Therapy with youth

Our approach to working with children and teens is warm, supportive and active.  Dr. De Silva’s expertise in prevention of symptoms and mental illness in youth was gained from years working with youth at risk for severe mental illnesses at two leading UCLA clinics. She saw firsthand with countless families how preventative steps can effectively change the course of a young person and their families’ lives, which has led to our practice’s priority in developing key life skills that have been shown to be protective for youth. The more well-equipped youth are to tolerate distress and cope with difficult feelings and experiences, the more emotionally resilient they will be throughout life. A key element of our work with children and teenagers (as appropriate) involves working collaboratively with parent(s).  For real lasting changes outside of the therapy room, we believe it’s critical to have the family involved.  Often one or both parents will join parts of sessions to work on skills together, cope with difficult feelings and symptoms, improve lines of communication and learn how to solve daily problems effectively. Depending on the child's age and needs, we conduct a combination of play and talk therapy to make progress towards goals set with parents. These goals might be centered around decreasing problematic behavior in home or school settings, improving unhealthy mood patterns or adjusting to changes in family composition. Childhood is an ideal time to make changes so that unhealthy ways of behaving and relating are improved before they become ingrained. 

The process of change

Our practice’s priorities for working with youth are to provide emotional support as well as reach desired change. Our clinicians have a playful and warm presence that allow youth to connect easily and genuinely enjoy their time together, allowing for a safe place where youth can share and explore feelings. We focus on every step of the process of change by first engaging in a collaborative process of identifying goals and creating clear treatment plans for reaching desired goals. For younger children and teens, parents often play an essential role in identifying the goals of therapy and recognizing what plans and recommendations will be most fitting and fruitful for their family. Older teens often play a larger role in this initial goal identification and treatment planning phase.

Once goals are clearly defined, the focus of therapy moves to helping the young person gain the skills and resilience needed to take steps towards goals. Often a variety of skills and tools are instrumental in enabling such movement. For instance, one may need to develop a more positive self-image, learn assertive communication skills, manage pressures more effectively, learn how to choose and keep friends well, and cope with difficult feelings and insecurities. For children, parents often play a role in assisting with skill development in between sessions. For instance, we may coach both the child and their parents on how they can create an open dialogue around feelings at home with different kinds of conversation starters that lead to openness. We often help families develop an age- appropriate language to speak about feelings such as red/ yellow/ green feeling zones to help ourselves and others know what we are feeling and what is needed to shift from more difficult red and yellow feeling zones (when we need to stop or slow down) to calm pleasant feelings in the green zone (when we are ready to go and engage). Developing coping skills that help youth know how to feel better and handle big emotions are an integral part of the therapeutic process. We will be there by your family’s side to develop tools and strategies to help youth make the changes needed for greater harmony in relationships with family and friends, improved self esteem and emotional resilience.

In the final stages of treatment when desired changes have been met, we work with youth and families to sustain the positive growth. Often, we create prevention action plans for families to catch symptoms early when they are easiest to manage and learn to respond quickly and effectively to return to comfortable emotional states. Youth and families will be well-equipped to cope with challenges as they arise and be able to enjoy a new baseline together that allows for greater harmony and thriving.

“The FeelingS coach”

Our therapists often refer to themselves as a feelings coach with children to help the process feel friendly, fun and collaborative. Parents have shared that talking to their kids about seeing a feelings coach (versus a therapist or doctor) helped their child be open and receptive to meeting. We ask parents what toys and activities their child is interested in and will have the young person bring in some favorite items to sessions. The use of play therapy is also accessed over telehealth sessions with both therapist and the child having various favorite toys available which serve as a means for them to talk about feelings and develop coping skills. For instance if Captain Barnacles is a child’s favorite, the child will master skills being learned through playing the role of Captain Barnacles who is teaching a fellow Octonaut what to do when sad or angry. When developing coping skills to manage feelings, we often create a “feelings toolbox” that holds representations of the various coping skills acquired so children have tangible access to skills and physical reminders of their many resources. We take a strength based approach that involves recognition and praise around what they already do well in addition to the skills they are successfully bringing in to their coping repertoire. We keep the process dynamic and interactive enabling the youth to fully engage in the process of learning how to effectively make changes that better their lives.

Therapy with teens

The process with tweens and teens can look different than work with younger children in various ways including the amount of parental involvement and the areas that are typically focused on. Depending on the emotional maturity and independence of the youth, we together determine how little or how much parental involvement is best. Most typically with older teens, the details of what is discussed in therapy is not shared with parents to ensure trust and rapport can effectively be built so therapy can become the teen’s safe place to discuss the full range of their feelings and experiences. In addition to improving self esteem and coping with symptoms such as depression and anxiety, how teens relate to school pressures, self identity, dating and substance use are all addressed as needed. Often teens will use the space to also explore who they want to be in life and how they can move towards future goals. Teens find our therapists easy to relate to and confide in and we tend to become an enormous source of support and guidance as they navigate the world of adolescence and move towards adulthood. For instance, many of Dr. De Silva’s teen clients have eagerly taken her on their journey from high school into college years via telehealth sessions, allowing her consistent support and guidance to be a source of well-being and resilience throughout these instrumental years.