Have you ever tried to do something that you’ve never done before without doing any research? How did that go? I bet that it was really hard and maybe didn’t go very well. The same is true for talking to your parents about your mental health. If you jump into that conversation without any preparation, you might not say everything that you wanted to say or not get the end result you wanted. This guide will help you have those difficult conversations so that you can get the help you need to build your life worth living.
Is counseling the same as therapy?
Yes and no. The majority of people use counseling or therapy interchangeably, but they do mean slightly different things. The main differences between counseling and therapy are the focus and duration of treatment.
Counseling is more focused on short-term issues and is solution-focused. Some examples of counseling would be career counseling, school counseling, or grief counseling. A counseling session will be focused on a specific issue or how to make a decision about something. It may only last a couple of sessions and will end once the issue is resolved.
Therapy or sometimes called psychotherapy, dives into deeper topics and issues. In therapy, you’re working to accept and change emotions, thoughts, and actions in order to find your life worth living. Therapists will use treatment modalities, also called techniques, to help you achieve your goals. Dialectical behavior therapy (DBT) is one of many effective treatment modalities. Therapy is usually more long-term, but you can also do short-term intensive therapy for certain issues, such as crisis counseling. People go to therapy for a variety of different issues, like trauma, anxiety, depression, emotion dysregulation, suicidal ideation, or self-harm.
Licensed professional counselors, licensed marriage and family therapists, social workers, and psychologists are all able to provide both counseling and psychotherapy. They may call themself a counselor or a therapist, or use both terms interchangeably.
How do I know if I need therapy?
Therapy can be helpful for a wide range of reasons. Since life is hard, it can be really helpful to talk to someone who is unbiased and help you get through the rough patches. There’s a lot of different reasons people go to therapy, so there’s no exact answer. However, here are some behaviors, thoughts, and emotions that suggest that it would be effective to start therapy. 
- Feeling overwhelmed by emotions
- Struggling to connect with friends or family
- Struggling to with motivation, especially with school work
- Difficulty focusing and completing tasks
- Feeling numb or detached
- Not enjoying things you used to enjoy
- Always feeling worried or anxious
- Low self-esteem
- Major life changes, this could be a traumatic event, moving, or the loss of a loved one
- Thoughts of suicide or self-harm
- Feeling lonely, even if you’re surrounded by other people
- Feeling misunderstood very often
- Physical symptoms like headaches, stomachs, or feeling tired more than usual
- Changes in sleeping habits, like getting significantly less sleep or sleeping way more than usual
- Thoughts of hurting other people
These aren’t the only reasons people come to therapy, especially since it is pretty general. Overall if something is causing you a lot of distress or you’ve noticed changes in how you normally act then going to therapy would be effective.
How do I know which therapist is right for me?
It’s kind of hard to say. It really is going to depend person to person on what is the right kind of therapist for you. However, we can talk about some factors that might help in choosing a therapist. Some of this will be up to your parents or caregiver to decide and therapy is most effective when you have a say in deciding who you will tell some of your deepest and darkest secrets to.
First thing is to think about what you’re seeking therapy for: anxiety, depression, neurodivergency, LGBTQ+ issues, substance use, etc. Every therapist is going to have something that they specialize in or focus on treating. That could be age, gender specific issues, LGBTQ+ issues, specific mental health issues, treatment modality, cultural issues, etc.
Cognitive behavior therapy (CBT) is the most common treatment modality because it treats a wide variety of mental health disorders. CBT is more of an umbrella term than one specific way to do therapy – DBT is a type of CBT. While we’re on the topic of treatment modalities, you want to consider if you want a more solution-focused, active approach or a more reflective, non-directive approach? In a more direct approach, your therapist will therapeutically call you out and give you things to do between sessions…yay more homework for you! In a more reflective approach, your therapist will allow you to have more control over what you talk about during sessions and focus more on your emotions.
