How to Encourage Resistant Teens to Consider Therapy

NOTE: Two communication tactics the mother in this story employed well with her teen were validating his feelings and opinions and using open-ended questions to get her son to open up. 

It’s not easy to approach tough subjects with teenagers, especailly when they’re already on edge. Seeing our kids stressed, anxious, and struggling to manage their anxieties (and other uncomfortable emotions) is hard! It's like watching someone who just can't get out of their own way, but that person is our own kid. This adds a whole new layer of 'not wanting to be too pushy' or 'needing to talk to them in a way they're going to be receptive to'.

A friend of Teen Brain Trust recently encountered such a conundrum when she spoke with her son about starting therapy. In this article, we’ll share how she worked through her son’s resistance and got him to consider therapy. We’ve decided to keep their identities anonymous so as to not identify the teen in this story. The mom recounted her experience with us to help other parents talk to their teens about starting therapy. For the sake of this story and our friend’s anonymity, we’ll call her ‘Mrs. R’ and her son ‘Andrew’ in the continuation of the text.

Even though it’s our role as parents to be there for them, we’re not necessarily the most qualified (or objective) person to help establish positive mental health habits that will follow them through life. There are times when it makes more sense to reach out to a professional for guidance. While talking with a therapist is more destigmatized than ever, a lot of teenagers can’t help but feel self-conscious about scheduling that first session and opening themselves up to the idea of asking for and receiving help.

Understanding her son's needs

Mrs. R’s son was always the most anxious of her children. When Andrew was younger, she was always able to work through his anxieties with him and talk it out.

When he went away to college, his anxiety grew as things got more complex. On his own for the first time, he had to manage his anxiety without parental support all while coping with a long-distance relationship and pressuring himself to get straight A’s at school. During his moments of high anxiety, he would call his mom and she would do her best to talk him through it, the way she did when he was younger. 

Mrs. R tried to provide adequate support over the phone, doing her best to validate his experience and going so far as to suggest breathing exercises. But she felt she was no longer the best person to provide that support. She realized a professional could be much more beneficial in helping him build the skills he needed to manage his own anxiety.

starting the conversation

In recounting this story to us, Mrs. R pointed out how challenging it was just to introduce the idea of therapy to her son. She was cautious about bringing it up for fear that he’d shut down and not be receptive at all. She herself had gone to therapy and recalled how difficult it was to acknowledge the need, so she wanted to be really mindful of the way in which she approached this topic. 

Once she finally did build up enough conviction to propose the idea of therapy, her son’s response was not encouraging. Upon her first, tentative, broaching of the subject, Andrew’s response was a brief “I don’t need therapy”. 

At this point in the story, Andrew still saw ‘going to therapy’ as an admission of ‘something is wrong with me’. Mrs. R’s trick was to both validate his perspective AND gently try to untie these two ideas.  She used open-ended questions to try to understand more. While she wanted to explain that going to therapy means you want to grow, not that something is “wrong”, she decided to leave it alone for the time being. It wasn’t the right moment - she needed to be patient.

Therapy is still closely tied to the notion of being unwell. The simple idea of asking for help can feel threatening to adolescents and adults alike. Even Mrs. R recounted feeling unsure about therapy when she first got started. She had to take into account what having a conversation about therapy meant to him. Would the idea of therapy make him feel ashamed? Would it stress him out even more? With these things in mind, she knew that she had to find a way to keep the conversation alive so he could come around to the possibility on his own. 

*TBT jumping in to suggest that, should you find yourself in a similar situation, using open-ended questions is a great way to deal with conversation stoppers like ‘I’m not the type of person who needs therapy’. Asking our teens things like “What do you mean by that?”, “Who do you think is best suited for therapy?”, and “what makes you feel that way?” are all good ways to keep the conversation going and not simply melt into a defeated puddle on the floor. 

leading the thought process

Over the next few months, Mrs. R continued helping Andrew manage his anxiety over the phone to the best of her abilities. She would occasionally bring up therapy in moments of calm, when tensions were low, and things were okay. When he was processing things out loud, she would listen, and then say things like “I am wondering if this is something you might want to talk through with someone who has more knowledge on giving support “ 

While Andrew continued to repeat his original response of 'I don’t need therapy', Mrs. R continued to bring up the idea every now and then.  

The next time he said 'I don’t need therapy', she posed a new question: “Who do you think might need therapy?” It was at this point that he changed his narrative. ‘It’s not that’ Andrew said, ‘It’s just that I'm not comfortable talking to someone I don't know'. This was something she understood, and that presented itself as an opportunity.

