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Talking to Your Therapy-Resistant Teen

All therapists who specialize in teen mental health have had referral calls like this: “How can I get my daughter into therapy?  She says she won’t go!”

Parents can feel like they’re at the end of their rope.  You may be seeing your child suffer, or have been told by their doctor or teacher that therapy is necessary.  You may feel like your home is a ticking time bomb with your teen at the center, and therapy is the only help available.  Maybe you don’t know where else to turn.

But your teen says no.

Here are some helpful ideas on how to talk to your therapy-resistant teen:

1. Don’t force it!

This might feel counter-intuitive, but when a teen is adamantly opposed to therapy, I encourage parents to give them space.  In my experience, teens who are “forced” into counseling rarely have a good experience, and it may even make them more hesitant to try counseling later on.  I’ve seen adult clients who waited a decade or more before seeking therapy because of a negative initial experience.  It’s true for teens and adults alike that therapy is only helpful if the person seeking it is minimally open to the experience.

2. Take the time to find the right therapist for your child

I’ve found that taking the time to find a therapist who specializes in teen mental health is well worth the effort in increasing a teen’s motivation to try it.  Because of their stage of development, teens are both hyperaware of themselves and others – meaning they often judge quickly whether someone can understand them.  Clinicians with true experience in teen mental health will feel genuine and approachable to your child.  We all like to feel special and important, and teens are no exception.  If your child has had any prior therapy, it may also be good to note that their experience as a teen in therapy will be different – they will be entitled to more privacy, and a teen mental health specialist will understand all the nuances of this.

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3. Attach a face to a name

If your teen has expressed hesitation about therapy, try showing them a photo and short bio of the therapist you've identified – like the bios on our website.  Seeing that therapists are actual people (who are also usually kind, cool, fun, or safe-looking) can help to both relieve anxiety and increase curiosity.

4. Be Gentle

If your teen has a negative initial reaction to the idea of starting therapy, use a gentle approach when you revisit it.  Remind them that it’s their decision, but you think the topic is important enough to bring it up again.  Describe the ways specifically that you think it will help.  Don’t apply pressure or use therapy as a negative consequence (i.e. “if you miss curfew again, you’re going to therapy for sure!”).  Instead, present it as a positive, healthy, and helpful option that is common and necessary for most healthy adults: like going to the doctor.  

5. Small Steps

Sometimes all it takes is a foot in the door!  Maybe the thought of committing to long-term therapy is overwhelming to your teen.  A good place to start is committing to an intake appointment.  Explain that they don’t need to feel excited about it, just curious: “Let’s meet Dr. Katey and see what she’s like – it will only take an hour.”  Your teen is more likely to say yes to this smaller commitment up front.  Then, once they meet their therapist, they often find therapy is not as intimidating, hard, or negative as they worried it would be, and they might be open to continuing.  If your teen says no to even an intake, take some space from talking about the issue for a week or two, and then gently revisit it.  Small steps still reach a destination in time.

Always remember that if your teen is experiencing a mental health crisis, or expressing thoughts of harming themselves or others, this is an emergency and you should call 911 or visit the closest emergency room. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 or text the Crisis Text Line (text HELLO to 741741).

August 7, 2020
Katey Nicolai, PhD

Katey Nicolai, PhD

Katey Nicolai, is a licensed clinical psychologist who received her PhD in Clinical Psychology from Seattle Pacific University. Dr. Nicolai provides services to adolescents and adults using evidence-based treatment rooted in cognitive-behavioral and psychodynamic therapies, including Dialectical Behavior Therapy, interpersonal therapy, and family systems. Dr. Nicolai has specialized training in treating trauma and PTSD, personality disorders, self-harm and suicidailty, family problems, emotion dysregulation, and mood and anxiety disorders. In addition to her work with UpLift, Dr. Nicolai is a co-owner, psychologist, and assessor at Lumos Assessment Services, which focuses on empowering underrepresented populations to achieve success in traditionally inequitable academic and career environments.

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