Working With Boys: Therapy Tools and Tips

Understanding Middle School Boys: A Therapist’s Guide to Behavior, Brain Development, and Tips for Building Connection 

Understanding middle school boys requires attention to the unique developmental shifts they experience during early adolescence. This period is marked by a mix of physical changes, emotional growth, and evolving social dynamics. These factors influence how boys engage with others, perceive themselves, and respond to their environments.

Communication and Engagement: Middle school boys often have a limited attention span during conversations, typically around 12 to 13 minutes. To maintain their engagement, it's beneficial to keep discussions concise and interactive. When addressing sensitive topics or providing feedback, it's important to approach with empathy and create a safe space for open dialogue. This approach acknowledges their developmental stage, where they are forming their identities and may be sensitive to criticism.

Social Dynamics and Competition: Competition plays a significant role in the lives of middle school boys. They often thrive in environments where activities are co-created, promoting fairness and collaboration. Encouraging grace and sportsmanship can help them navigate competitive situations healthily. Additionally, fostering a sense of belonging within peer groups can positively impact their social development and reduce feelings of isolation.

Emotional Development and Identity: During middle school, boys are navigating the complexities of puberty, which brings about physical changes and questions about personal identity. They may experience confusion regarding their bodies, attractions, and emotions. Providing psychoeducation can empower them with knowledge about these changes, helping them understand and accept their experiences. Open-ended questions and discussions about their opinions can further support their exploration of values and beliefs.

Addressing Toxic Masculinity: Research indicates that certain traits associated with toxic masculinity, such as dominance and low empathy, can hinder boys' willingness to intervene in bullying situations. A study by Ingram et al. (2019) found that middle school boys exhibiting higher levels of dominance and pro-bullying attitudes were less likely to act as bystanders in bullying incidents. Conversely, higher empathy levels were linked to increased intervention. These findings suggest that promoting empathy and challenging harmful masculine norms can encourage prosocial behavior among boys.

Social-Emotional Needs and Behavioral Trajectories: A study by Tan et al. (2019) identified distinct patterns among middle school boys concerning social-emotional needs and behaviors. Boys with poor social skills and conduct problems exhibited higher levels of aggression and substance use over time. Interestingly, boys with positive social skills but moderate learning and anxiety issues also showed increased verbal aggression and substance use, possibly due to their susceptibility to peer influences. These insights underscore the importance of early interventions tailored to specific behavioral profiles.

Physical Fitness, Self-Beliefs, and Academic Performance: Physical activity and self-perception significantly impact academic outcomes for middle school boys. Srikanth et al. (2015) found that boys with higher cardiorespiratory fitness, strong academic self-beliefs, and robust social support from family and friends performed better in reading and math. This highlights the interconnectedness of physical health, self-esteem, and academic success, emphasizing the need for holistic approaches in education.

Strategies for Support & Interventions for Therapists:

Validation and Empowerment: Recognize and affirm boys' experiences and emotions to build self-esteem and resilience. 

• Intervention: Personal Shield Activity

  • Have the client draw a “shield” with 4 sections: strengths, things they’ve overcome, people who support them, and goals. (or use this template Coat of Arms / Family Crest | Worksheet | Therapist Aid )

  • Visually reinforces resilience and self-empowerment - can be great for reflection and sharing.

• Intervention: Letter to Younger Self

  • Guide the client to write a short letter to their younger self offering encouragement, support, and reminders of how far they’ve come.

  • Fosters self-reflection, pride, and emotional insight.

• Intervention: Self-Portrait 

  • Guide clients to draw a self-portrait of who they hope to be in the future. Encourage them to include physical elements, character traits, values, achievements, or dreams that represent their ideal self. This can support therapeutic goals of enhancing self-esteem, empowering youth to define their identity, and providing motivation and structure for goal setting. (Picture frame template: Picture Frame Art Project | Worksheet | Therapist Aid )

  • Prompt examples: “What kind of person do you want to be?”, “What do you want people to know about you?”, “What will your future self be proud of?”

  • Processing questions: “How is this version of you different from who you are now?”, “What steps could help you move toward this version of yourself?”, “What strengths do you already have that will help you become him?”

Psychoeducation: Provide information about developmental changes to demystify their experiences and reduce anxiety.

• Intervention: Timeline of Me: Then, Now, and Coming Soon

  • Have the client draw a 3-part timeline: childhood self, current self, and anticipated future self. Add in social, emotional, and physical milestones.

  • Encourages reflection on growth and helps normalize ongoing change.

• Intervention: “What’s Normal?”

  • Explore with clients “What I’m experiencing” vs. “Why it’s normal for my age” for issues like shifting moods, peer drama, or sleep changes. Validates the adolescent experience and reduces anxiety. 

• Intervention: Lots of videos/articles to educate on adolescent development https://actforyouth.org/adolescence/brain.cfm?utm_source

Open Dialogue: Encourage discussions that allow boys to express their thoughts and feelings without judgment.

• Intervention: Teaching & Practicing “I” Statements

  • Introduce the concept of “I” statements as a communication tool to express feelings and their needs in a non-blaming, assertive way. Teach the basic formula: “I feel [emotion] when [situation] because [reason]. I need/would like [need].”

  • “I” statements promote assertiveness and reduce defensive reactions from others. They help boys express emotions more clearly, take ownership of their feelings, and communicate needs in a healthy, socially appropriate way.

Courtesy of Hannah Levy

Challenge Cognitive Distortions: Help boys identify and reframe negative thought patterns that may affect their behavior.

