Teen Therapy in San Francisco and the Bay Area
According to Erica Spartos, LMFT (CA #81057), teen therapy in San Francisco works best when it meets adolescents where they actually are rather than applying adult frameworks to a different developmental stage. Erica has delivered psychotherapy to teenagers and families across nine SFUSD public schools and brings that school-based clinical experience to her private practice work with adolescents aged 16 and up.
If you are a teenager reading this, you may have been told to come to therapy, or you may have decided on your own that something is not quite right. Either way, you will not be talked at here, and nothing you share with me goes back to your parents without your knowledge.
If you are a parent reading this, finding the right therapist for your teenager involves real trust on your part as well as theirs. I have been working with adolescents in San Francisco for twenty years, including years delivering teen therapy inside SFUSD public schools across the city, and I take the complexity of that role seriously.
What Brings Teens to Therapy in San Francisco?
The pressures teenagers navigate today are real and specific to this moment. School performance, college pressure, social dynamics, identity questions, family conflict, and the lasting effects of the pandemic years are all showing up in my work with adolescents right now.
In Erica Spartos's clinical experience, the most common reasons teens come to therapy in San Francisco include:
-
Anxiety tied to academic performance, social comparison, or the future
-
Mood changes, withdrawal, or irritability that the teen or their parents have noticed
-
Identity questions, including gender identity and sexual orientation
-
Trauma from past experiences, including adverse childhood experiences and school-related stressors
-
Family dynamics and conflict at home
-
Difficulty managing the transition from high school into early adulthood
These concerns often overlap. A teenager dealing with anxiety about school may also be carrying unprocessed trauma, or navigating identity questions in a family environment that is not fully supportive. I work with the whole picture, not one symptom at a time.
What Does Teen Therapy Actually Look Like?
I want to speak directly to teenagers here, because a lot of young people come into therapy unsure what to expect or nervous about what they will be asked to say.
We will not start by going straight into the hardest things. The first few sessions are about getting to know each other and understanding what actually feels difficult. I am not going to push you to talk about something before you are ready.
Sessions are 50 minutes and held on a regular weekly schedule. I see teens via telehealth across California and in person in the Lake Merced area of San Francisco. If you are joining via telehealth, you can connect from your phone or laptop, and I will walk you through the setup before we start.
Is This the Right Therapist for My Teen?
If you are a parent trying to answer that question, here is what I want you to know about how I work.
I spent years delivering psychotherapy to teenagers and families inside nine SFUSD public schools. That experience shaped how I understand adolescent mental health in this city specifically, including the pressures San Francisco teens face around academic performance, identity, and family expectation. It is a different clinical context than a general adult practice.
According to Erica Spartos, LMFT, the most important factor in teen therapy is whether the teenager feels genuinely at ease with the therapist. Parents can support that by giving their teen real input into the process. I offer a free 30-minute consultation for parents before anything is scheduled, and I am glad to answer questions about approach, confidentiality, and what parental involvement looks like. Additionally, for teens who have experienced something specific they can't move past, evidence-based trauma processing through EMDR is often a better fit than open-ended talk therapy.
LGBTQ+ Teen Therapy in San Francisco
Identity is one of the most significant things many teenagers are working through, and for LGBTQIA+ teens, that process often happens in environments that are not fully safe or affirming. Organizations including the American Psychological Association have identified affirming relationships and affirming care as key protective factors for LGBTQIA+ youth mental health.
I have been providing LGBTQIA+ affirming therapy since 2006. For teenagers, affirming care means that questions of gender and sexuality are not treated as the problem to be addressed. They are part of who the person is, and the therapy is designed to support the whole person. In Erica Spartos's clinical experience, LGBTQIA+ teens benefit most when they do not have to spend session time educating or justifying themselves to their therapist.
San Francisco is a relatively affirming city, but the Bay Area is not uniformly safe for queer and trans youth, and home environments vary significantly. I hold that complexity in my clinical work with adolescents.
How Do Parents Stay Involved in Teen Therapy?
That depends on the teen's age and what we all agree to at the start of treatment.
For teenagers aged 16 and up, confidentiality is a core part of the therapeutic relationship. I will not share the content of sessions with parents without the teen's knowledge and consent, except in situations that involve safety. That clarity is part of what makes the space work for adolescents.
At the same time, many teens benefit from some parental involvement, particularly when family dynamics are central to what they are navigating. I discuss what that looks like with both the teen and the parent early on and revisit it as the work develops. There is no one fixed structure.
Is Teen Therapy Available Online in California?
Yes. I offer teen therapy via telehealth to adolescents aged 16 and up anywhere in California. You do not need to be in San Francisco or the Bay Area. Telehealth works particularly well for teenagers who have their own device, want privacy, or prefer engaging from their own space rather than a clinical office.
For teens in the Bay Area who prefer in-person sessions, I have limited availability in the Lake Merced area of San Francisco. I also offer EMDR for teens when it is clinically appropriate and the teen has the readiness and stabilization skills for that work. You can read more about how EMDR works on my EMDR therapy page.
What Does Teen Therapy Cost, and Does Insurance Cover It?
I work out-of-network only and do not bill insurance directly. Please visit my fees page for current session rates.
If your PPO insurance plan includes out-of-network mental health benefits, you may be eligible for reimbursement. I provide a superbill after each session with the diagnostic and procedure codes your insurer needs to process a claim. Many families recover between 40 and 70 percent of session costs through this process.
A free 30-minute consultation is available for parents before any sessions are scheduled. I recommend starting there so we can assess whether the fit makes sense for your teenager.
Frequently Asked Questions About Teen Therapy in San Francisco
What age range do you work with?
I work with adolescents from age 16 through young adulthood. Many of my teen clients continue working with me into their 20s as they navigate the transition out of high school and into college, early careers, and independent living.
Will you tell my parents what I say in sessions?
Not without your knowledge. Confidentiality is an important part of how I work, and for teens aged 16 and up, the content of our sessions stays between us except in situations that involve safety. I go through what this means with you and your parents at the start so everyone understands what to expect.
My teen does not want to go to therapy. What do you suggest?
This is common. In my experience, teenagers who feel like therapy is being done to them rather than for them tend to disengage quickly. It helps to give your teen real input into the decision, including the option to have a first session just to meet me with no commitment required. A forced fit rarely works, and I will tell you that honestly in a consultation.
Do you work with LGBTQ+ teens?
Yes. LGBTQIA+ affirming therapy has been central to my practice since 2006. I understand the specific stressors that LGBTQIA+ teenagers navigate, including the impact of family environments that are partially or not affirming, and I approach that work with care and real clinical experience.
Is teen therapy available via telehealth in California?
Yes. I offer teen therapy via telehealth to adolescents aged 16 and up anywhere in California. Teens do not need to be in San Francisco or the Bay Area, and many find the format works better for their schedule and comfort level than in-person sessions.
How do I know if my teen needs therapy or is just going through a phase?
Duration, intensity, and functional impact are the signals to watch. If changes in mood, behavior, or functioning have persisted for several weeks, are affecting school or relationships, or your teen has expressed that they are struggling, that is worth taking seriously. A consultation is a low-commitment way to get a clearer picture before deciding anything.
Ready to Take the Next Step?
Whether you are a teenager looking for support or a parent looking for the right fit for your child, I would like to hear from you. The first step is a free 30-minute phone consultation. We will talk about what is going on, what you are looking for, and whether working together makes sense.
You may also be interested in: