Teens
A few words for teens...
If you are reading this, it probably means that either you or someone important in your life, like a parent, teacher or friend, thinks you may be having difficulties. That's actually a good thing that someone is concerned, because many people needlessly struggle for years or a lifetime in difficult situations without ever getting help. Fortunately there are many routes to happiness and improved situations, and I have guided teens and their families to wellness in the past. At the same time, maybe you don't agree with those who think you are having difficulties. Maybe you feel fine, or you don't see any problems around you. If that's the case, I'd like to hear your perspective. Maybe you have a different view or insight into what's going on. See below for more information about how I work with teens and their families to help clarify and improve situations.
A few words for parents...
Perhaps you are seeing your teen struggle, or a teacher or coach was concerned about your teen's well being. Maybe you are feeling stressed out by parenting, and want a fresh approach to improve the situation. Whatever reason has brought you here, there are many routes to turning the situation around and to having your teen flourish. See below for details on how I go about helping teens and parents move from difficulty to success.
Initial Phone Contact
If you think I might be helpful to you, after reviewing my website, the first step is to give me a call. Following a brief conversation on the phone we can decide together on the best next step. Typically the first call is made by parents, but in the case of older teens, it may be made by the teen.
Assessment
The first step on the path to wellness is a good assessment. It's always surprising to me that we all go through life getting annual physicals from a pediatrician or primary care physician, but we rarely take the time to assess our emotional and mental health. The assessment is not a test, but rather it's a time when I will listen to the teen to try and understand the situation. I also listen to parents or teachers to hear their perspective. I first check in with teens about communication with parents, and I'm careful to maintain the teen's privacy unless there is a serious danger. I will try to holistically understand the teen's unique strengths and vulnerabilities within the context of school, community, key relationships, recreation, and adolescent development. Often teens have never had a broad and in-depth assessment, and this alone can be therapeutic, because sometimes solutions emerge directly from it. Once we’ve finished the assessment, I’ll discuss treatment planning and options with the teen and parents. The plan might include psychotherapy, medications, exercise, nutrition, or other tools -- see below for further details on some of these topics. We’ll revisit the plan regularly to make sure it is up-to-date and working.
Medication
Prescribed medication is only one tool from a big toolbox that we can use. I find that decisions about medication are best handled as an open discussion between teen, parents and doctor. This involves reviewing the risks, benefits, and alternatives to medication. There are often other options that can be tried first or along-side medication. Sometimes medication alone is sufficient, and at other times it is not necessary at all.
Psychotherapy
Psychotherapy, in the broadest sense, is often a vital part of treatment for teens. Relative to the treatment of younger children, the treatment of teens, especially older ones, tends to be more focused on the individual, although adults remain involved. For teens whom I see in individual therapy I am careful to maintain the teen's confidentiality when speaking to parents, although parents are always closely involved in any issue of imminent danger. We may also have occasional “check-in” meetings where both the teen and parents are in the room at the same time, although I will carefully maintain both parent and teen confidentiality at those times, allowing each party to decide what to share with the other. If parents are struggling with discipline or other aspects of raising a teen I am very careful about how meetings are arranged, because teens may be quick to perceive adults as teaming up against them, and trust can be quickly lost. For this reason, when parents need some extra help, occasionally the parents and the adolescent are best served by the support of separate therapists. This may seem complicated, but in certain cases it's very important, and I'm here to guide the process along so that trust remains high and the therapy stays effective. For those teens who already have a therapist whom they like, or when it would be most useful for me not to be the therapist, I may focus on other tasks such as medication, referrals, and interval assessments. In cases where the teen is receiving psychotherapy elsewhere, I may work primarily with the parents. There are also times when therapy with the whole family or parts of the family is useful, but how that fits with the overall treatment process can be complicated and is easiest to explain through a discussion after the initial assessment. In summary, there are many options for how to structure treatment and I'm happy to discuss these options with you. Generally, however, these days my clinical practice is focused on the provision of integrated psychotherapy and medication (if needed) services.
Additional Aspects of Treatment
Since I approach your teen's care holistically, there may be other aspects of treatment that are very important. At times addressing issues related to nutrition, sleep, medical issues, or exercise can help, and when appropriate I might make referrals for assistance in those areas. For teens with disabilities or complex medical problems, collaborating with caregivers and other professionals is often key. Together we will figure out what are the best solutions. Our meetings may be longer or shorter, and more or less frequent, depending on what is needed.
Other Adolescent-Related Services
Occasionally families or other professionals request specialized services, such as expert witness testimony and custody evaluations. I am happy to discuss these services with you.