• Intervention: Educate clients on recognizing cognitive distortions: Cognitive Distortions | Therapist Aid

• Intervention: Cognitive Restructuring Worksheet: Putting Thoughts on Trial | Therapist Aid

• Intervention: Challenging negative thoughts worksheet: Challenging Negative Thoughts (Therapist Aid) 

Promote Empathy: Foster understanding and compassion to counteract tendencies toward aggression and disengagement.

• Intervention: Role Reversal Storytelling

  • Ask the client to tell a story from someone else’s perspective (sibling, teacher, friend, etc.) 

  • Builds emotional intelligence and social perspective-taking

Address Harmful Norms: Confront and discuss societal expectations that may contribute to toxic masculinity.

• Intervention: Emotion-Strength Reframe Activity

  • List emotions commonly labeled as “weak” (sadness, fear, empathy) and work with the client to identify how each can actually represent strength.

  • Example: “Empathy = being brave enough to care about others.”

  • Reframes emotions as signs of strength and leadership.

• Intervention “What Does It Mean to Be a Boy?” Reflection

  • Use a worksheet or verbally ask questions: “What messages have you heard about how boys should act?” followed by “Which of those do you agree with/disagree with?”

  • Encourages critical thinking about social norms and invites them to begin forming their own identity.

• Intervention: “If I Could Say What I Really Felt...”

  • Use writing, drawing, or even music to express feelings that are often hidden due to gender expectations. 

  • Reduces shame and encourages safe expression of emotions like fear, sadness, or vulnerability.

Support Social Needs: Facilitate opportunities for positive peer interactions to enhance social skills and reduce isolation.

• Intervention: Social Skills Role-Plays

  • Practice scenarios where the client initiates conversations, responds to peer conflict, or expresses disagreement respectfully.

  • Enhances confidence and skills for real-life peer interactions.

  • Develop scripts together or use cards with “What would you do if…?” scenarios.

• Intervention: The filters I use before talking printout 

  • Use a visual handout or worksheet that outlines helpful “filters” clients can use before speaking.

  • This tool teaches self-awareness and thoughtful communication. It helps boys slow down and reflect before reacting impulsively or harshly in conversations.

  • Ideas for use in sessions: 

    • Introduce each filter and practice applying them to real-life situations (responding to a sibling, talking to a teacher, reacting to teasing)

    • Use role-play or scenario cards to reinforce when and how to apply the filters 

Courtesy of www.plantlovegrow.com

Encourage Physical Activity: Integrate regular exercise to support physical health and academic performance.

• Intervention: Mind-Body Check-In

  • Incorporate short stretching, movement, or breathing exercises at the beginning or end of session.

  • Connects physical awareness with emotional regulation.

• Intervention: Ball Toss Sharing 

  • Therapist and client gently toss a ball back and forth while taking turns responding to prompts or emotion-related questions. 

  • Encourages physical activity while building emotional insight and connection.

  • Combines light movement with emotional processing to keep engagement high, regulate energy, and create a safe, playful environment for sharing. (Can be especially effective for those who struggle with hyperactivity and sitting still)

• Intervention: Emotional Regulation Obstacle Course 

Courtesy of Hannah Levy

Quick Summary: What Therapists Should Know About Middle School Boys

• Developmentally unique: Middle school boys experience rapid brain, body, and emotional changes that influence behavior, attention, and mood regulation.

• Communication needs structure: They typically have a short attention span (12–13 minutes); conversations should be engaging, direct, and judgment-free.

• Identity formation is active: Boys are exploring personal values, social roles, and emotions while navigating puberty and self-image.

• Competition matters: They often engage in comparison and status-seeking; collaborative activities build fairness and reduce peer conflict.

• Validation is essential: Boys benefit from strengths-based reflection, emotional acknowledgment, and encouragement to explore vulnerability.

• Empathy needs to be taught: Emotional literacy and perspective-taking help decrease aggression and increase prosocial behavior.

• Toxic masculinity is a barrier: Challenging harmful norms around emotions and masculinity supports healthier expression and connection.

• Social needs drive behavior: Boys are wired for peer connection; positive social skill building can reduce isolation and future risk behaviors.

• Movement is a must: Physical activity supports mental regulation, learning, and engagement in therapy.

• Therapeutic relationships matter: Trust, consistency, and creativity are key to unlocking growth in this dynamic and often misunderstood stage of life.

By implementing these strategies, educators, parents, and mentors can create supportive environments that nurture the growth and development of middle school boys. 

References:

Ingram, K. M., Davis, J. P., Espelage, D., Hatchel, T., Merrin, G. J., Valido, A., & Torgal, C. (2019). Longitudinal associations between features of toxic masculinity and bystander willingness to intervene in bullying among middle school boys. Journal of School Psychology, 77, 139–151.

Tan, K., Gorman-Smith, D., Schoeny, M., & Choi, Y. (2019). Patterns of social-emotional needs and trajectories of aggression and substance use among middle school boys. The Journal of Early Adolescence, 39(9), 1217–1243.

The Center for Parenting Education. (n.d.). Child development by age: Characteristics of the 10-year old. Retrieved from https://centerforparentingeducation.org/library-of-articles/child-development/child-development-by-age/#10

The Center for Parenting Education. (n.d.). Child development by age: Characteristics of the 11-year old. Retrieved from https://centerforparentingeducation.org/library-of-articles/child-development/child-development-by-age/#eleven

Srikanth, S., Petrie, T. A., Greenleaf, C., & Martin, S. B. (2015). The relationship of physical fitness, self-beliefs, and social support to the academic performance of middle school boys and girls. The Journal of Early Adolescence, 35(3), 353–377.