Going to therapy is hard enough for adults. Stigma, fear, and a misunderstanding of how counseling works sometimes stops many of us from picking up the phone and making that first appointment. Plus, therapy is hard work. It often requires revealing our vulnerabilities, delving into difficult challenges, changing unhealthy patterns of behavior, and learning new skills.
So, it probably comes as no surprise that kids might not want to go either. This resistance only escalates when they misunderstand how therapy works. Many children are afraid or nervous to go to therapy, especially if they have the belief that they are in trouble or that they shouldn’t have the feelings they experiencing.
So how can you engage your child in therapy when that’s the last place they want to be? It is important to get to the bottom of why your child is being resistant and try to change his or her mind. Understanding the reasons your child has for being resistant will help you tailor how you respond. Convincing older kids to do something they don’t want to do is difficult, to say the least. As your child grows, especially during the teen years, they want — and, developmentally speaking, they need — to have more control and independence.
Here are some common reasons why a kid might say no to treatment and what you can do about it.
He doesn’t think he needs help. Sometimes children will disagree that they have a problem, or think that what they are struggling with is a part of them that can’t or shouldn’t be treated. When kids think that they can’t get better it is sometimes because he can’t imagine feeling better or because he has started finding comfort in it, so the idea of getting treatment can actually be quite scary. When kids don’t think they have a problem or are uncertain about what treatment can do for them, start by asking the child what he wants to get out of it — not what you or his teachers or anyone else wants. What is he looking for at this stage? What kinds of things would he like to be able to improve? Then the therapist, parents, and child can outline how the things he’s motivated toward might be achieved in therapy.
She feels ashamed of going. One common mistake a parent sometimes makes is to shame or blame the child. An example would be using the therapist as a punishment: “If you don’t cut that out, you’re going back to Miss Kelly’s office!” This causes the child to feel like she is a bad person. Instead, be honest about why you want your child to attend therapy. Say something like: “We are going to therapy because _______ happened in our family/at school. This is a special place where you can talk about your worries and your feelings in a safe place. It is also really fun and the person who will be helping us is really nice.”
The parent hasn’t told the child of the appointment. Another mistake parents make when trying to get their kids to go to therapy is not telling them they’re going to therapy in the first place. Oftentimes, the therapist will later find out that parents have told their child on the way to the therapy appointment so there is no time for the child to express themselves, ask questions, express concerns or even ask for reassurance or a hug. Springing this on your child is never a good idea and sets an example that manipulation is okay. Instead, give your child time to adjust to her feelings of seeing a therapist and answer any questions she may have.
He is scared of being vulnerable/having feelings. Not understanding a certain feeling makes children uncomfortable. They haven’t yet learned to process through a feeling that causes discomfort. They just know they don’t like the emotion they are having. However, it’s important to not run from the discomfort or dislike. Work with the therapist to help your child navigate his or her discomfort. For older teens, it is imperative to add that receiving counseling is not a sign of weakness. It takes courage to address problem areas and examine painful feelings. Entering counseling is taking the first step in resolving these difficulties. A child will need to learn to identify different emotions, oftentimes because he was taught that only a couple were permissible. He needs to be able to vocalize his feelings and thoughts without fear of being reprimanded; identify “safe” people for relationships; avoid repeating behaviors that parents may have taught him; and how to conquer the little critic deep within him. Without a guide such as a counselor, a child might be overwhelmed with trying to learn how to navigate through that muddle of emotions and behaviors he is experiencing.
The parents are not engaged in the therapy process. It’s not helpful when parents avoid engaging with the therapist. Many parents will arrange transportation for the child to attend therapy and the parents never set foot in the office. Or the parents don’t encourage the child to utilize the skills she is learning in therapy. This hinders progress, and prevents kids from learning to work with their parents — their primary support. Many kids are working on learning new and effective ways to express their feelings, and if their parents are not open to hearing and allowing their child to express themselves this could be detrimental to the healing process.
She doesn’t think therapy would work. Whether you are concerned about behavior, ADHD, or a mental health issue, start by talking to your child’s primary care physician. A doctor can assess your child’s needs and help determine whether there is a physical issue or if your child needs counseling. If your teen isn’t willing to listen to your recommendations about how therapy can be helpful, she may be willing to listen to her physician. Her doctor may be able to explain how counseling works and how treatment could address the symptoms. When therapy is necessary, use statements to help your child understand why therapy is so important such as: “I love you too much to not do this right now. I love you too much to allow this pain you are feeling to continue without help.”
The therapist isn’t a match. It is important to find a therapist who is a good match for your child’s personality. If she doesn’t like or respect the person that she’s working with, or thinks she can outsmart her counselor, it isn’t going to be a good fit. Although it’s very frustrating, you may need to keep looking until you find the right person, preferably a therapist who has worked with children and teens in the past. Sometimes parents decide to come to the initial visit, without their child, to meet the therapist and ask some questions. Clinicians should also have good pointers on what you can be doing at home to help. If your teen has already tried getting treatment but it hasn’t helped, or she didn’t like the person she was working with, ask your child why she thinks that is. For example, what wasn’t helpful or what didn’t she like about therapy? What did she like? You can keep these qualities in mind and work together to find a therapist who does more of the positive things.
He thinks getting help is embarrassing. It’s common for teens to be embarrassed by their problems and it can be hard for them to admit they need help. So it’s important to avoid sending a message that could cause him to feel ashamed. The way you express your concerns makes a big difference in how your teen is likely to respond. Say something like, “I wonder if it would be helpful for you to have someone to talk to besides me.” Or say, “I don’t always know how to help you with problems so I wonder if it could be helpful for you to talk to someone who works with teens.”
