Young adults, in this practice defined by people 18 years or older AND financially dependent on their parents/guardians, are a special population. That one is considered an adult at 18 years old is mostly a legal designation. We now know that a young person's brain is developing in important ways until around age 26. Financially independent young adults of college age or younger are extraordinarily rare in the Bay Area.
A common concern I have heard is that parents of young adults often feel left in the dark for their loved one's treatment. To me, that seems an easily addressed obstacle.
It is my view that if parents are funding their young adult dependent's treatment, then they are investors and stakeholders. As such, they have a right to let their goals of treatment be known, to have a voice in the process, and to get occasional updates on concerns and progress. Therefore, in my work with young adults, the initial evaluation is the same as for adolescents unless the parent waives that right. I find it helpful to get a parent's perspective on their loved one's problems, and also to elicit from them a detailed family and developmental history. This helps me to be an effective clinician.
I value and respect confidentiality. And I do want a young adult taking ownership of his/her treatment. The expectation is that after the initial evaluation he/she and I will work almost exclusively together, and almost all of the work we do together will remain private. However, I want the young adult's consent to keep avenues of communication with his/her parents open for them to understand the broader strokes of treatment. If a parent is willing to be excluded from that process, then this is acceptable to me. However, when a parent wishes to be involved and a young person denies them, I find this often to be a significant barrier to successful treatment.
As much as I want to be flexible and accommodate a young person, treatment success is the ultimate goal and it is extremely important that the framework of our treatment relationship allow this success the greatest possible likelihood.
Let me know if you have any questions about this or other philosophies. Additional details about the treatment of young adults can be ascertained from the other pertinent sections of this website.
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