Clinical Psychologist: Why Teens Won’t Make Their Own Appointments, and More

I recently received a request for a consultation from the mother of a 19-year-old college student. She was deeply concerned that her son couldn’t master simple, day-to-day responsibilities that any young adult should, including:

  • Calling the bank about his over-drawn checking account (or not over-drawing it in the first place);
  • Registering for college courses before the deadline; and
  • Remembering to refill his prescriptions.

These “dropped balls” were a source of constant friction in their relationship. The more she pleaded with him to be responsible, the more he complained about her “nagging and micro-management.”  This ongoing tension came to a head when, home from school on break, he neglected/refused to call his dentist’s office to move an appointment that conflicted with his work schedule.

Between 18-25, one’s identity morphs gradually from teen to young adult.(Twenty20 @chantylove)

What should a parent do when their college student won’t so things for themselves?

What’s a parent to do?

The answer might surprise you.

Why? Because the transition from adolescence to emerging adulthood—roughly ages 18-25—is a time when one’s identity morphs gradually from “teenager” to “young adult.” An important step in this transition is taking responsibility for a variety of administrative tasks formerly supervised by parents and other adults.

Managing finances, scheduling appointments, attending to healthcare—these are things that most teenagers don’t need to worry about, whereas most adults do. Taking ownership of these tasks is an important part of the curriculum of transitioning to adulthood.

This mother was appropriately concerned that her son was failing this developmental task. But frustrating as his behavior was, this phenomenon—a mysterious and stubborn avoidance of simple administrative tasks and responsibilities—is breathtakingly common among adolescent-to-adult transitioners. 

Dr. McConville’s book, “Failure to Launch”

Why is it so difficult for teens to manage their own appointments?

In my psychotherapy practice working with this age group, I have encountered this phenomenon hundreds of times. “What gives?” We might ask. “What is so difficult about calling a doctor’s office? Or setting up a job interview? Or contacting the bank about an overdraft?“ 

This mystery was solved for me several years ago by a young client—about the same age—whose father had arranged a summer job interview for him with a business associate.  All the young man had to do was to call the business associate and schedule the interview.  Instead, he dithered and procrastinated and repeatedly “forgot,” until his frustrated father made the call and scheduled the interview for him.  

Several months later, this young man confessed to me—with considerable embarrassment—that he found speaking to adults, in “real-world” situations, intimidating. He was afraid he would “say something stupid,” and the adult would think he was “just some kid.” “Passing myself off as an adult,” as he put it, ran the risk of making him feeling foolish and humiliated. So he did the logical thing: he avoided interactions with the adult world whenever possible.

The transition form teen to adult requires a shift in identity

This is critical for parents to understand.

Why? Because one of the things we adults forget is that the transition from adolescence to adulthood requires a dramatic shift in identity. This shift doesn’t happen automatically, but by virtue of numerous interactions in which you effectively pass yourself off as an adult—which often feels like faking it—only to find that the adult world does take you seriously.

This repeated process gradually allows you to begin to take yourself seriously, and to think of yourself as an adult. But therein lies the danger: “What if the adult world doesn’t take me seriously?” The likely answer is that you may be humiliated, just like my phone-call-avoiding client.

So how did this insight help the mother whose college-student son wouldn’t call the dentist?

In this way: I asked if she would arrange a brief Zoom meeting between him and me, which she did. On Zoom, I asked him the key question: “Have you ever called a doctor’s office before?” 

The answer, of course, was, “No.” 

“What do you imagine happens when you call to reschedule an appointment?” I said.

“They’ll probably get pissed,” he replied. 

Mystery solved! He didn’t want to call the office because he imagined that the office staff would be angry with him. Yet with no experience, how could he know that dental offices are actually thrilled when someone calls to reschedule, since no-shows are a perennial problem. I advised his mother to make the call on his behalf—but with him at her side, and with her phone on speaker.

His reaction afterward: “Oh. That was simple.” 

Give your teens training wheels and let them practice with you

And, of course, most of these minor administrative tasks are simple—once you’ve done them. But if you have never called a bank about an overdraft, or registered for a college course, or called a doctor’s office to reschedule an appointment—these easy but unfamiliar tasks can seem intimidating. Because as bright and mature as 19-year-olds are in many ways, they also know precious little about how the adult world really works.

This mother’s son— just like my client of several years ago— knew how to make a phone call. He just didn’t know how to make a phone call as an adult.

More to Read:

The True Meaning of the Term “Adulting:” What Parents Need to Know

About Mark McConville

Mark McConville Ph.D. is a Clinical Psychologist in private practice, specializing in adult, adolescent, emerging adult, and family psychology. Dr. McConville is a senior faculty member at the Gestalt Institute of Cleveland, and has published and taught widely on the subjects of adolescent and emerging adult development, parenting, and counseling methodology. His book Adolescence: Psychotherapy and the Emergent Self was awarded the 1995 Nevis Prize for Outstanding Contribution to Gestalt Therapy theory.

Additionally, he is co-editor of The Heart of Development: Gestalt Approaches to Childhood and Adolescence, vols. I & II. His newest book is Failure to Launch: Why Your Twentysomething Hasn’t Grown Up... and What to Do About It. He lives in Shaker Heights, Ohio, with his wife.

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