What if your teen refuses to talk with me?

You’re worried about your teenager, and think therapy might help. Your teenager, on the other hand, wants nothing to do with therapy.

First, let’s acknowledge that I may not be the right therapist for your teen. Therapy depends on the relationship between the therapist and client, and I’m not going to be right for everyone. But let’s imagine I could be a good fit for your teen. You and I talk on the phone, and maybe I remind you of an aunt or teacher your teen has a good relationship with. You’re encouraged, but your teen continues to say, “Look, you can drag me there but I’m not going to talk. You’re just wasting your money.”

In my first session, I ask you to be in the room while I go over confidentiality. I tell both of you about how I don’t disclose anything a client tells me unless a) I have their explicit permission, b) they’ve made a statement of wanting to harm or kill themselves or someone else, or c) they are under 18 and disclose reportable abuse that I am legally required to disclose. I tell you that I can give updates such as, “Alex has been really engaged in therapy,” or, “Alex isn’t really engaging,” but nothing specific about the content of our sessions. I ask you to share a little bit about why you’re concerned for your teen, who might scowl and mutter, “That’s so not true.” I thank you and ask to have the rest of the session one-on-one with your teen.

More often than not, teens want to have a say. If nothing else, they want to express why it’s so stupid for their parents to be making them do therapy. It might go something like:

Alex: This is so stupid.
Me: What’s stupid?
Alex: My parents making me come here! They think I’m crazy or something. 
Me: What do you think?
Alex: I think I definitely don’t need therapy. 
Me: OK, what do you need? 
Alex: I don’t know. Friends? A social life? 
Me: What’s getting in the way of having friends and a social life? 
Alex: I don’t know. 
Me: … 
Alex: I don’t know! Like, other people have such an easy time making friends, and for me, it’s like it never works out. 
Me: That sounds really hard. 
Alex: Yeah! And so I come home and I’m all upset, and my parents think I’m crazy. 
Me: So, you’re not crazy, you just have this thing in your life that isn’t going how you expect or want. 
Alex: Right!
Me: Well, a lot of my work as a therapist is helping people figure out those types of things—some part of life that isn’t going how they expect. 
Alex: …
Me: So, if you’re willing to give it a try, I’d like to see if maybe we can work together to figure some of this out. 
Alex: [mumbles] OK, I mean, my parents are already paying for it.

Ok, but what if our meeting doesn’t go perfectly as written above? (I admit, it’s pretty easy to do therapy with an imaginary client.) What if they just sit across from me, giving me the death glare, refusing to talk at all? When that happens, I do the following: I take some deep breaths and focus on being present in the room with this person who is in pain. I think about totally accepting them as they are right now, of filling the room with a sense of acceptance and calm. I tell them, “If what you need is to sit in silence with me, that’s ok. This is your time.” Usually, a few minutes pass and the teen asks me, “Isn’t this awkward for you?” and I tell them no, that I’m comfortable with silence if that’s what they need, but is it possible they’re feeling awkward? And then we usually end up talking.

If your gut is telling you that your teen needs some professional help for something like anxiety, depression, trauma, or another mental health issue, I encourage you to listen to that! Change is hard and scary, and your teen might try to dissuade you from getting them help out of fear of the unknown, but in my experience it is worthwhile to help a young person face that hard, scary thing rather than letting them avoid it.  

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