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We’ve talked before about common signs your child should meet with a mental health professional. Of course, there can be a big chasm between you, the parent, deciding your kid should do something and getting them to go along with it. Especially pre-teens and teenagers, who aren’t always the most cooperative when they don’t want to do something. And even if you get your child to an appointment, that doesn’t mean they’ll be willing to participate. So, we wanted to offer some advice for what to do when your child refuses therapy.

Encouraging Your Child to Agree to Therapy

  • Don’t make threats or punish your child for refusing therapy. It’s an unfamiliar and scary prospect to most kids. A negative approach only increases negative feelings toward therapy, and can exacerbate some of the issues your child may already be dealing with, such as anxiety or behavioral problems. You’ll be much more successful with a positive, supportive approach.
  • Don’t make therapy seem like a punishment. This goes along with the above. Your child needs to see it as a positive step. But because it’s something they’re being made to do, they will be more inclined to see it as a punishment. If you threaten it as a consequence or bring it up during fights, it’s only natural that your child will become resistant.
  • Don’t make your child feel ashamed. Children and teens are usually embarrassed about their struggles, even if they’d never admit it to you, and often aren’t too keen on asking for help. Never call your kid crazy, tell them they’re not capable of making good decisions, or use other derogatory language about their issues. Frame therapy as something that helps people overcome struggles and makes them feel better. Remember: Be positive, not negative.
  • Explain what they can expect. Kids—especially younger ones—don’t know. They often think they’ll be tested, or even that they’ll get shots like at other medical appointments they’ve had. They worry about being judged and even scolded. Let them know they’ll just be talking, and that the therapist is there to listen and to offer suggestions for coping with the things they’re struggling with.
  • Stress that they have privacy in their sessions. One of the biggest concerns most children and teens have about counseling is that their parents will find out what they say, and that they might get in trouble. Explain in an age-appropriate way to your child that therapy comes with privacy, and that they shouldn’t worry about sharing honestly or getting in trouble for anything they say.
  • Emphasize therapy as being for the family. Nobody likes to feel singled out. It’s OK to let your child know that you’re struggling with things too. By framing counseling as something that can help the whole family, your child will probably become more receptive.
  • Consider offering your child alternatives to one-on-one, in-person therapy. For some kids, the idea of sitting alone in a room with a stranger to talk about themselves is very intimidating. It can be helpful to offer alternative options, such as group therapy sessions with other kids their age, or even online telehealth sessions.
  • Ask your child to give it a try for a certain number of appointments. If you’re still facing resistance and wondering what to do when your child refuses therapy, try compromising. Ask them to go to three or four sessions to see what it’s like, and then they can decide whether to continue. Kids are typically more open to this, as it lets them feel like they’re in control, and there’s comfort in having an end in sight. Often, a skilled mental health professional can change a child’s outlook on counseling in a few sessions. But honor the deal on your end if they choose to stop.

Should You Force Your Child Into Counseling?

If nothing helps and you’re still wondering what to do when your child refuses therapy, eventually you’ll arrive at the question of whether you should force them into it. In general, this isn’t beneficial.

It’s basically impossible for any mental health professional to help someone who doesn’t participate in their therapy. Also, the patient-therapist relationship should have a fundamental equality to it. But when someone has been forced into it, they naturally feel like they’re on inferior footing.

In the long run, pushing a kid into therapy against their will can do more harm than good. It reinforces the perception that it’s a punishment, rather than something that can help them. It may be best to drop it for the time being and revisit the subject again later.

Consider entering therapy yourself. It’s important that you manage the stresses you’re dealing with. You can learn good strategies for meeting the challenges your child presents, and constructive ways to help them, as well.

There’s one major exception here, though: A child who is self-harming, threatening to harm themselves or others, or suicidal needs immediate professional help.

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