Psychotherapy for Psychosomatic Disorders in Teens: Therapy Options & Treatment Plans
Hearing that your teen has a psychosomatic disorder can feel like stepping into fog. The diagnosis alone may be confusing, so it’s easy to imagine that treatment could be just as unclear.
What often surprises parents is that once the condition has a name, the way forward becomes more structured, with psychotherapy forming the backbone of the process. There may still be moments that feel complicated, but compared to the uncertainty before diagnosis, there is typically a clearer sense of direction.
If you suspect your teen has a psychosomatic disorder, or they’ve already received a diagnosis, a mental health professional can help you better understand the root causes and treatment options. This page can also work as a guide to psychotherapy for psychosomatic disorders in teens by exploring:
- How psychosomatic disorders are treated
- The psychotherapies commonly used to treat PSD
- Why psychotherapies could be challenging for some teens
- When a psychosomatic disorder can hide behind other issues
- How Mission Prep can help with the treatment of psychosomatic disorders
What Are Psychosomatic Disorders?
- Persistent headaches
- Stomach pains or nausea
- Shortness of breath during stressful moments
- Fatigue despite adequate rest
- Muscle tension and aches
- Sleep problems
For teenagers, symptoms such as these can be especially troubling because the timing of stress at school or in relationships can contribute to flare-ups.
At this point, it may be important to distinguish psychosomatic disorders from somatic symptom disorders, which are where the symptom itself causes constant focus and worry. Psychosomatic disorders work differently, with the stress creating the symptom rather than the anxiety around it.
As a result, parents can feel caught in tough spots: their child is clearly struggling, yet every medical explanation comes back inconclusive. Yet, by understanding how emotional strain can translate into physical problems, it becomes easier to see why treatment needs to address both the mind and body together.
How Are Psychosomatic Disorders Treated?
1. Assessing and Explaining
The first step in treatment is a thorough assessment that rules out serious illness and helps the person understand what’s happening. Doctors then explain how stress and other emotions can all show up physically, which often helps take away some of the fear that something dangerous is being missed. From here, core care plans can be created 3.2. Creating a Core Care Plan
Crafting of the main core plan typically involves consistent and structured follow-ups with one main clinician,3 building in steady reassurance and gradual steps back into normal activities. This may also be the stage in which therapies like CBT or psychodynamic work are introduced, which will be covered in more depth later in this guide.3. Considering Medication Options
When symptoms are overwhelming, medication can play a role in supporting recovery. These aren’t necessarily “cures” for the disorders present, but can act as central modulators that calm overactive pain or stress pathways. Which one is chosen usually depends on the type of symptoms being experienced. For example:- Fibromyalgia: Medicines like duloxetine or pregabalin can reduce pain and help with energy, while low-dose amitriptyline is often used to improve sleep.4
- Gastrointestinal pain or IBS symptoms: Low-dose tricyclics such as amitriptyline are often the first choice, while SSRIs or SNRIs may be considered if mood or anxiety are strong drivers.5
- Mixed somatic symptoms: Antidepressants from the TCA, SSRI, or SNRI families may reduce the overall symptom burden and ease co-existing anxiety or depression.6
While medication can certainly help in easing the intensity of symptoms, it isn’t the central focus of treatment for psychosomatic disorders.7 What typically makes the most difference in the long run is the therapies that give people new ways to respond to stress. These options can also help people process the negative emotions that physical symptoms can have on daily life.
In the next section, we’ll look more closely at these therapies and the research showing how they can truly change the course of recovery.
What Psychotherapies Are Used to Treat Psychosomatic Disorders?
When doctors or therapists talk about treatment for psychosomatic disorders, the conversation often circles back to psychotherapy. But within this conversation, the styles of therapy can sound very different.
Some psychotherapeutic approaches are highly structured and practical, while others are more about exploring what’s underneath symptoms. What links these approaches is the idea that the mind and body don’t work in isolation, and if one is overwhelmed, the other will usually carry part of that weight.
Below, we take a look at some – but not all – of the different therapies used to treat psychosomatic disorders.
Cognitive Behavioral Therapy (CBT)
CBT is often the first “go-to” therapy considered for psychosomatic symptoms, and this comes down to how widely researched it is. The way it works is fairly straightforward: noticing the patterns between thoughts and physical symptoms, and then breaking these patterns down.
A therapist might ask someone to keep a diary of stressful situations and what their body does in response, usually because writing this down makes the connections easier to see.
