You have identified that your teen can benefit from professional mental healthcare, and you’ve already scheduled the first appointment with a mental health professional. These are important first steps to have behind you. And as you now await that initial appointment, if you have not already done so, talking with your teen about attending therapy is very important.
In my practice as a Licensed Clinical Social Worker, I have met many teenagers who did not know they were heading to a therapist’s office that afternoon. Generally, when teens feel forced or tricked into going to therapy, their motivation to work toward change is low and the experience will likely not be very effective. Therefore, engaging with your teen before the appointment and involving them in the process is highly recommended.
Below are some discussion points to consider in order to help increase your teen’s buy-in and improve the overall experience.
Express Your Concerns
A thoughtful and intentional approach can make a world of difference. A teen who is approached in an accusatory manner will likely respond defensively, and a teen who is approached as someone who is disappointing and in need of fixing will likely feel ashamed. Instead, share your concerns for their well-being as openly, lovingly, and non-judgmentally as possible.
Focus on the behaviors or moods that have heightened your concern, and strive to not define or label your child based on their behaviors or moods. For example, you could say, “I am concerned about the sudden way your grades dropped and the changes in how you have been interacting with your siblings, coaches, and friends.” Also make an effort to eliminate words like “never” and “always” when discussing your concerns. For instance, avoid saying, “You are always in a bad mood” or “You never leave your room anymore.”
Be honest about your limitations as your child’s parent/caregiver, and let them know that it could be beneficial for them to have a mental-health professional outside of the family who they can talk to and who is experienced at helping teens through difficult experiences.
Explore Hopes, Expectations, and Fears
Every teen is different in how open they are to therapy and how expressive they are with their thoughts and feelings. Asking some open-ended questions can help you gain more insight into what your child is thinking and feeling before their first appointment. Here are some questions to ask your child:
- What do you think about therapy? What do you think will happen there?
- How do you feel about talking to a therapist? What makes you feel ___ [insert emotion]?
- What do you think you might want to talk to the therapist about? How could they help you?
- What questions do you have about going to therapy? About this first appointment?
If concerns arise in their responses, you may feel comfortable addressing the concerns yourself, while others you could look up together online. Jot down any remaining questions, and ask them at the first appointment.
For children who are either not as able or comfortable communicating these things, hearing you ask questions will show that you are there to help and support them in a nonjudgmental way. This alone may help spur your child’s self-reflection about their own wants and needs.
Discuss Boundaries Pertaining to Information and Privacy
Your teen’s mental-health professional will explain to you the limits of confidentially, which define what information is exempt from the “what is said in here stays in here” protection of talking with a therapist. These limits vary by profession/license and state; however, the most common limits involve an imminent risk of suicide, threat to others, child abuse/neglect, and elderly adult abuse/neglect.
What is important to realize is that depending on your child’s age and your state’s laws, as their parent/guardian you likely have a right to their records and documentation. It is important to discuss with your teen and with the therapist what sort of boundaries can be expected and what level of confidentiality your teen can expect. While you likely will not have this all sorted out until the first appointment — where you will learn exactly what limits exist and the therapist likely has recommendations on how to handle status updates — it is helpful to begin this conversation with your teen ahead of time.
Ideas for When Your Child Refuses Therapy
You and your teen may not be on the same page regarding the concerns that you have shared, or your teen may just not feel ready or comfortable engaging with an outside mental-health professional. So if your child is resistant to therapy and refusing to attend, consider some additional options.
- Try negotiating for an agreement to attend at least the first five sessions (or go down to three).
- Determine if accessing therapy via an online platform would be more agreeable to your teen and appropriate based on their need.
- Consider offering a reward or incentive for attending the first session, such as dinner out afterwards at their favorite eatery, extra time playing a video game, or buying movie tickets for them and a friend for the weekend.
- If you haven’t already, identify if there are any school-based services offered that may be a better fit for your teen.
- If there are reasons to be concerned about safety as a result of suicidal thoughts and behaviors or risky behaviors, such as substance use, it is appropriate to make attending sessions a requirement, because their concerning behaviors have an impact on their decision-making ability. In the end, as the parent/caregiver, you have a responsibility to provide them with medical care and safety.
Getting outside help, especially for the first time, is generally anxiety-provoking for most people. As a parent, you may have an urge to decrease your own anxiety or limit your teen’s anxiety by not discussing these topics. While avoiding these conversations may help in the short term, overall it could be quite unhelpful in the long term. Increase the likelihood of success as your teen gets help by including them in the process, providing them with a respectable level of privacy in therapy, and addressing their needs, wants, and fears openly and with negotiation if needed.
My hope is that through your support, a helpful mental-health provider, and your teen’s participation, your child can get back to better with a healthier life ahead of them.