• Dr. Julie Granger DPT

Eliminate the Awkwardness: 3 Top Tips For Working With Teens in Your Practice

Every parent has probably been told “just wait until you get to the teen years” from a more experienced parent who has come before them.

As a healthcare provider, you may have a similar sentiment when it comes to working with teens.

  • Maybe you have a current or future caseload of teen clients, and you feel anxious and eager because you don’t know where to start with them.

  • Perhaps working with teens just feels—let’s be honest—AWKWARD. You understand how to work with either younger kids or adults but get weirded out at the thought of caring for a teen. You know you need guidance on how to connect with teens, speak their language, and help them in ways that won’t result in eye-rolling, wincing, or awkward blank stares.

  • Maybe you just don’t feel like you know enough to be effective with teens. There are other experts out there who are good with teens, and yes, you’re pretty okay-ish or maybe even kinda good sometimes, but you want more knowledge and mentoring so you can feel confident that you’re giving them the best care possible.

If that sounds like you--you are not alone!

The thing is, being a health provider of a teen doesn’t have to look and feel awkward, difficult, or completely dramatic.

And just because the teens you help in your practice seem to be addicted to drama doesn’t mean that you have to give in to the hype yourself.

For several years now, I have lovingly introduced myself (or been introduced by others) as the “teen whisperer.”

And yes, for better or worse, I have a way of relating to teenagers that allows them to trust me, open up to me and tell me things they wouldn’t tell anyone else, and guide them to gain courage, confidence, and direction in their lives at a time when their parents can’t seem to get through to them.

Sometimes I think it’s because I still consider myself a kid!

Other times I think it’s because I just get what they’re stacked up against these days and have a great deal of compassion for them.

But my real secret to working with teens is not just being able to speak their language.

No, it is much bigger than that.

Usually, teens and their parents can start to become at odds with each other. Maybe they don’t see eye to eye on some things (or all things)...

And because of that, working with them as a health professional can start to feel strained, awkward, or like there is an elephant in the room.

So how do you navigate this time without inciting World War 3?

1. Call out the elephant in the room … but be loving about it

No really, just go ahead and do it. It’s ok to just put all the truths out on the table when you start a session with a teen and/or their parents.

You can let them know that you get it can be awkward to talk about health conditions.

You can let them know that they may think you’re crazy or you don’t know anything about them.

You can acknowledge that they may be sick and tired of being sick and tired (or injured, or sad/depressed, or whatever it is).

And most importantly -- if they seem like they want nothing to do with you or they don’t want to be there -- let them know it’s ok if they feel that way and that if you were in their shoes you wouldn’t want to be there either.

But do this in a really loving and empathetic way. Don’t use a tone that accuses them of being WRONG when you illuminate these truths.

If they roll their eyes at you, it’s ok to gently call them out and ask them what’s going on behind the eye roll. You can say “I’m sensing that what I just said isn’t what you wanted to hear…how are you feeling?”

AND then leave open for them to fill in the gaps.

2. Be a role model.

Remember that teens take their cues from you and from other adults about what is ok

and not ok behavior.

If you talk dramatically about her medical conditions or use fear tactics, she will talk dramatically about it to others and become more anxious.

Instead, if you are confident and calm, she will take her cues from you.

If you play “mediator” between her and her parents when they argue over seemingly meaningless things, she will not learn to speak up for herself.

Instead, if you spend time letting the teen talk, then letting the parent talk, then facilitating a discussion where they calmly talk with each other -- then they will learn to work together as a team. Bottom line -- don’t give the appearance that you’re taking sides, even if you WANT to side with the parent.

If you play into their dramatic stories, they will think it is ok. It doesn’t go the other way around. Someone has to be the adult in the relationship.

Instead, you can listen empathetically and ask questions to get to the deeper issue, but you don’t have to agree with them (even if you do actually agree).

3. Ask instead of tell

People ask me all the time how to get teens to “buy-in” to health programs, treatment plans, or recommendations.

Here’s the deal: teens are literally programmed to NOT buy-in.

As their brains are reshaping and becoming more “adult-like,” it is NORMAL for them to challenge what you say, to “rebel,” to act aloof as if they don’t care, to “forget” to do their homework or other things, or to appear as if they aren’t caring for themselves.

This is part of them developing executive functioning, decision-making, learning consequences, and learning to be independent adults.

They’re most programmed to do this in response to what their parents say or tell them to do.

And if it’s their parents’ idea to work with you, then you are -- in their eyes -- simply an extension of their parents.

So, when you come at them with a list of SHOULDs -- what they SHOULD be doing, what they SHOULD be eating, how they SHOULD be sleeping, how they SHOULD be exercising, how they SHOULD be taking care of themselves -- they may challenge you.

It doesn’t matter how much of an expert you are, or whether you are the adult and think you know better than them.

The bottom line, the teen thinks she knows better about her body and health than you. And a lot of times she actually does! We just need to slow down and listen and let her be heard.

Recognize that this is completely normal and it is nothing personal. In fact, we want to allow them to make decisions, mess up, and experience consequences.

If we don’t, they will never learn how to survive in a world on their own without having some adult tell them what to do.

Instead, ASK teens what they want to do. Ask what’s going on in their lives. Ask what their schedule is like. Brainstorm possible options together, then ask which of a certain number of options they’d like to take on.

If they don’t want to do any of it -- that’s ok. Your job is not to force anything on them (within reason…. If they are a life-threatening harm to themselves, then you do need to act and act loudly).

And -- if they choose not to buy in or participate, then they will experience the consequence of feeling poorly. You can still support them in their choice, as long as you’ve given them the opportunity to make a choice, that is.

Sometimes the pressure we feel to get teens to “buy-in” when we work with them comes not from whether we think we know better or not, but from the unconscious pressure we feel from wanting their parents to be happy with the outcome.

In this case, it’s important to also learn to speak “parent” and let them know that you can’t guarantee results, that you will allow the teen to be an active participant in their own care, and you do not take the “force it on the teen” approach. You can put this in your intake forms and get parents to agree that they understand this.

A lot of times, this conversation alone helps very well-meaning parents learn that they, too, need to back off a bit and let teens step into “owning” their own health a bit more.

I also recommend having parent debrief sessions if it works with your particular schedule or service. This way you can coach the parent on how to set their teens up for success, allow them

to experience consequences, and support them as they learn their own independent decision making.

Got it?

Learning to “speak teen” takes practice, patience, and a whole lot of creativity and love. These 3 tips are a great jumping-off point to get you going or help you sharpen your skills with teens.

Want to dive in and learn more? I invite you to join us in our FREE global online community, the Health Pros for Healthy Teens Facebook Group.

In this group -- which is full of teen experts from all over the globe -- we tackle the hard conversations and tough teen cases we face. There are weekly live trainings, weekly challenges, and tons of collaboration.

Got other questions about how you can best serve teens in your health and wellness practice?

I love to support physical therapists and health professionals to eliminate the awkwardness that often comes with treating teens -- and confidently connect with them so that they can set teens up for success in their health in adolescence and into adulthood.

I’d love to hear from you! Get in touch and let’s brainstorm!

In love and health,

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