Working With Adolescents: Seeing the Person Behind the Diagnosis

Adolescence can be complicated.

It is a time of tremendous growth, identity development, independence, and change. At the same time, teenagers are navigating relationships, school expectations, family dynamics, social pressures, technology, trauma, and questions about who they are and who they want to become.

For some young people, these challenges are compounded by anxiety, depression, ADHD, autism, mood disorders, trauma-related symptoms, substance use, behavioral concerns, or other complex mental health challenges. Assisting a young person navigate these issues is key to them having satisfied and happy adult lives.

This is why my work with adolescents has become such an important part of my professional life.

More Than a Diagnosis

One of the most important lessons I have learned working with young people is that a diagnosis never tells the whole story.

A teenager who is refusing school may not simply be "defiant."

A young person who is angry may not simply have "behavior problems."

A teenager who isolates may not simply be "unmotivated."

A child who struggles to communicate may be communicating in a different way.

Before asking, "What's wrong with this young person?" I believe we need to ask:

"What happened?"

"What are they trying to tell us?"

"What do they need?"

"What strengths are we missing?"

Understanding the function behind a behavior can completely change the way we approach treatment. Therefore, I have developed my own unique approach that focuses on strengths rather than deficits.

My Work With Youth and Families

My career in mental health began with a focus on children and adolescents, and I have continued to work alongside young people and their families throughout my nursing and psychiatric career.

My work has included residential treatment, school-based mental health, and community-based services. In my current work with youth, I have the opportunity to meet young people in many different environments—not just in an office.

That might mean meeting with a young person at school, participating in a treatment meeting, talking with a family at home, collaborating with teachers and clinicians, or working alongside an interdisciplinary team to respond to a crisis.

This community-based perspective has reinforced something I believe strongly:

Mental health treatment cannot always happen behind four walls.

Sometimes we need to understand the environment in which a young person lives, learns, develops relationships, and experiences stress.

Working With the Whole Family

When working with adolescents, I am not only working with the teenager.

I am also working with parents, caregivers, siblings, teachers, therapists, case managers, schools, and other members of the young person's support system.

Family involvement can be incredibly important, but it can also be challenging.

Parents may feel overwhelmed.

Teenagers may feel misunderstood.

Caregivers may feel that they have tried everything.

The young person may feel that everyone is talking about them rather than with them.

My role is often to help create a space where everyone's perspective can be heard.

That does not mean everyone will agree.

It means we can begin with curiosity rather than blame.

Giving Teenagers a Voice

Adolescents deserve to have a voice in their own treatment.

Whenever possible, I want young people to understand why we are recommending something, what their options are, and what role they have in the treatment process.

Psychiatric treatment should not feel like something that is simply being done to a young person.

It should be something we work on with them.

This can be especially important when discussing medication.

Medication is one tool—not the entire treatment plan.

I believe in helping young people and families understand potential benefits, risks, alternatives, expected effects, and what we will monitor over time.

Medication may be part of treatment, but so are relationships, coping skills, therapy, sleep, nutrition, movement, school support, family connection, meaningful activities, and a sense of belonging.

Creating a Safe Space

Many teenagers have had experiences where adults did not listen to them.

They may have been labeled as difficult, oppositional, dramatic, attention-seeking, lazy, manipulative, or noncompliant.

Sometimes those labels follow young people from one setting to another.

I try to approach each adolescent with a different question:

What if the behavior makes sense when we understand the whole story?

Creating a therapeutic relationship requires trust.

It requires consistency.

It requires being willing to listen without immediately correcting.

And sometimes, it requires simply sitting with a young person who is having a difficult day.

Understanding Neurodiversity

My work with adolescents has also deepened my appreciation for neurodiversity.

Young people with autism, ADHD, intellectual and developmental disabilities, and other neurodevelopmental differences may experience the world differently.

Traditional mental health environments do not always account for differences in communication, sensory processing, executive functioning, social interaction, or emotional regulation.

A behavior that looks like noncompliance may actually reflect sensory overload.

A missed appointment may reflect executive-function challenges.

A young person who cannot answer a question immediately may need additional processing time.

A crisis may represent communication when a young person does not have another effective way to express what they need.

The goal is not to make every young person fit the system. Sometimes we need to change the system to better fit the young person.

Mental Health and the Adolescent Brain

Adolescence is also a period of significant neurological development.

Young people are developing emotional regulation, decision-making, impulse control, social awareness, and increasingly independent identities.

This does not mean we should excuse harmful behavior.

It means we should understand development when determining how we respond.

A teenager needs accountability and compassion.

Structure and flexibility.

Boundaries and connection.

Treatment and hope.

Looking for Strengths

One of my favorite parts of working with young people is discovering their strengths.

Sometimes those strengths are easy to see.

Other times, we have to look harder.

A teenager may have an incredible sense of humor.

Another may be deeply compassionate toward animals.

Another may be creative, artistic, athletic, mechanically gifted, technologically skilled, or passionate about music.

Some young people have survived circumstances that required an extraordinary amount of resilience.

These strengths matter.

They are not simply pleasant additions to a treatment plan.

Strengths can become part of the treatment.

Interests can create connection.

Relationships can create safety.

Purpose can create motivation.

Success in one area can build confidence in another.

Crisis Work Has Taught Me to Slow Down

Working with youth who experience psychiatric crises has taught me the importance of slowing down when everything around us feels urgent.

During a crisis, our instinct can be to immediately solve the problem.

But the first intervention should actually be connection, giving the young person a voice, and reviewing what led up to the crisis situation.

Who is this young person?

What happened before the crisis?

What are they communicating?

What has helped before?

What makes things worse?

Who does this young person trust?

What does safety look like for them?

What does the family need?

What does the treatment team need?

Crisis intervention is not simply about preventing hospitalization.

It is about understanding the young person well enough to identify opportunities for stabilization, connection, and recovery.

My Approach to Adolescent Mental Health

My approach is integrative and patient-centered.

I believe in evidence-based psychiatric care while also recognizing that mental health is influenced by many aspects of a young person's life.

Treatment may involve psychiatric medication and psychotherapy, but it may also involve addressing sleep, nutrition, physical health, school stress, family relationships, trauma, social connection, substance use, sensory needs, and environmental factors.

I also believe that adolescents should be treated with dignity.

They are not just diagnoses.

They are not their worst day.

They are not their symptoms.

They are developing human beings who deserve the opportunity to be understood, supported, challenged, and encouraged.

Why I Continue This Work

Working with adolescents can be challenging.

It can also be incredibly rewarding.

There is something powerful about watching a young person who once felt hopeless begin to recognize their own strengths.

There is something meaningful about seeing a family move from constant conflict toward understanding.

There is something hopeful about watching a teenager begin to advocate for themselves.

And there is something incredibly important about reminding young people that their current circumstances do not have to define their future.

My work with adolescents has taught me that sometimes the most therapeutic thing we can offer is not another diagnosis or another intervention.

Sometimes it is connection.

Sometimes it is curiosity.

Sometimes it is patience.

Sometimes it is simply saying:

"I see you. I hear you. And we are going to figure this out together."

That is the kind of mental health care I strive to provide.

Supporting the Next Generation

At Lakeside Integrative NPs in Psychiatry, our goal is to create a safe, compassionate, and individualized approach to mental health care for young people and their families.

Every adolescent has a story.

Every family has a story.

And behind every diagnosis is a person who deserves to be seen as a whole person—not a collection of symptoms.

Because when we take the time to understand the person behind the diagnosis, we create the possibility for something much more powerful than symptom management: we create the possibility for healing, growth, and hope.