Once these links are on paper, the sessions can focus on developing new skills that teach the person how to stop spiralling thoughts before they fuel more pain or fatigue. CBT has been successfully used with everything from irritable bowel syndrome to fibromyalgia, as there is strong evidence to suggest that CBT can lower the intensity of symptoms themselves.8
Short Term Psychodynamic Psychotherapy (STPP)
STPP is a shorter version of psychodynamic psychotherapy; therefore, it focuses on the “before” rather than “right now.” For example, pain or gastrointestinal problems might not have anything to do with the body. Instead, they may be about emotions that were pushed aside and now surface in physical form. Therefore, a psychodynamic therapist would encourage the person to look at past experiences and hidden conflicts, and to notice how they still play out in relationships and physical health. The point here is to loosen the grip these old patterns have on the present.
Controlled trials suggest that once people begin to recognize these links, the physical symptoms often settle, and the benefits can last well beyond the sessions.9
Mindfulness-Based Therapies
Mindfulness therapies are a little different from the previous options mentioned, as they help people accept what is happening without turning towards panic. Sessions often use techniques like guided meditations and gentle yoga, with the aim that, over time, these can soften the stress response that tends to make psychosomatic conditions flare.
For instance, someone with gut problems may learn to sit with discomfort rather than immediately turning to fearing the worst, which can lower the intensity of flare-ups. Research shows that these mindfulness approaches can consistently improve quality of life, especially in conditions where stress is a big trigger.10
Hypnotherapy
Hypnotherapy may bring to mind old movie scenes where someone is made to act in ways outside of their conscious control, but the reality of the technique is very different. In real practice, hypnotherapy aims to create a deep state of relaxation where the mind becomes more open to suggestion. In this state, a therapist might introduce calming images or suggest new ways of experiencing symptoms.
For example, for IBS, hypnotherapy might involve visualising a calm digestive system. For chronic pain, it may require imagining tension loosening and releasing. People often practice these techniques outside of sessions too, and studies have shown that, especially in gastrointestinal conditions, the benefits can last long after therapy ends.11
Biofeedback
Biofeedback is a type of therapy that is as practical and hands-on as treatment can get. It involves using sensors to measure things like muscle tension or heart rate and displays them on a screen so the patient can literally watch how stress shows up in their body. With guidance, they can then practice relaxation skills until they see these signals change. This effect-cause relationship can teach people undertaking this therapy to lower their stress response at will. Therefore, it has been used successfully for treating migraines, headaches, hypertension, and other conditions where stress quietly builds into pain.
Further, results from studies have shown that this method of therapy, when combined with other therapies, can rival standard medications for conditions such as persistent migraines.12
Each of these therapies approaches psychosomatic disorders differently, but what ties them together is the recognition that mind and body feed into each other. Together, they offer a wide toolkit, which can be important as psychosomatic disorders are rarely straightforward, and no single method is guaranteed to work for everyone.
Why Psychotherapy Could Be Challenging for Teens With PSD
What you might have noticed from previous sections on treatment options is that most of the research didn’t mention how effective these forms of therapy are for teens specifically. This may leave parents wondering where their teenager fits into this information: Will the same methods really translate, or could the experience feel completely different for someone younger?
While research into treatment methods isn’t in abundance with teens specifically, one 2020 study on adolescents with PSD showed that anxiety was a big factor in developing PSD.13 This was an important finding as the researchers were then able to surmise that the teens’ anxiety wasn’t so much about physical symptoms. Instead, it was about what the illness meant for their place in the world.
For a young person trying to carve out independence, walking into a therapy room in a hospital or a professional setting can make such fears loom even larger.
This is why psychotherapy, at least in its standard form, isn’t always a neat fit, so the same study experimented with art therapy. Researchers noticed the tone shifted in this setting, as teens weren’t treated like patients, but welcomed into a creative space where they connected with others facing similar struggles. As a result, anxiety levels dropped, as did any co-occurring physical symptoms.
Of course, this doesn’t mean art therapy or any other holistic approach is a sure fix. But what it does show is that adolescents sometimes need different entry points into therapy. Creative or holistic methods can make the process feel safer and more relevant to their lives, while more traditional therapies may still have a role to play over the long run.
When Psychosomatic Disorders Hide Behind Other Conditions
One of the reasons psychosomatic disorders can be so difficult to understand is that the symptoms often blur into other mental health conditions. For example, research shows that anxiety and depression frequently appear alongside somatic symptoms, but sometimes, the physical complaints are the first thing anyone notices.14 A teenager might come forward with headaches, fatigue, or stomach pain, while the real driver is hidden distress.
This overlap makes it hard to separate where one condition ends and another begins. Plus, at least a third of young people with somatic symptom disorders also live with anxiety or depression.
For parents, this can create a confusing picture. Is it a physical illness? Is it anxiety? Is it depression? Or is it psychosomatic? These questions can leave you feeling stuck and second-guessing every answer. This is why reaching out for professional help is so important. Mental health professionals are trained to untangle these overlaps and give your family an anchor when the road feels unclear.
