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How Do I Get My Teen To Attend Therapy? PDF Print

Many parents come to a place where they think their son or daughter could benefit from some counseling, but they are unsure how to get them to come in.

Let me first say that therapy is most successful with people who want to be there. However, it is the rare teen that walks up to their parent and says, "Mom, Dad, I've noticed I haven't been myself lately. You don't know this, but I have been using methamphetamine and thinking about killing myself the past 2 months. I think I could use some counseling." Instead, parents see the behavioral signs - the yelling, mood swings, isolation, drop in grades, etc. A balence must be struck between insisting your child attend therapy (as you would a doctor's appointment), and realizing that therapy will not be successful if the teen adamently does not want to be there.

Just a note: If you have the rare blessing of a teen or pre-teen asking for counseling, please seek counseling. It is usually a teen that is in a large ammount of pain, and their efforts for getting help should be taken seriously.

About 2 weeks ago, I had a 14 year old girl come in with her mother. Her arms were crossed, her eyes were glaring, and she was giving one word answers. This is not so unusual. When I asked her why she thought she was there in therapy, she said she didn't know, and that her mother had told her they were going shopping but instead they had come to therapy.

This is a set-up for failure both for the teen and for myself. How can she NOT be angry and defensive about therapy when she was lied to? In situations like these, it is difficult to move past the initial anger and betrayal and move into a time of processing the reasons for attending therapy.

This would be an example of how not to have your teen attend therapy.

If you believe your teen may be open to attending therapy, I recommend you speak to her about some of your concerns before coming to session. Explain why you think counseling may be a good idea. Some teens think therapy is a punishment. Some think they are attending therapy because you (the parent) think they are REALLY messed up.

Here are some conversation starters:

"Sara, I have noticed that lately we have been fighting alot. And I realize that I don't really know how to stop arguing with you about your grades, because you used to get A's and now you get D's. I love you and I'm worried about you. I would like us to attend counseling so that we can work on this together. I'm not sure if it would be better for us to meet together or for you to meet alone with the counselor. But, I'm going to schedule and appointment, and we can all sort that out together."

Or:
"Jake, I am very upset about finding that you've been smoking cigarettes. I am worried because if you've been sneaking around smoking, it makes me wonder what else you've been doing. I am going to schedule a session with a counselor, and if she is a good match for you, I am hoping you guys can talk about what is going on."

Or:
"Amber, I have noticed that you just don't seem like yourself lately. You look sad, you've stopped attending choir, and you look like you've lost joy. Have you ever thought about talking with a counselor? I think it will help. I am going to schedule a session."

It is asking alot of a teen or pre-teen to have them say that they want to attend therapy. If they are going along with it with minimal resistence, that is often their way of agreeing without losing face.

If your teen does not want to attend therapy, I recommend telling her that you want her to attend 4 sessions, and then you, she, and myself will discuss if more sessions are needed. Often, during the first session, the teen is so angry about being "forced" to attend therapy, that the first session is spent understanding that anger. If the teen were to decide if they wanted to continue therapy at this time, many would say no, just to get back at mom or dad for having forced them to attend.

During the 2nd through 4th sessions, we are often able to get past this initial anger, and begin discussing the pain. It is when the teen begins to discuss their pain, that their reason for attending therapy becomes less about being "forced" to attend, and more about reducing their own pain.

Here are some conversation follow-ups for teens that are not open to therapy:

"Sara, I know you don't think you need counseling, but I do. Your well-being is important to me. Let's make a deal. If you genuninely try counseling for 4 sessions, and then hate it, (barring any safety concerns), I won't force you to keep going. But for the agreement to stick, you have to really try counseling. Do I have your word?"

Or
"Jake, no I don't think you're crazy. I think you're creative, wonderful, and stuck in a rut. The teen years can be really difficult, and I want us to go to counseling so that you can be all that you can be, and not get bogged down by peer pressure, stress, or whatever is making you want to smoke. I want you to attend 4 sessions. After 4 sessions, you, me and the counselor will sit down and discuss if you need to keep coming. Would you prefer going on a Saturday or on a Monday evening?"

Or
"Amber, yeah, I know talking with a stranger about your problems sounds weird, but I think it's really important. I'd like you to try it for 4 sessions. If you don't like it after that, then we'll find a different counselor that might be a better match for you."

It may be appropriate to continue counseling after the 4 sessions, even if your teen is not open to continuing. We will assess and decide that together.

There are exceptions to the 4 session recommendation. If there are safety concerns such as any type of suicidal ideation, substance use, self-mutilation, or if your teen is a danger to herself or others, they are not in the position to decide if they want to continue therapy or not. Until their safety concerns are resolved, they should attend therapy for their own safety.

Here are conversation starters for a teen with safety concerns:

"Stephanie, last night when we were fighting, you said you wish you were dead. I don't know if you were joking or if you were serious. I know you're going to say you were joking. But I care about you too much to take a chance, so I am scheduling an appointment with a counselor so we can sort this out together."

Or,
"Todd, when the cops brought you home and you were drunk, it really scared me. I don't know if it was a one time thing, or if you have an alcohol problem, but I love you and don't want to ignore something so serious. We are going to attend counseling. We can talk about why we're attending counseling, but just know that you are not talking me out of attending. We are meeting on Thursday after school."

Or,
"Emily, I read on your MySpace that you cut yourself sometimes. This really scares me. I want you to talk with a counselor because I love you and want to help you through this time."


If you would like help in creating a plan for talking with your teen about attending counseling, call me, and we can schedule an appointment to create a plan that would work best with your teen.