1. Therapeutic Engagement With Adolescents
Oetzel and Sherer, 2003
Psychotherapy: Theory, Research, Practice, Training Volume 40 (3)
And it’s on ACME!

2. Therapeutic Engagement…
Why does it matter so much? It is strongly linked to:
Good outcomes
Persistence in therapy
First impressions create a self-fulfilling prophecy
Overall, alliance is the most important component of therapy.

3. Why such a problem? Stigma associated with getting help
Feeling forced into counselling
Need for independence
Many methods were developed for adults and do not translate well to young people
Development is individualistic and uneven
Social context and experience of young people is different from the counselling experience

4. Developmental Considerations and Options
The alliance is likely much more a process with teens because of rapid and uneven development and will require more initiative (will be less reciprocal) than with adults
Adolescents need active validation
Specific articulation of concern and commitment for the clients well being
Authenticity (rather than being ‘cool’) and candour are helpful
Include developmental assessment as part of the overall picture of understanding the client e.g. if clients are skilled at perspective taking, introducing issues to highlight cognitive dissonance can be helpful

5. Considerations to do with Sociological Context
Directly address the question of stigma early in the process
Educate about the process and the parts each play
Educate about the range of ‘normal’ functioning
Offer choice whenever possible

6. General Observations
Engagement will not normally (as with adults) come from getting out of the way and responding to client approaches as youth may not have an initial desire or investment in counselling
Presenting a positive initial picture about the adolescent’s capacity, the process of counselling and potential outcomes helps
‘Adolescents respond best to therapists who are empathic yet forthright and assertive, who do not flaunt expertise, and who are not abrasive and confrontational’ (Oetzel and Sherer, 2003 p. 223)
Create a way for families to be involved and supported.

7. Link to Case of Paul
Considering the case of Paul, what are some issues that might arise and ideas that you might have related to the establishment of therapeutic alliance?