This was the underlying information that Mrs. R needed to help Andrew work through and consider pursuing the idea. She finally had a more clear understanding of what the apprehension was. This pointed her in the direction of making more compelling conversation points - because she resonated with that. She understood where he was coming from and felt like she could work with that.

“My first move was to inform him that I understood. I said something like, 'I feel uncomfortable sharing my deepest darkest secrets too'. I then went on to talk about any new friend, girlfriend, or other relationship. It takes time to get to know someone before you can really share your vulnerabilities.” 

Mrs. R felt that she couldn't just tell him to see a therapist. In order for therapy to work for him, he had to want to go. He had to see it as potentially helpful. The desire to see a therapist had to come from him. So what could she do to get him to want to see a therapist?

how she got him to think about therapy

Ultimately, Mrs. R had to put a few parenting tools to good use, but what helped the most was just really validating how he was feeling when he’d have bouts of anxiety. They’d discuss his anxiety and his feelings around therapy, and she validated his perspective when he was stressed and anxious. She had to be patient.

When he was stressed and in need of help, she would say 'that situation seems like it could be helpful to talk to someone about. They might be more constructive than me'.

And then just keeping quiet, listening to his responses, and validating whatever he said. Not having therapy on the agenda at all.

“After months of doing this, there was one time when he got really really anxious and stressed and I just listened and sat in the stress with him, not trying to be the fixer but just being with him. This period was deeply felt by him. After that episode, he came home and said to me  'I'm really sorry I was so short and belligerent  to you'. I said it’s okay, I know you were really stressed and anxious. 

This was endearing to me because I didn't think he was being mean at all. I knew it was the stress manifesting. In retrospect, I think he was reflecting on how he acted toward me and felt bad about it, and wanted to apologize for taking it out on me. While he was curt and perhaps irritable during this time of intense anxiety, I was so in it with him that it never occurred to me that he was being mean-spirited. I didn’t take it personally because I knew it was his stress, not me.” she recounted.

Mrs. R recognized that this was her 'in'. He was self-reflective and unhappy with how he was acting. She responded by saying “It’s okay, I totally get it, you were stressed and I felt for you.” She followed that up by saying 'When you’re feeling so stressed, might it be helpful for you to talk with someone about it other than me?'

He responds, 'Yeah, I think it might be helpful. I think I might need it'.

the breakthrough

This was the moment Mrs. R had been hoping for. They’d finally come to an agreement that there’s nothing wrong with seeking help from the pros.

Mrs. R asked if Andrew would like her to find some referrals for psychologists, to which he agreed.

She asked 'would you like me to just pass you their names, or do you want me to talk to them first to get a sense of their style?' and he responded by saying 'Yeah, I'm very happy for you to screen them before you send them to me, as it might be overwhelming for me’. 

BTW - Therapists are sensitive about talking to parents - they wanted to make sure the teen  gives permission for them to talk with the parent. Mrs. R wound up sending him two recommendations to talk to and see who he felt more comfortable with.

starting therapy

After Andrew had his first session with one of the recommendations, Mrs. R excitedly asked him how it went. He said it was a lot, and shared how he felt uncomfortable talking with someone he doesn’t know. Mrs. R validated his experience.

She said, "I totally get it, I know it's gonna take some time, and I know it's hard".

NOTE: It’s important for parents to understand that teens might not have an easy time in therapy. Their experience might not reflect theirs or the ones they've heard about.

Mrs. R felt like a weight had been lifted off her shoulders. An expert would help guide him through this. As hard as this was, she knows that her son learning to manage his anxiety and stress is such an important life skill for him to have.

“No matter how hard going through this process with him is, I have full conviction that it will be worth it. I'm giving him the best life skill ever by teaching him to take care of himself and manage his own anxiety. 

He's taken the first step forward into his next level of growth, which is uncomfortable. I couldn't be prouder of him for taking on that discomfort to work things out for himself.”

what we think worked

Overall, this venture was full of replicable lessons for parents struggling to talk with their teens about therapy. Here’s a summary of what we think made it work for Mrs. R and Andrew. 

• She was able to sit with his discomfort and allow him the space to work through it
• She actively validated his feelings and opinions, making sure he feel heard
• She was open to and accepting of his resistance to therapy 
• She didn’t push him into it, instead letting him come to the decision on his own
• She made sure he felt like he could really ‘vet’ the therapists to make sure he found someone he was comfortable talking to. It's all about fit!

It’s important to remember individual differences in adolescents. While Mrs. R got his buy-in, that's not how this story might end for everyone. Therapy needs to speak to them. Another friend of Teen Brain Trust had two kids that happily went to therapy while the third needed a completely different approach to even consider it. 

Lest we forget, it’s never going to be the same process for two different teens. We’re always curious to hear your stories and start a conversation.