Mission Prep: Professional Support for a Variety of Teen Mental Health Issues
At Mission Prep, we’re equipped to address the complex challenges that often come with psychosomatic disorders, including issues like:
Our team works closely with teens and their families to create treatment plans that can bring clarity and stability back into daily life. With locations across the US, we offer both residential care for those who need a structured environment and outpatient options that can fit around school and home life.
Wherever your teen is on their journey, we provide the support and expertise to help them move forward with confidence. Contact our team today to learn more about the treatments we offer.
References
- Husain, M., & Chalder, T. (2021). Medically unexplained symptoms: assessment and management. Clinical Medicine, 21(1), 13–18. https://doi.org/10.7861/clinmed.2020-0947
- Mewes, R. (2022). Recent developments on psychological factors in medically unexplained symptoms and somatoform disorders. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.1033203
- Tuttle, M. C., Ciampa, D. J., Godena, E., Kim, B. K., Sakmar, K. A., Vanwort-Meng, L., Verma, D., Stern, T. A., & Yeung, A. S. (2024). The Evaluation and Treatment of Somatic Symptom Disorder in Primary Care Practices. The Primary Care Companion for CNS Disorders, 26(1), 51195. https://doi.org/10.4088/PCC.23f03549
- Jones, E. A., Asaad, F., Patel, N., Jain, E., & Alaa Abd-Elsayed. (2024). Management of Fibromyalgia: An Update. Biomedicines, 12(6), 1266–1266. https://doi.org/10.3390/biomedicines12061266
- Hanna-Jairala, I., & Drossman, D. A. (2024). Central Neuromodulators in Irritable Bowel Syndrome: Why, How, and When. The American Journal of Gastroenterology, 119(7), 1272–1284. https://doi.org/10.14309/ajg.0000000000002800
- Kleinstäuber, M., Witthöft, M., Steffanowski, A., van Marwijk, H., Hiller, W., & Lambert, M. J. (2014). Pharmacological interventions for somatoform disorders in adults. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd010628.pub2
- Agarwal, V., Nischal, A., Praharaj, S., Menon, V., & Kar, S. (2020). Clinical Practice Guideline: Psychotherapies for Somatoform Disorders. Indian Journal of Psychiatry, 62(8), 263. https://doi.org/10.4103/psychiatry.indianjpsychiatry_775_19
- Liu, J., Gill, N. S., Teodorczuk, A., Li, Z., & Sun, J. (2019). The efficacy of cognitive behavioural therapy in somatoform disorders and medically unexplained physical symptoms: A meta-analysis of randomized controlled trials. Journal of Affective Disorders, 245, 98–112. https://doi.org/10.1016/j.jad.2018.10.114
- Emily Henderson. (2020, December 22). Study determines the effects of psychodynamic psychotherapy on functional somatic disorders. News-Medical. https://www.news-medical.net/news/20201222/Study-determines-the-effects-of-psychodynamic-psychotherapy-on-functional-somatic-disorders.aspx
- Gaylord, S. A., Palsson, O. S., Garland, E. L., Faurot, K. R., Coble, R. S., Mann, D. J., Frey, W., Leniek, K., & Whitehead, W. E. (2011). Mindfulness Training Reduces the Severity of Irritable Bowel Syndrome in Women: Results of a Randomized Controlled Trial. American Journal of Gastroenterology, 106(9), 1678–1688. https://doi.org/10.1038/ajg.2011.184
- Adler, E. C., Levine, E. H., Ibarra, A. N., Boparai, E. S., Hung, Y., McCrary, Q. D., & Lee, J. K. (2025). Gut‐Directed Hypnotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta‐Analysis. Neurogastroenterology & Motility. https://doi.org/10.1111/nmo.70037
- Catanese, L. (2025, May 27). Could biofeedback help your migraines? – Harvard Health. Harvard Health. https://www.health.harvard.edu/mind-and-mood/could-biofeedback-help-your-migraines
- Prokhorova, Z., Polyakov, V., & Rychkova, L. (2020). Art Therapy for Treating Anxiety in Adolescents with Psychosomatic Diseases. International Journal of Biomedicine, 10(4), 453–456. https://doi.org/10.21103/article10(4)_oa24
- Yi, S., Hu, X., Wang, C., Ge, J., Ma, Z., & Zhao, Y. (2024). Psychosomatic health status and corresponding comorbid network analysis of college students in traditional Chinese medicine schools. Frontiers in Psychiatry, 15. https://doi.org/10.3389/fpsyt.2024.1467064
