What to Do When Your Teen Refuses Therapy: A Sketchnote
To the frustration of parents everywhere, many teens struggling with mental health symptoms initially refuse to see a therapist. In this article, you’ll learn how to help connect therapy-reistant teens with mental health providers through:
- changing how you communicate about the symptoms they are experiencing
- educating your teen about what therapy is and how it works
- and understanding how therapy refusal doesn’t have to be the end of options for getting your teen help.
A Patron recently introduced me to a parenting podcast called Ask Lisa: The Psychology of Parenting. In this series, parent and psychologist Dr. Lisa Damour joins cohost Reena Ninan to engage the most pressing questions of modern parents.
As I listened to a recent episode, I sketched along as Dr. Lisa explored strategies for helping struggling teens who refuse therapy. You can listen to the full episode here: #65: My Depressed Teen Refuses Therapy. How Do I Help? Ask Lisa: The Psychology of Parenting
Got a podcast, research article, or other resource you’d like to see visually translated? I love recommendations! Drop me a comment below or use my contact form.
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Teen-hood isn’t just a phase of development that affects mood and attitude, it’s also a life-stage in which many mental illness symptoms begin.1 In fact, “One half of all serious adult psychiatric disorders start by age 14 years.”1
Figuring out whether your teen is just bumping through a difficult period of development or struggling with the symptoms of a mental illness can be challenging – but it’s not something parents have to figure out alone.
Now more than ever, teens can benefit from the support of a therapist or mental health counselor. Some struggling teens can benefit from simply building a nonjudgmental relationship with a non-parent adult (see: this article on PCEs) while other teens may need specific therapy interventions to treat more serious mental health symptoms.
Consulting, as a parent, with a therapist that works with teens is often the best first step. In fact, it’s the strategy that Dr. Lisa Damour of the Ask Lisa podcast recommends that parents follow when they are struggling with a teen who refuses therapy.
In the sketch note below, I illustrate the three strategies that Lisa recommends for parents of teens who don’t want to go to therapy:
Meet with the therapist for parent coaching.
Therapists who work with adolescents are experts in communicating with teens.
Even if your teenager refuses therapy, you can use an adolescent counselor as a resource for information or advice about what your teen is going through and how to get them to therapy.
As a bonus, this often outsmarts waiting lists. If you wait on a therapist’s waiting list for a consult, when your teen agrees to go, you’ll already have a no-waiting-list therapist ready to meet.
Talk with teens about what therapy is (make it less scary)
Therapy in the movies (especially some movies) seems pretty horrible. Combine that with the stigma that still persists around mental health, and it makes sense that teens would refuse therapy!
Like anything, talking about going to therapy can reduce stigma and fear. Tell your teen about a time that you yourself had a positive experience in therapy or explore media with positive representations of therapy.
Media Depicting Therapy Well
While there is always a bit of dramatization when filmmakers depict the process of psychotherapy, some good movies and TV shows to watch with your teen include: Good Will Hunting, Sixth Sense, Monk, Crazy Ex-Girlfriend, or A Million Little Things.
For more authentic and intimate portrayals of real therapy, appropriate for older teens, I highly recommend the podcast of Dr. Hillary L. McBride, “Other People’s Problems” which features recordings of actual sessions that clients have consented to share.
Connect your teen with the therapist you met.
It’s likely, if you get coaching from a therapist that works with adolescents and begin having nonjudgmental but educational conversations with your teen about what therapy is, that at some point (perhaps a low point) they will agree to check out therapy.
Don’t wait for an enthusiastic yes. Look for a moment of “maybe” and give your teen a chance to check it out with one visit.
For therapy to work, it’s important for your teen to feel like their therapist is theirs and that their sessions are private. Once you connect your teen to a therapist, give them both space.
Talking with Teens about Going to Therapy: How to Convince Your Teen to Go
1. Reframe
According to Dr. Lisa, parents of teens who refuse therapy should avoid language that reinforces the idea that they are “sending their teen to therapy.” Many teens are already concerned by their own mood swings and strong feelings. Normal adolescence can feel like going crazy sometimes! Be sensitive to this fear.
