Lindsay Fleming, LPC, knows how to talk to teenagers. It’s her superpower. In private practice, on a psychiatric floor, or as a guest on a podcast hosted by a teenage mental health advocate, Lindsay possesses an innate ability to hear, connect with, and treat young people in crisis. This skill goes a long way to explaining the steep arc of her career as a mental health professional-just a few years after receiving her license in counseling. It also helps explain how she has acquired half a million TikTok followers and almost 60,000 Instagram followers thanks to a social media presence that began as an exercise in limiting teen screen time.
While her social media presence has helped get the word out on urgent matters of teen mental health, the heart of her work is in her private practice, which is grounded in its deep ties to the community it serves. Fleming grew up in the western suburbs of Chicago and attended the University of Iowa. Inspired in part by her own learning difficulties in school, she became interested in becoming a therapist, which ultimately led to her enrolling in the Master of Arts in Counseling program at The Chicago School.
Lindsay joined me over Zoom from an overstuffed brown couch in her living room for a lively chat that included a cameo appearance from a chipper white terrier.
Why did you decide to attend The Chicago School?
Well, I knew I wanted to be in Chicago. I looked at The Chicago School, and I really loved that the M.A. in Counseling program had that Latino concentration. There is such a large Latino population in Chicago that I felt it would be very beneficial for me to be in a program that really focused on culture, race, and ethnicity.
You’ve said that you had a learning disability.
My kindergarten teacher requested that I get tested for a learning disability.
I had an individual education plan (IEP) throughout my whole time in the school, and I struggled with confidence a lot because of my learning disability. No one really explained to me how my brain was working differently, and the strengths that come with having a learning disability, for creativity and different pieces like that. It was a journey to gain my confidence to feel that I could make a difference in the world.
How did you come around to becoming confident, as opposed to feeling somehow disadvantaged in comparison with your peers?
I always knew some strengths, like being good at talking with people. At Iowa, I found that when I was working with kids and teens, they didn’t care if I knew how to spell something. They just cared that I listened and I created a safe space for them.
Once I got to The Chicago School, I’d say that’s when I really started to believe in myself academically and believe in my potential. And a lot of that, too, came from getting more experience in the community.
While I was there, I decided to volunteer as a coach for a competitive cheer team at a middle school in my hometown and ended up taking over the entire program for a time. Dealing with parents, dealing with a lot of kids, and all those things taught me how to stand on my own feet and that I am capable of doing these things. I went to therapy when I was in grad school as well, and that really helped me with my confidence and feeling capable.
Was that the first time that you were in therapy?
I was in therapy when I was a grade school. I tried a few therapists. But I never really found one that was a good fit. And that was part of the reason why I wanted to become a therapist. Because I thought there had to be something that can be done to help people who felt like I did. I was struggling with anxiety. I had panic attacks when I was in middle school, and I had undiagnosed ADHD. I think they just kind of thought everything was within the learning disability. These people were saying, “Do the things that you’re told are going to be helpful,” and I just didn’t find the right fit.
Would it be fair to say that The Chicago School was the learning environment you needed to be in?
Yes, I loved my experience at The Chicago School. I felt like I learned so much. And it just really changed my whole worldview, what I pay attention to, and where I get information.
Will you describe your journey from graduation to when you opened your practice?
Through internships in graduate school, I ended up in paid positions at Lurie’s Children’s Hospital and a private practice and was just trying to figure out what I wanted to do next. I loved Lurie’s program, but they don’t hire LPCs. My heart is in working with families and kids, so I decided to go into my own private practice.
The mother of one of my cheerleaders has a law degree and is a therapist. She was looking to open her own practice. I said, “Hey, I’m doing this if you want to join me.” And she said, “All right, I’m in.” We both are super involved in our community. That really helped our practice grow.
I created a leadership workshop in our practice for middle school girls. The first 45 minutes we would talk about confidence or social media or school stress. And the second 45 minutes of the workshop we would create our own philanthropy project. The girls loved the program. And then COVID hit, and I had to close down my workshops.
I was counseling virtually and a lot of the girls were reaching out. These girls didn’t necessarily need therapy. They just loved having that space. And I asked myself, “What can I do to help support these girls?”
I challenged them all to decrease their social media time. They shared their screen times and their goals, and I said, “If everybody meets their goal by next week, I’ll buy you all Starbucks.”
They all met their goals, and one of the girls said, “Lindsay, we don’t want Starbucks. We want you to download TikTok.” I said, “Absolutely not. That is your space. I have no interest.”
But there I was with my workshops closed down and knowing a lot of these girls are struggling and isolated. I thought, “I’m going to make a TikTok, just to brighten their day.” My first five TikToks were five tips for middle school girls to build confidence.
One of them went viral and got 5 million views, And I thought, “Oh my goodness.” People were asking me all these questions, and just organically I thought, “Wow, there’s a big need here, and people want this information.” So, I started posting mental health content.