DBT is a blend of direct and reflective approaches. DBT gives you skills to help solve the problems you have and works to help you figure out how your emotions impact you and your behavior. If you want to know more about what DBT is check out this blog.
Some other things to consider would be age and gender identity of the therapist. A lot of women prefer to have a therapist who is also a woman. Some people prefer to have a therapist who is closer to their age than their parent’s age. That way it doesn’t feel like they’re talking to one of their parents. People of color might prefer to have a therapist who has the same or similar experiences to them.
Ultimately, you want a therapist who listens to you, you feel safe with, and you trust. It takes time to build trust with your therapist. If you’re not sure, give it at least 5-6 sessions to see if you and your therapist click. If you don’t feel comfortable sharing with your therapist, then you might want to talk to your parents or caregiver about finding a new therapist.
Will my therapist tell my parents what I say?
Yes and no. Therapists are legally and ethically bound to maintain confidentiality, meaning that what you talk about in therapy, stays in therapy, just like doctors and other medical professionals. The only times therapists can break confidentiality is if you mention threats to harm yourself or others; mentions of abuse, specifically animal abuse, child abuse, elder abuse, or abuse to anyone with a disability (this doesn’t include domestic violence or interpartner violence between adults), or a court order/supeona. However, with minors (aka kids and teens) confidentiality is a little different because your parents have to be involved in your care since in Ohio you need parental consent to start therapy.
Technically, your therapist could tell your therapist everything that you say in sessions. But, in order to gain your trust and form a working relationship between you and your therapist, most therapists will try to maintain as much of your privacy as possible. How much is shared with your parents will depend on the situation, but for the most part your therapist will give general progress updates. For the most part what stays between you and your therapist is your thoughts, feelings, and specific details of your sessions.
How do you ask your parents to get you a therapist?
A lot of people struggle in asking for help, especially when it relates to mental health things. The biggest thing to keep in mind when asking your parents to start therapy is to be honest with why you want it. DBT has a skill called DEAR MAN which helps you structure what and how you want to ask a question in order to increase the chances that you’ll get what you want. Here’s an example of how you could use DEAR MAN:
- D is for Describe. This is where we’re describing what’s going on in your life and the facts of the situation. Include the who, the what, and the where.
- “I’ve been struggling to stay on top of my homework and sometimes won’t even turn it in. I haven’t been hanging with my friends as much and I’ve been spending a lot of time playing video games.”
- E is for Express. Now that you’ve laid out the facts to your parents, you tell them how you’ve been feeling. This would also be a good place to say your thoughts or opinions.
- “I’ve been feeling really sad and anxious recently. I think I might need some help.”
- A is for Assert (aka ask). This is where you ask your question. You want to be direct in asking, don’t hint about what you want. Being direct will decrease the chance of any confusion and increase the chances of you getting what you want.
- “Can I start seeing a therapist?”
- R is for Reinforce. What you’re doing here is explaining why it is a good thing for the person (in this case your parents) to say yes to what you’re asking. There’s a couple of different ways you could go about this, explaining how it would benefit you.
- “I’ll be able to become happier and less stressed if I go to therapy.”
- M is for Stay Mindful. Sometimes in tense or difficult conversations other topics get pulled in, intentionally or unintentionally. You want to keep the conversation on asking to start therapy. If other things get looped in, redirect it back by continuing to repeat your question or ignoring the other topics.
- A is for Appear Confident. If you know what you are asking for and appear confident, you’ll increase the likelihood that you get what you want. Use a confident tone, try to not use filler words (e.g. like, um), make eye contact, and have good posture. You don’t have to do all of these things, but even doing just one of them will be better than doing nothing.
- N is for Negotiate. Sometimes you have to be willing to give to get. You can offer solutions and ask your parents to offer solutions too. Maybe you look for therapists with your parents together, as a potential solution.
Using DEAR MAN to help script what you’re going to say will increase your chances of getting what you want, BUT it isn’t a guarantee that you will. Interpersonal situations are never a guarantee because we can’t control other people and you don’t know how they’ll react.
