starting teen therapy. In general, what your teenager shares in session stays in session — that is what makes therapy work. There are specific exceptions: if a teenager discloses that they are at risk of harming themselves or someone else, or if there is a disclosure of abuse, the therapist has a legal and ethical obligation to act on that information. Outside of those exceptions, the content of sessions is private. We discuss this clearly with both parents and teenagers at the beginning of the work so everyone understands the structure.

Connect with a clinician to gain a clearer understanding of your symptoms and concerns. We will help you determine the most appropriate path forward based on your needs.

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