How Do I Talk To My Teen About Therapy?

Parents often call me with concerns about their adolescent or teen.  They may be concerned that their son is withdrawn or that their daughter is defying every instruction given.  They may be worried about who their child is spending time with, or a recent dramatic drop in grades.  Their teen won’t talk to them anymore so they don’t know what’s really going on or what to do.  It is common for parents to feel confident that their child needs counseling but be completely unsure how to convince them to go.  “I can’t even convince them to eat breakfast!”  Below are some strategies that may help:

1.     UNDERSTAND THAT THEY PROBABLY WANT TO GO:  Believe it or not, if you think your child would benefit from counseling there is a good chance they think so too. They just don’t want to admit it to you or anyone else.  There is a stigma to going to counseling and so they need to find a way to “save face” if they do agree to go to counseling.  Keep this in mind as you begin to talk to your teen about counseling.

2.     I’M NOT TRYING TO FIX YOU: Avoid bringing the topic up in a way that says “there is something wrong with you and a counselor can help you fix it”.  Instead say something like “It makes sense to me that you are finding your independence and aren’t talking to us like you used to.  I’d like to find a counselor that you feel good about talking to in case you need an adult’s perspective and don’t want to talk to us about it.  I can send you a list of counselors that accept our insurance and I’d like for you to pick at least one that you are willing to meet with and just see if it could be helpful to you.”

3.     EMAIL/TEXT/WRITTEN NOTES:  Allow them to communicate with you about this without verbally engaging you.  Start with a verbal conversation but let them respond in other ways that are more comfortable to them.  Saying, “I’ll email you some counselor websites and you can let me know which ones you want to meet with,” allows them to email or text you back if that’s easier for them.  This will help them to “save face”.

4.     LIMIT YOUR EXPECTATIONS:  The maximum requirement you should have is that they meet with at least one counselor at least 4 times.  Ideally they will meet with more than one, pick one and meet with that one 3 more times but don’t require this.  This will give them an opportunity to open up to the idea and possibly decide that it’s helpful because THEY want it—not because you do.  Beyond that it’s not very helpful.  Forced therapy is just as pointless for teens as it is for adults.

5.     LIMIT FOLLOW UP:  Don’t press too hard for how they feel about the counselor after the session.  A simple “thoughts?” will suffice.  If they don’t respond, that’s okay.  Just follow it up with “Okay, just let me know by Friday if you are going to see this counselor or the other one and I’ll get it set up.”  Don’t get mad or huffy that they aren’t responding.  It’s hard for them to talk about and hard to admit that they like a counselor so let them sit in silence about it.  Also, if they’ve decided on a counselor and decide to keep going don’t act too happy or talk AT ALL about how happy you are that they’ve decided to keep going.  Oftentimes teens don’t want to make you happy so this will backfire.  At a minimum they will roll their eyes at you, at a maximum they will refuse to go no matter what privileges you remove.  Stay cool.

6.     SCHEDULE THE APPOINTMENT:  If the deadline to decide comes and goes without a response give a quick reminder “I’m going to call today to make the second appointment with one of the counselors you talked to, can you let me know which one?  If not, I’ll go ahead and pick one.”

7.     PRIVILEGE REMOVAL:  Yes, you can make privileges contingent on meeting with counselors and even having a few follow up sessions.  If they really don’t want to go after that it’s important to know that it’s very unlikely that it will be very valuable for them.  Would it be valuable for you?  Thank them for trying and tell them that they can let you know at any time if they want to try other counselors or go back to one that they met with before.  When you discuss taking privileges, say it this way “It’s important enough for us that you give counseling a try that we have decided that we can only let you use the car if you at least meet with these counselors and have at least 3 follow up sessions with one.  As long as we’re working on that, you can use the car.”

8.     DO YOUR RESEARCH:  Find a counselor that builds rapport with adolescents and teens well.  Many teens are reluctant to go to counseling because they have gone to counseling in the past with a counselor that wasn’t very good at their job.  Other teens are reluctant because they have a very “cliché” concept of what therapy will be like.  If you pick someone who isn’t good at this you can just expect it to fail right away.  It takes a special skill set to work with adolescents and teens and just because a counselor says they’ve done it before doesn’t mean they are actually good at it.  Ask your friends, ask the school counselor and talk to the counselors themselves about how they “build rapport”.  Oftentimes counselors who have only done outpatient counseling are not a good fit for adolescents and teens.  Counselors who have worked in Residential Treatment facilities or Wilderness Therapy settings are a good bet.  They have experience with some of the most therapy-opposed clients out there and have likely found some great tools to build rapport.

9.     GET YOUR OWN SUPPORT:  Even though it takes a different skill set to work with teens, counseling still supports teens in the same way it supports adults.  It gives them a place to be seen and heard.  I often have parents call me before a session and say “He got angry and threw something across the room last night.  Can you talk to him about new coping skills or find out what he’s so upset about?”  My response is usually a resounding “no”.  Imagine if your partner called your counselor up before your session and said “Betty has been really depressed this week.  Can you talk to her about coping skills?”  That’s just not how counseling works.  The only person who really gets to decide what they work on is the client.  What you CAN do, though, is get your own counseling with someone who is also skilled at Parent Coaching.  This will allow you both the time to be seen and heard and supported through all of the emotions that are coming up for you AND some concrete skills to support your teen.  This is especially important if your teen refuses counseling.  You may be surprised at how much your child’s behavior can improve because you are getting the help you need.