Reaching for the unreachable

As child and adolescent psychotherapists, we spend many years training in how to work with young people who are struggling with their mental health, reflecting on how to support them with their relational difficulties and developing ways of being with them to create a therapeutic space that can foster change and growth – but what do we do when they don’t want to see us, when they are unwilling or unable to engage in psychotherapy or, for that matter, therapy of any kind? What can we do that can impact on their worsening state of mind, their increased risk-taking, or their deteriorating relationships? How can we reach the unreachable? In this chapter, the authors use their considerable experience of working with parents of adolescents in crisis to explore the themes encountered in such work and the efficacy of parent work in helping improve the adolescent–parent relationship and overall crisis presentation. They focus on a model of time-limited, evidence-based parent work – Open Door’s Approach to Parenting Teenagers (APT) – and illustrate the theoretical underpinnings of this intervention with detailed clinical vignettes, amalgamated from their work as both practitioners and supervisors.