How to help a teen with anxiety: Understanding social media pressure, resistance, and what actually works in therapy

Celina Serna:
“If we can get a teen in our door, and we can understand that as clinicians—coming from that lens with compassion—and just focus on that initial connection with our teens, most times the willingness, the cooperation, and the trust that we’re able to build, even in that 30-minute to one-hour assessment (however long it takes), makes a huge difference.”

Kent Toussaint:
“Hi, my name is Kent Toussaint. I’m a Licensed Marriage and Family Therapist, and I specialize in teen counseling—helping kids, teens, and families live happier lives.

I lead two organizations: Teen Therapy Center, a group private practice in Woodland Hills, and a nonprofit organization called Child and Teen Counseling, both located in the same office. I’ve been in this field for about 20 years—a long time.”

Celina Serna:
“My name is Celina Serna. I’m the Program Director here at Clear Behavioral Health and a Licensed Clinical Social Worker. I also work with teens and families, and all together I’ve been doing this work for about eight years as a clinician, going on five years in this role.”

Kent Toussaint:
“The expectations—especially the perceived expectations—sometimes the parents’ expectations don’t match what the kids think the expectations are. I don’t know if that’s where you’re going, but that disconnect can really show up.”

Celina Serna:
“Yes, exactly. And the values being placed on our teens by their parents—there’s so much to unpack there.

For example, having to get all A’s, needing a certain GPA to get into college—it’s incredibly competitive now. So many teens I’ve worked with feel that pressure from parents and teachers. And to your point, the cognitive distortions that come with that—those negative core beliefs—really stick with teens. That’s why it’s so important to talk about and bring awareness to this in our work.”

Kent Toussaint:
“Absolutely. And piggybacking off what you’re saying, all of that pressure gets magnified by social media.

Teens compare themselves to what they see online: ‘She’s going to this college,’ or ‘She’s doing this,’ or ‘She has a perfect life.’ Of course, that’s not reality—but that’s the impression they get.

Parents fall into the same trap, comparing their parenting to what other parents project online, which often isn’t an accurate picture of what’s really happening. It becomes this constant ‘keeping up with the Joneses.’

When no one’s talking about it, all of that pressure just builds in this vacuum, and the anxiety grows—for teens and parents alike.”

Celina Serna:
“And this goes beyond academic pressure. It includes body image, presenting a certain way, and seeking validation from peers online.

There’s also an addictive component—chasing that dopamine hit from likes and validation. We’re seeing this more and more with teens. And I don’t think there’s enough education from adults—parents, teachers, mentors—around setting limits with social media or helping teens understand what’s real versus what’s being portrayed.

Most of what we see online is just the highlight reel—the glamorous parts. It doesn’t show the day-to-day reality. Helping teens recognize that difference and break those comparisons is incredibly important.”

Kent Toussaint:
“So how do we help teens who are struggling with anxiety or panic attacks?

In the moment, it’s often just triage. But real anxiety treatment happens in between—it’s about self-care. It’s like brushing your teeth. You don’t just take care of them when you go to the dentist; you do it every day. It’s boring and tedious, but it prevents bigger problems.

I usually frame resiliency in four categories: healthy physical stimulation, healthy creative stimulation, healthy social stimulation, and healthy spiritual stimulation. Not every kid will have all four, and that’s okay.

If a teen finds joy and confidence in even one area—like piano, sports, art, or a meaningful activity—it builds self-esteem and self-worth. Anxiety doesn’t disappear, but the intensity and frequency decrease. It helps them think, ‘This is a terrible day, but I have this one thing.’ Do you see that too?”

Celina Serna:
“All the time. Parents often say, ‘Help me fix my kid.’ But what does that really mean? These are lifetime experiences.

It’s about building awareness, learning to do things differently, and also accepting that anxiety will still show up sometimes. The goal is that it becomes less intense, less frequent—and when it does come up, teens know what to do.”

Kent Toussaint:
“We deal with resistant teens all the time—honestly, that’s Tuesday for us. I always tell parents, if you can get your kid into our office, we can take care of the rest.

Often, kids want to talk—they’re just scared, or they don’t want their parents to know. We’ll do the intake with parents present, and the kid is silent. As soon as the parents leave, they open up. Then we bring the parents back and the kid says, ‘That was stupid.’

There’s often resistance at first, and sometimes it takes time to break through. But once teens realize we’re on their team—not acting like a vice principal—that changes things.

We prefer in-person therapy when possible because it’s usually more effective. We do offer online therapy, but if a teen is resistant, that can make things harder. And in more serious cases, a higher level of care—like residential treatment—may be needed. It always depends on the individual.”

Celina Serna:
“I completely agree. There’s also something important to recognize about resistant teens—the sense of powerlessness they feel.

Parents talk about feeling helpless, but teens feel that too. When they’re forced into treatment, it can feel like they’re losing control.

That’s why, again, if we can get a teen in our door and approach them with compassion—focusing on that initial connection—the trust we can build, even in a short assessment, makes a huge difference.

I tell parents all the time: just come tour. No commitments. Bring your teen in, let them see the environment, meet the staff. This isn’t a hospital setting, and once teens see that, it can really help lower their guard.”