“Help! My Teen Needs Therapy But Won’t Go!”
By Alaina Boyle (LMHC)
Sometimes, the people who need help the most are the least willing to accept it. For parents and caregivers, this can be one of the most painful and frustrating situations to face. You care deeply about your teen and invest enormous time, energy, and resources into supporting them. When you see them struggling, the natural response is to try to get help. If they refuse therapy—or attend reluctantly without meaningfully engaging—it can leave parents feeling helpless and discouraged. Meanwhile, teens may feel angry, misunderstood, or stripped of their independence. Clinicians can also feel stuck or pulled into the parent-teen tension.
So what do we do? Every family’s situation is unique, but there are some common reasons teens resist therapy, and several productive paths forward...
Why Doesn’t My Teen Want Therapy?
Stigma around Mental Health Support
While social awareness of mental health has improved significantly in recent years, there can still be stigma in getting help, especially in certain communities. As a parent, you can help by normalizing counseling as one of many healthy forms of support. This might include sharing your own positive experiences (when appropriate), or noting how common it is to seek counseling. Did you know that 1 in 5 adolescents nationwide is receiving mental health counseling? (CDC Children’s Mental Health Data, 2021-2023).
Anxiety, Discomfort, or Embarrassment
For many youth, initial resistance is rooted in anxiety or self-consciousness, especially if therapy is new to them. “What do you mean I’m going to sit alone with a stranger once a week and talk about my most secret thoughts and hardest moments?” Embarrassment and discomfort with being perceived often peak during adolescence, making it an especially vulnerable (and sometimes crucial!) time for therapy. Ideally, as a teen builds rapport and trust with their therapist, these initial fears diminish. I usually recommend asking a teen to commit to 3-6 sessions initially to give it a solid try and allow time for comfort in the therapy space to grow.
They truly don’t see a problem
Sometimes, teens genuinely do not believe they need therapy. Imagine having to show up somewhere after a busy school day when you’re exhausted and not really understand what you’re supposed to be doing. It can feel like a waste of time and energy. While providers will do our best to provide psychoeducation on the therapeutic process, give options for goals, and offer engaging and constructive activities, sometimes a teen really finds it “pointless”. In this case, it can be helpful to explore how and why the parent and teen may see things so differently and which, if any, of the parent’s goals might also be something the teen would see as valuable.
The therapist may not be the right fit
Each clinician has their own personality, style, approach, and expertise, and at times, by no fault of either the client or the clinician, it’s just not a match! If your teen dislikes therapy, it may be worth exploring whether they dislike therapy itself, or just the current fit. Our Sequoia clinicians are always open to feedback and happy to explore internal or external referrals to find the best match.
My teen still won’t go. What do I do now?
Option 1: Require therapy while offering choice and autonomy
In some situations, especially when there are safety concerns, significant behavioral escalations, or impactful loss of functioning, parents may decide that therapy is non-negotiable. While your teen (if 13 or older) will still need to sign their own consent to treatment*, parents can often direct their youth to attend sessions through consequences or rewards. In this case, try to offer as many options for the young person as possible within the limits of attending therapy. For example, “For your safety, we need you to be seeing a professional right now, and you can choose which therapist you work with, whether you meet in person or online, what time works best for you within the therapist’s schedule, and how you spend your session time!” There are so many things in their lives that teens have little to no control over. Offering choice and autonomy whenever possible empowers them to recognize that their life is their own.
*If a youth refuses to consent to treatment, caregivers do have another option: Family-Initiated Treatment (FIT). Through this program (outlined in RCW 71.34), parents can initiate an evaluation for the 13-17 year old to determine medical necessity, and if deemed medically necessary, the parent can be the one to consent to the teen’s treatment. This can include up to 12 outpatient appointments within a 3 month period, or up to 1 month of residential treatment. Keep in mind that this process necessitates specific criteria be met, and providers are not required to participate in FIT.
Option 2: Pause individual therapy and try other supports!
Sometimes, forcing therapy backfires. Especially during critical developmental periods such as adolescence, coercion into counseling can create a negative association with therapy that lasts for years. They may be left with a bad taste in their mouths that makes them not want to pursue therapy in the future. Conversely, if we allow youth to make their own decisions about engagement, they may be more likely to voluntarily seek support when they are ready.
In the meantime, you have other options! Many practices, including Sequoia, offer Parent/Caregiver Coaching. Research overwhelmingly shows that these interventions can make meaningful change for teen mental health outcomes, even when a young person is not in therapy themself. And, you can know you’re doing everything you possibly can to support your child until they’re ready to get their own support.
Another idea is to explore other wellness options. Maybe your highly anxious teen hates the idea of talk therapy but is open to massage or acupuncture… Maybe their doctor has recommended SSRIs and they’re open to trying them!... Maybe there’s a support group at school they have friends in that they want to join… Maybe regular exercise from joining the cross country team improves their depressive symptoms! While none of these things are a replacement for evidence-based mental health counseling, therapy is far from the only intervention that can make an impact in a youth’s life.
At the end of the day, these are extremely difficult decisions to make. Parents often feel caught between respecting independence and responding to real concerns. In true DBT (Dialectical Behavioral Therapy) fashion, I always recommend listing out each option’s pros and cons and making sure you’re in your wise mind when making choices. Most importantly, remember that you do not have to navigate this alone. With the right guidance, you can find a path that protects both your teen’s wellbeing and the parent-teen relationship.
