For health care professionals, does age matter?

Young mental health professionals may have an advantage when counseling young clients.

Above: Casey Lorusso likes to share her interests with her clients and teach them to channel their feelings into activities like therapeutic boxing. She also is interested in equine therapy. Photograph courtesy of Casey Lorusso.

By Ali Follman/Matters of the Mind

Building a successful relationship with your client is important for any mental health professional, providers say.

But navigating that relationship can take special care when the client and young worker are close in age.

“It’s really hard when you’re so close in age with people, they think, ‘What am I going to learn from someone who’s 24?’”


“It’s really hard when you’re so close in age with people, they think, ‘What am I going to learn from someone who’s 24?’” says Casey Lorusso, 24, who is pursuing a master’s degree in mental health counseling from the Massachusetts School of Professional Psychology. She plans to graduate in June 2015.

For experience, Lorusso interns at Tides Family Services in Rhode Island. Tides is a not-for-profit agency that provides community-based services for 500 at-risk youths and their families, according to its website.

When professionals and clients are close in age, the challenge comes when the health care worker tries to find common ground to break down walls—while not over-sharing in order to forge a bond. Lorusso says teenagers tend to misinterpret boundaries. “You’re not supposed to self-disclose in therapy really. It generally doesn’t help the client because it places the focus on you.”

Don’t Let Age Get in the Way

As the president of the American Mental Health Counselors Association, Stephen Giunta, Ph.D., 58, understands the difficulties—and benefits—for clients and counselors who are in close in age.

Stephen Giunta, PhD, is the president of the American Mental Health Counselors Association. Photo courtesy of the Giunta family.

Stephen Giunta, PhD, is the president of the American Mental Health Counselors Association. Photo courtesy of the Giunta family.

On one hand the connection can help. On the other, it poses challenges.

He believes self-disclosure is only helpful when it can benefit the client and counselor’s relationship. “You have to ask yourself, ‘Why am I disclosing this information, is it for my sake or for the client’s sake?’” Giunta says.

Olivia Tousignant-Pienkos, 23, has been a counselor at a Boston eating disorder clinic for two years. She says she helps patients manage their treatment plans by restoring regular eating habits and finding new coping mechanisms.

With her patients, she says she doesn’t let age get in the way. “When I first started, it was never easy,” Tousignant-Pienkos, 23, says. “At this point, I sort of approach all of them with the same front. I never really find myself thinking of their age.”

As is the case in most professions, counseling gets easier with experience. “It’s not that big of a deal if you’re a different age than your client, or different gender, color or religion,” Giunta says. “As you get more experience, it’s easier to compensate for being in a different demographic class.”

Giunta is a professor at Alabama’s Troy University in the division of counseling, rehabilitation and interpreter training. Through training college-aged students, he notices that most of them aren’t nervous about starting with little experience in their careers.

They start out by interning and then, with enough hours of experience, become certified counselors. “New counselors can have a hard time; they get anxious that they’re a different age or gender, or color, and worry that their clients might not listen to them. But it’s pretty rare,” Giunta says.

He tells his students that the best way to be successful with a client is to build a healthy relationship. “There has been a ton of research over the years since the ‘50s about what makes [therapy] work,” Guinta said. “Years of experience is far less significant than the counselor’s ability to establish a solid relationship with the client.”

Giunta agrees that being close in age can have benefits for the client. “If you’re the same age, there’s less likelihood that you’ll confuse the client by using an experience that they’re not familiar with,” Giunta says.

The goal is to find the proper balance between relating and helping.

Finding the Balance

Jennifer Rollin, 24, received a bachelor’s degree in public communication from American University and her master’s degree from the University of Maryland in Clinical Social Work. She is a licensed graduate social worker and a program therapist at Adventist HealthCare Behavioral Health & Wellness Services in Rockville, Maryland. In the therapeutic group home, she says she works with girls and women who have bipolar disorder, major depression and/or schizophrenia.

Above: Jennifer Rollin, MSW, works at a group home in Rockville, Maryland. Photograph by Ali Follman.

Above: Jennifer Rollin, MSW, works at a group home in Rockville, Maryland. Photograph by Ali Follman.

Rollin says she acts professional-but-relatable in her group and individual sessions. “I don’t know if I would say [I am] careful but you want to be appropriate,” Rollin says. “I don’t disclose too much personal information about myself. I focus on boundaries. I have to be careful with constantly assessing their mental state,” or picking up on small comments.

“I don’t disclose too much personal information about myself. I focus on boundaries. I have to be careful with constantly assessing their mental state,” Rollin says.


These small comments may hint of more serious issues, such as someone contemplating suicide, she says. So it is critical that mental health professionals know how to decode therapy session discussion.

Adds Lorusso: “You can talk about more general things like self confidence because everyone struggles with that. It’s such a fine line.”

That fine line can be tough to navigate at any age.

Understanding Millennials: Self Esteem and Body Issues

Rollin works with clients who have low self-esteem and body issues that can complicate mental illness. Additionally, she pays attention to the millennials’ social circles, which can be a more of a negative than positive influence.

“What we know from human development is that teenagers’ social groups are really important,” Rollin says. “With these girls it is more pronounced. When you’re struggling with depression it makes relationships with people even more important. It can trigger another bout of serious mental illness.”

But a good counselor can make a difference. “A lot of times you get resistance or pushback from the girls. [It’s great] when someone makes a comment that they like you and the therapy clicks.”

 “The field is adapting to the next generation that’s coming its way,” Giunta says. “ [But] the field doesn’t always adapt as fast as the generation does.”


Mental health care workers turn to a range of therapy techniques to reach young clients, from mindfulness to media literacy.

Lorusso says she incorporates therapeutic boxing, meditating and martial arts to get her male clients, 18-year-olds and above, to focus. “Boys have a difficult time accepting that there’s another emotion other than anger,” Lorusso says, “not to be completely stereotypical.”

As a mixed martial artist and competitive horseback rider herself, Lorusso takes pleasure in teaching some of the activities she loves to the patients at Tides. Sometimes she is faced with a group of young men who don’t want to learn from a woman. But once she shows them she knows what she’s doing, they’re sold. She does a warm up with the boys, and then practices footwork and boxing techniques.

In addition to Lorusso’s methods, other efforts are underway.  “The field is adapting to the next generation that’s coming its way,” Giunta says. “ [But] the field doesn’t always adapt as fast as the generation does.”

Note: In this article, the words “client” and “patient” are used based on how each mental health professional addresses the people they work with.

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