She’s feeling defensive. This an understandable reaction from someone who is tired of repeatedly struggling or getting negative attention over behavior. This is the season when children, especially teens, are developing their personal identity, and if they feel they are being judged, they may turn away from whatever their parents say or suggest. Recognizing this stage of life may be helpful when encouraging your teen to attend therapy. Tell your daughter that you don’t think something is wrong with her and that you’re not encouraging the therapy sessions to “fix” any flaws. Instead, explain that therapy can be a judgment-free place in which a person can talk with a counselor about the many important, stressful decisions she faces on a daily basis. Inform your teen that the therapist will not try to change or judge her for any past mistakes. Assure your teen that the therapist will gradually get to know her. Reassure her that you are proud of her accomplishments instead of focusing on the possible negative factors that may have been a cause for beginning therapy.
She thinks the therapist will tell the parents everything talked about in therapy. Many kids and teens do not want to go to therapy because their parents reveal their problems to the therapist in front of them or will ask for a report of the session and what was talked about. Communicate with the therapist in private about both struggles and positive changes at least once a month. However, confidentiality is important to everyone, including (and perhaps especially) teenagers. Teens don’t want to feel that their parents and the therapist are ganging up on them. Explain that the therapy office is a private place and that conversations between therapists and clients are confidential. Remind your teen that you are not expecting the therapist to team up against her, but rather to be an additional support. Let your child know that you will only be asking for an update of things that you can help with at home but will not ask for specifics. The therapist should also go over what can and can’t be told to mom and dad.
The therapist challenges him or the work/behavior change is too hard. Healing doesn’t just happen inside the therapy office. It’s important to implement interventions at home, which is another key part of parents being involved in the process. Provide feedback to the therapist about what has worked and what has not worked. Also, be supportive. Let your child know that they can talk to you about how they feel therapy is going. Because your child will be confronting difficult issues in therapy, they’ll need your support. The therapist may give you a forecast of upcoming sessions that may be difficult for your child. Tell your child, “I know the next few sessions may be more difficult for you, but I am here to help you through it. Your therapist is here to help you too. Together we navigate these difficult feelings.”
There is a stigma attached to therapy. There is sometimes an unfair bias against getting help for mental health issues. When you suggest counseling the child hears judgment or they hear they are a horrible human being! Because of this stigma, you have to work extra hard to remove the humiliation that counseling sometimes carries. The best way to do this is to normalize therapy. Children embrace therapy much faster when parents let therapy be a normal and not secretive or shameful experience. It also helps when parents can explain the process, be supportive, communicate regularly with the therapist, and show their child that seeing a therapist is nothing to be ashamed of. The way you frame treatment is equally important. People go to therapists for the same reason they go to their other doctors — they want to feel better. For reluctant children, it may help to compare therapy to working with a coach. Even professional ball players need coaches to learn new strategies, learn new skills, think about different ways to succeed. Your son can do therapy to learn these skills and practice them over and over, and eventually he won’t need the coach anymore.
She doesn’t know what to talk about. Let your child know that she doesn’t need to know what to talk about before she come. In counseling, people examine whether there are ways they think, feel, or behave that they can improve. Your counselor will help you identify these areas and how discussing them could be helpful. In the process of exploring, students often discuss issues such as academic performance, relationships, adjusting to life challenges/changes, managing stress, or choosing a major.
He feels like he is betraying the family. Counselors are sensitive and respectful of concerns about family traditions and privacy. If conflicts about loyalty to family and culture are of concern, these issues can be discussed in the first session before more personal matters are addressed. Let your son know he is really talking about himself. About his story. About how to handle and internalize situations and life-changing events. About how he sees relationships. About his worth or sense of worthlessness. That will be the focus for his therapy: his emotional well-being. In a safe environment, with the right mental health professional, he can talk about others without fear or repercussions because it is his story he is focusing on.
She feels like it will be too expensive. The fees associated with going to therapy are often high and older kids may feel like this is a burden on mom or dad. However, assure your child there are a lot of different options for therapy and that you will find what works best for your family situation. Some therapists use a sliding scale that depends on their clients’ income. You can see whether your workplace or the child’s school offers free counseling or if your insurance will pay for it. Often, local churches also may provide therapy or help pay for therapists in the area.
He says he is over the issue. Now, this might be true. However, your child may have some unresolved emotions that he needs to discuss. Therapy won’t magically patch up all the holes that the issue has created, but therapy may help him learn how to craft an emotionally healthier life and coping skills in case that issue ever presents itself again.
He can’t see the point of going. The benefits of therapy are various. People who attend therapy usually gain…
- Long-lasting change
- The feeling of being understood
- Better health due to facing repressed emotions
- The skills needed to handle future flashbacks or setbacks
- A greater ability to express his/her thoughts
- A greater sense of self-worth
- A better understanding of who s/he is
- A better understanding of other people
- Greater empathy
- Deeper relationships
- Rewired brain
- Better skill set for handling pain, sorrow, and frustration
- Reduced stress
- Better boundary-setting
- Increased spiritual understanding
- And much more.
If your child still refuses to go to counseling, don’t despair. You still have several options about how to get help. Seek counseling on your own without your child. Often, parent-training can be one of the most effective ways to help your child. Whether your child is struggling with behavioral issues or a mental health problem, a therapist can help you identify strategies to help your child.
Talk to your child’s therapist about their resistance to attending counseling sessions. Most therapists are more than willing to problem-solve and explore barriers to counseling. Plus, most also are open to providing referrals if they’re not the right fit for your child or family.