If you are reading this, it probably means that either you or someone important in your life, like a parent, teacher or friend, thinks you may be having difficulties. That's actually a good thing that someone is concerned, because many people needlessly struggle for years or a lifetime in difficult situations without ever getting help. Fortunately there are many routes to happiness and improved situations, and I have guided teens and their families to wellness in the past. At the same time, maybe you don't agree with those who think you are having difficulties. Maybe you feel fine, or you don't see any problems around you. If that's the case, I'd like to hear your perspective. Maybe you have a different view or insight into what's going on. See below for more information about how I work with teens and their families to help clarify and improve situations.
A few words for parents...
Perhaps you are seeing your teen struggle, or a teacher or coach was concerned about your teen's well being. Maybe you are feeling stressed out by parenting, and want a fresh approach to improve the situation. Whatever reason has brought you here, there are many routes to turning the situation around and to having your teen flourish. See below for details on how I go about helping teens and parents move from difficulty to success.
Initial Phone Contact
If you think I might be helpful to you, after reviewing my website, the first step is to give me a call. Following a brief conversation on the phone we can decide together on the best next step. Typically the first call is made by parents, but in the case of older teens, it may be made by the teen.
Assessment
The first step on the path to wellness is a good assessment. It's always surprising to me that we all go through life getting annual physicals from a pediatrician or primary care physician, but we rarely take the time to assess our emotional and mental health. The assessment is not a test, but rather it's a time when I will listen to the teen to try and understand the situation. I also listen to parents or teachers to hear their perspective. I first check in with teens about communication with parents, and I'm careful to maintain the teen's privacy unless there is a serious danger. I will try to holistically understand the teen's unique strengths and vulnerabilities within the context of school, community, key relationships, recreation, and adolescent development. Often teens have never had a broad and in-depth assessment, and this alone can be therapeutic, because sometimes solutions emerge directly from it. Once we’ve finished the assessment, I’ll discuss treatment planning and options with the teen and parents. The plan might include psychotherapy, medications, exercise, nutrition, or other tools -- see below for further details on some of these topics. We’ll revisit the plan regularly to make sure it is up-to-date and working.
Medication
Prescribed medication is only one tool from a big toolbox that we can use. I find that decisions about medication are best handled as an open discussion between teen, parents and doctor. This involves reviewing the risks, benefits, and alternatives to medication. There are often other options that can be tried first or along-side medication. Sometimes medication alone is sufficient, and at other times it is not necessary at all.
Psychotherapy
Psychotherapy, in the broadest sense, is often a vital part of treatment for teens. Relative to the treatment of younger children, the treatment of teens, especially older ones, tends to be more focused on the individual, although adults remain involved. For teens whom I see in individual therapy I am careful to maintain the teen's confidentiality when speaking to parents, although parents are always closely involved in any issue of imminent danger. We may also have occasional “check-in” meetings where both the teen and parents are in the room at the same time, although I will carefully maintain both parent and teen confidentiality at those times, allowing each party to decide what to share with the other. If parents are struggling with discipline or other aspects of raising a teen I am very careful about how meetings are arranged, because teens may be quick to perceive adults as teaming up against them, and trust can be quickly lost. For this reason, when parents need some extra help, occasionally the parents and the adolescent are best served by the support of separate therapists. This may seem complicated, but in certain cases it's very important, and I'm here to guide the process along so that trust remains high and the therapy stays effective. For those teens who already have a therapist whom they like, or when it would be most useful for me not to be the therapist, I may focus on other tasks such as medication, referrals, and interval assessments. In cases where the teen is receiving psychotherapy elsewhere, I may work primarily with the parents. There are also times when therapy with the whole family or parts of the family is useful, but how that fits with the overall treatment process can be complicated and is easiest to explain through a discussion after the initial assessment. In summary, there are many options for how to structure treatment and I'm happy to discuss these options with you. Generally, however, these days my clinical practice is focused on the provision of integrated psychotherapy and medication (if needed) services.
Additional Aspects of Treatment
Since I approach your teen's care holistically, there may be other aspects of treatment that are very important. At times addressing issues related to nutrition, sleep, medical issues, or exercise can help, and when appropriate I might make referrals for assistance in those areas. For teens with disabilities or complex medical problems, collaborating with caregivers and other professionals is often key. Together we will figure out what are the best solutions. Our meetings may be longer or shorter, and more or less frequent, depending on what is needed.
Other Adolescent-Related Services
Occasionally families or other professionals request specialized services, such as expert witness testimony and custody evaluations. I am happy to discuss these services with you.
Michael Swetye, M.D., P.C. ~ Adult, Adolescent, and Child Psychiatry in San Francisco ~ Phone (415) 942-8589 ~ Fax (415) 715-9555
Copyright © 2019 Michael Swetye, M.D., P.C. ~ All Rights Reserved
Copyright © 2019 Michael Swetye, M.D., P.C. ~ All Rights Reserved