What was the post that went viral?
The first one that went viral was a virtual session. And I was holding up a sign that said, “What happened when you Facetimed your ex?” and then “What happened in the math test?” I was trying to show why a lot of teens feel like it’s hard to do virtual therapy. You might not have a space where you feel like you’re safe speaking, or you might be worried people are listening in. So, it was kind of making a funny video of, “Here’s an option. You can hold up signs to your client and ask them what’s really going on.”
Is virtual therapy a particular challenge for teenagers?
I’d be doing a session, and a parent would pop in just because they wanted to say hi to me. It’s not necessarily that they’re always trying to listen in, but it’s the boundaries. We talked about people who don’t have their own bedroom or a space they can go to where they know they’re not going to be heard. There’s the thought of, “Oh, someone might hear me,” or, “Oh, my mom might pop in.”
When we talk about the teen mental health crisis is that something that you see coming directly from the pandemic or are the roots deeper than this last two years?
Suicide rates have tripled for 10- to 24-year-olds in the past 10 years. We know genetics and environment play a role in our mental health. Well, we can’t change your genetics. So, we have to look at the environment. Even before COVID, we found three pillars of what was causing this crisis.
Social media is a big piece. It causes comparison; it’s hard to get off the app. Fewer parents are observing what’s happening, so there’s a lot more cyberbullying.
A second thing that plays a huge role was a world that feels scary, unsafe, and unpredictable. We’re just exposed to a lot, and people are going to social media for their news more.
The last factor is high expectations. Teens are really feeling this pressure to succeed. For parents, the workforce looks different and that makes them anxious, so they double down and say, “You need to do well in school. You need to go to this really good college.”
When I was in high school, I compared myself to people in my class. Now we have teens comparing themselves to TikTokers who have 100 million followers and are just putting out their highlight reel.
Add to all these pieces the pandemic and the isolation, we now have a shortage of therapists in the U.S. People need this help, and I don’t know if our workforce is enough. That’s why I have also been looking more into prevention work.
You’ve suggested, paradoxically, that your entry into this world of social media began with an exercise trying to limit social media for teens. And now we’re talking about a shortage of therapists. Is it realistic to say you can combat these issues through social media?
Just like in everything, there are a lot of different avenues people can get their information. We know meeting teens where they’re at can be super helpful. So, I think social media can for sure be the engine of prevention work. Where I wish we did more in schools is to help kids learn what is accurate information on the internet.
So, just how great it can be, it also comes with some costs. The benefits are that everyone has access, you can really reach people where they’re at, and you have far reach. However, I see some content creators who aren’t licensed, including some who claim to be and they’re not. People are starving for this information, and they just take it at face value. I always tell my followers even to check me. If I say something, look it up.
What is the demographic of the patients that you see?
So, I used to see a lot more children with behavioral issues, ADHD, and anxiety. As a lot of my clients have gotten older too, I’ve been in private practice for a couple of years now. I’m dealing with a lot more middle school, high school, and young adult age. I still focus on anxiety, ADHD, and behavioral issues in my practice.
I have a wide range. Probably over half my caseload is within the LGBTQ+ community. I have male clients. And then a lot of girls as well.
How are your LGBTQ+ clients coping with the trend of politicians who are passing laws targeting gay and transgender teens?
It’s extremely harmful, and I see it in my office. We have people who don’t feel safe coming out, even with support. We say what’s really helpful is having a supportive family. But I hear more and more about, “Even if I have a supportive family, what’s the rest of the world going to be like?” And feeling extremely unsafe.
We also know that suicide rates are even higher there, and because of things like this. It’s extremely harmful to our youth. I’m having a lot of conversations with my clients about how to manage their feelings and hearing other people talk about it. Because you’ll hear other adults speaking of it, or people at school, and how do we manage when we want to use our voice? That we don’t always have to be the voice for our entire community.
Given these challenges that your clients and the youth are facing today, if you had a magic wand, what are there two or three things that you want young people to take away in this difficult time?
First, connection is key. For a lot of teens, their world feels out of control and isolated. It doesn’t have to just be with peers, people your age, but connecting with people within your community, with volunteer groups, with art, being creative. Finding outlets to feel connected can be super powerful.
Second, pay attention to yourself and become more aware of what you’re feeling. What small changes can we make that benefit us in a bigger way over time?
My last piece of advice is to find your screen time sweet spot. I love social media, and I would be hesitant to show you my own social media time, but what we’re seeing is that the three-hour mark as a dividing line. If teens are spending more than three hours on social media, then we see they’re more likely to self-report depressive symptoms, an increase in suicidal thoughts, and anxiety. So really watch your social media time, it really does impact our mental health.
Lindsay’s first TikTok post:
@lindsay.fleminglpc♬ original sound – Lindsay Fleming, LPC