Reframing can help. Reframing is a method therapists frequently use that involves rephrasing a self-critical thought with self-compassion.
Help your teen shift away from thinking “my parents think I need therapy, I must be crazy” to “I need and deserve care my parents can give right now.” In the latter example, getting connected with a therapist re-phrases the issue as one of self-care and parents’ care rather than labeling.
2. Name the voice of mental illness
Teens tend to respond well to a therapeutic approach that gives symptoms, or an entire mental illness, a name. By personifying the symptoms, it is easier to think of them as separate from our identity (which is a very good thing, since over-identifying with trauma or mental illness can slow recovery).2
Naming ADHD symptoms “Gary,” for example, allows a teen to have a conversation with their ADHD symptoms rather than thinking their worst mental health symptoms are “who” they are.
This can benefit self-esteem, but more importantly, it can help us make decisions using more rational parts of our brain.
For parents, this might look like saying “I know you don’t want to go to therapy and that you don’t think that it will help, but that’s your depression talking.”
3. Admit your limitations
When kids are young, they think that parents can handle anything. Adolescence is a period of shifting into a more adult view of parents. Acknowledging your limitations can be a way to acknowledge what they are already sensing: mom or dad can’t fix this. The job of a good parent, then, is to connect them with resources that can.
Image Description for Screen Readers:
Sketchnote titled “When Teens Refuse Therapy. A sketchnote from @AskLisaPodcast by @LindsayBraman.”
A grey banner at the top of the left side column reads, “Strategies for Parents.” Under this are three images with suggestions. The first is an image of two people talking to one another. The text reads, “1. Meet with a teen therapist for parent coaching. (Pro-Tip: this outsmarts the waiting lists).” The second image is of a person reading a book titled “THRPY,” and the text next to it reads, “2. Talk with teens about what therapy is. (make it less scary).” The third picture is of a person standing in a room with a couch and a lamp. The text next to this reads, “3. Connect your teen with the therapist you met.”
Below this, black, hand-written text reads, “it’s okay to… ASK your teen if they are having dark thoughts. Phrase it like: ‘Are you safe? Do you need more support to keep yourself safe?’ (written in a speech bubble and a light bulb). If no, don’t wait for treatment. Call pediatrician or go to ER ASAP.” Next to this is a drawing of a game controller connected to a screen that is displaying the back oof a person’s head as they stare out at roads cutting through mountainsides.
On a yellow banner in the center column is written in black handwriting, “Every teen secretly worries they’re crazy.” An arrow points from this banner to more text that reads, “And that’s normal! Adolescence is hard, but getting ‘sent to therapy’ reinforces it.” An arrow points from this text to the right side of the image, where there is a number one in a grey circle. Next to this is written, “Reframe: Change ‘My parents think I need therapy, I must be crazy! Into “I need and deserve care my parents can’t give me.” The last two phrases are each written inside gold frames.
Underneath this is grey circle with the number two inside. Next to this is written “Name the voice of mental illness.” In a speech bubble is written, “I know you don’t want to, but that’s the voice of depression.” A blue and white checkered line is in the middle of the image. On the right side of the image is the number three in a grey shape. Next to this is written, “Say: What we’re doing now is NOT WORKING (written on a yellow background for emphasis). Therapy might.” The source of this image is Ask Lisa: the psychology of parenting podcast. Episode #65. Visually translated by @LindsayBraman.
- Committee on Adolescent Health Care. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/07/mental-health-disorders-in-adolescents
Number 705. July 2017. [↩] [↩] - “Beginning with a definition of oneself as mentally ill and the assumption that mental illness means incompetence and inadequacy, a process may unfold in which persons become at risk of ceasing to try to work and fit into their communities.” Yanos, P. T., Roe, D., & Lysaker, P. H. (2010). The impact of illness identity on recovery from severe mental illness. American journal of psychiatric rehabilitation, 13(2), 73-93. [↩]
