The door that is always closed
They are not in crisis, they are not in trouble, and they are also not in the kitchen anymore. Conversations have shortened to logistics, and every attempt to open one is received as an interrogation.
Specialties
Mental Health Therapy for Teens: Depression, Anxiety & Stress
Adolescence is not a malfunction to be corrected. It is rapid development happening under academic pressure, constant social exposure, family expectation, and a phone that never goes quiet. What therapy offers a teenager is something they get almost nowhere else: a private, steady place to think, with an adult who is not grading them.
What It Is Actually Like
When the pattern is costing more than anyone can see
A teen may be dealing with depression, anxiety, emotional intensity, perfectionism, school avoidance, conflict at home, a friendship that fell apart, identity questions, trauma, or a sudden change in sleep, motivation, or grades. Sometimes they ask for help. More often a parent notices first, and the teen arrives having agreed to exactly one session as a negotiating position.
That is a workable place to start. I am not interested in winning the argument about whether they need to be here. I am interested in whether the hour turns out to be useful to them, because a teenager who finds the room genuinely their own will engage, and one who experiences it as an extension of parental management will not.
High-achieving teens are a particular group in my practice. The grades look fine, so the distress goes unexamined for a long time. Underneath there is often severe self-criticism, exhaustion, a fear of disappointing people that has become the organizing principle of their life, and a suspicion that the only thing anyone actually values about them is their output.
Parents usually arrive somewhere between worried and depleted, having tried several things that did not work and being told, in various ways, that this is their fault. It generally is not. Adolescence puts pressure on the whole family system, and the parents who ask for help are not the ones I worry about.
You Might Recognize This
Not a symptom list. A Tuesday.
The assignment that never gets started
Not laziness. The stakes have become so high in their head that beginning means risking finding out it will not be good enough, so the deadline arrives with nothing on the page and a fight afterward.
The phone at one in the morning
The group chat has moved on without them, or something has been posted, or nothing has. Either way the social evaluation does not stop at the end of the school day anymore, and neither does the monitoring of it.
The mood that turns in a hallway
They left the house fine. Something happened between second and third period that they will not describe, and the whole evening at home is now weather nobody can predict.
What People Bring Me
What usually gets named on the first call
Nobody arrives with a tidy summary. These are the versions I hear most often, and what the work is pointed at once we start.
Common challenges
- A grade slide that nobody can fully explain
- A door that closes earlier every evening
- Friendships that reorganize overnight
- Panic before school that is real, not a performance
- Irritability that is easier to show than sadness
- Parents who are guessing and hate guessing
What we aim the work at
- A relationship with an adult who is not grading or managing them
- Language for what is happening before it becomes behavior
- Skills for the moments that currently end in a slammed door
- Getting back into school, sport, or friendship at a workable pace
- Parents who know what to do at 10pm on a bad night
- Enough privacy that therapy is worth showing up to
Direction, not a promise. Nobody can guarantee where therapy lands, and I will not pretend otherwise.
The Work
What the first month looks like, and the sixth
01
The first job is engagement, and I will spend real sessions on it. Teens generally decide within two or three meetings whether an adult is worth talking to, and they are usually right. I am direct with them, I do not talk down to them, and I do not pretend to be their age, which they find insulting and can spot instantly.
02
Confidentiality is explained clearly to everyone at the start, including the limits: safety concerns are shared. Within those limits, what a teen tells me is theirs. Parents receive collaboration on themes, progress, and strategy rather than transcripts. Families who understand this arrangement from session one tend to get much more out of the work than families where it has to be negotiated later under pressure.
03
The work itself uses CBT for the thinking patterns driving avoidance and self-criticism, DBT skills for emotional intensity and impulsive responses, and relational exploration of identity, family, friendship, and what they have absorbed about their own worth. Between sessions I will ask for something small and specific — one behavioral experiment, one tracked week, one conversation attempted differently.
04
Parent involvement is calibrated by age, risk, and clinical judgment. Sometimes the most effective intervention is not with the teenager at all but with how conflict is handled in the house, and I will say so, carefully.
Modalities
Skills and understanding belong together
I integrate DBT, CBT, and psychodynamic or relational work according to the person and the problem—not because every hour needs every acronym.
CBT for school, avoidance, and self-criticism
CBT gives teens usable structure for testing catastrophic predictions, restarting stalled work in smaller units, and noticing the internal commentary that turns one poor grade into a verdict on their entire future.
DBT skills for intensity
DBT-informed distress tolerance and emotion regulation help with big feelings that arrive fast, urges to act on them immediately, and the interpersonal repair that comes afterward. These skills translate unusually well to adolescence.
Relational work for identity and family
Psychodynamic and relational exploration makes space for who they are becoming, what they have learned about need and worth at home, and the difference between the version of themselves they perform and the one underneath it.
Specifically, for this
- DBT skills adapted for teenagers, taught without condescension
- CBT for school avoidance, performance fear, and social worry
- Developmentally informed exploration of identity and belonging
- Parent sessions on approach, limits, and what to stop saying
- Clear confidentiality terms explained to everyone at the start
- Coordination with school or a prescriber when it is warranted
Closely Related
Where this work often widens
What parents actually get
Parents frequently want to know what they are paying for if they do not hear the content. What you get is a clinician who will tell you what is going on thematically, what approach we are taking, what to do differently at home, and — clearly and immediately — if there is a safety concern.
What you also get, and this is less visible on a monthly statement, is a teenager who has one adult relationship in their life that is not evaluative. For a high-achieving adolescent who experiences most adult attention as assessment, that is not a small thing.
Plainly
What I am honest with you about
Where progress is slow, what therapy will not fix, and what the work asks of you.
- Teen therapy often moves in a different order than parents expect. Engagement comes first, and it can take four to six sessions before much appears to be happening. That period is not wasted time; without it, nothing that follows works.
- Behavior at home is frequently the last thing to change, not the first. Internal shifts — less self-attack, better regulation, more accurate thinking — usually precede the visible improvements by a while, which can be hard to sit with when you are the one living with the door that stays closed.
- Therapy cannot make a teenager want to be there, and it cannot substitute for changes that need to happen in the household. Where the pattern is genuinely family-level, individual therapy alone will underperform, and I will tell you that rather than continuing quietly.
- I will not report the contents of sessions back to parents, and that limit is not negotiable, because it is the thing that makes the treatment work. Safety concerns are always the exception.
In My Practice
How this shows up for the people I see
Questions
Common questions about therapy for teens therapy
What is kept confidential from parents?
Session content is generally confidential. Safety concerns are shared. I explain the specific arrangement to teens and parents together at the start so nobody is surprised later, and I keep to it.
My teen does not want to come. Is it worth trying?
Often yes. Reluctance is normal and is not a prediction. A consultation can help work out whether this is a good fit and how to introduce it without turning the first session into a battle.
Do you meet with parents separately?
Yes, where clinically appropriate. Parent sessions focus on themes, strategy, and what to do differently at home, rather than on relaying what your teen said.
Do you see teens by telehealth?
Yes, for teens physically located in California when telehealth is clinically appropriate and a private space is available. In-person sessions are available in Santa Monica.
A Place To Begin
A teenager does not need to be in crisis to benefit from somewhere thoughtful to think. Sometimes the most useful thing available to them is one hour a week with an adult who is not measuring anything.
- · Individual therapy, 50 minutes, $300
- · Telehealth anywhere in California, or in person in Santa Monica
- · Free consultation call with a parent or guardian first
- · Private pay with superbills for out-of-network reimbursement