How to ask your parents for therapy?
After you start the conversation with your parents they’ll probably ask a lot of questions about how long you’ve been feeling this way, what caused it, and how it’s impacting your life. It might feel like an interrogation a little bit, but the point of it is for them to get information they’ll need to help you find a therapist. This is also a great chance for you to communicate how serious this is for you and how much you need help. If you are worried that you’ll get overwhelmed by their questions, come up with the answers they might want ahead of time and write them down, that way in the moment you’ll already know what to say.
If you’re worried that your parents might be against the idea of therapy, explain to them that a lot of people go to therapy. There has previously been a lot of stigma against therapy and mental health issues, but therapy is becoming a more normal thing for a lot of people. Life is hard and some really awful things happen. Therapy can help you process and get through the really awful things by learning coping skills and accepting things that have happened to you.
The last thing to keep in mind when asking to start therapy is to be patient. Your parents may not fully understand what you’re experiencing or why you want to go to therapy. I totally understand that sense of urgency and frustration you may be feeling. You asked for help and you’re being told to wait, it feels like it’s not fair. However, you’ve been experiencing this way for a while and have a pretty good understanding of what’s going on, they just found out. It might take some time for them to process what you just told them. It could also take some time to find a therapist who is the best fit for you.
How to tell your parents you’re depressed?
It can be very difficult to tell your parents about your mental health, but especially depression. It’s not just that you feel sad a lot of the time, but it’s feeling hopeless that things will never get better or change. You can use DEAR MAN to help you figure out how to tell your parents that you’re depressed. You can describe how you’re affected by your depression in both describe and express of DEAR MAN. In the describe section you can talk about the things that your depression is causing you to do or not do. In the express section you would tell them about how you feel when you’re depressed. Depression symptoms include:
- Depressed mood most of the time
- Little interest in thing you normally enjoy
- Significant weight loss of gain
- Sleeping very little or sleeping a ton
- Significant restlessness or it feels like it takes so much effort to move
- Having very little energy
- Feeling worthless or unjustified guilt
- Difficulty focusing
- Suicidal ideation
If you’re worried that you’re going to get overwhelmed and forget everything you wanted to say, write it down. Coming up with what you want to say ahead of time will also give you chances to practice what you want to say. You could also practice your script with your friends or siblings. Or if you don’t think you would be able to get the words out, you could write it out and then give it to them.
You also want to pick the best time. Pick a time when your parents don’t seem to be stressed, busy, or distracted. You should also pick a private place – it wouldn’t be very effective to have this conversation in the middle of a busy grocery store, but at home, where you likely won’t be interrupted. You might even ask them to help you find a time that you could have an important conversation. Of course, there’s no way to fully tell when is the “perfect time”. But looking for these things should help you find an effective time to talk.
How can I approach my parent about my feelings of self-harm?
It can be very difficult to talk to your parents about self-harm and your emotions might get in the way of you talking about your emotions. It’s normal to feel shame and guilt about self-harm. Shame drives us to hide things that we think might cause other people to reject us. You might be worried that if you tell people about your self-harm that they’ll think that you’re doing it for attention, to manipulate them, or to fit in. But those are myths or mistaken beliefs. Your parents might not fully understand why you self harm, but telling them won’t lead to rejection. Practice opposite action by acting opposite to the shame. If shame wants you to hide your behavior then acting opposite would be to tell someone you trust who won’t reject you.
Not to repeat myself, but you can use DEAR MAN to talk to your parents about self-harm. When you tell them, they’ll probably “freak out”and start asking you a bunch of questions. They might ask to see where you have hurt yourself and ask how long you’ve been self-harming. It might appear like they’re angry at you, but in actuality they’re probably feeling sad and anxious. Anger motivates us to do things and sometimes people will feel anger because it’s easier to feel anger than it is what they’re actually feeling.
Your urges to self-harm aren’t going to go away overnight, as much as you might want them to. After you tell them about you hurting yourself, they’re probably going to limit your access to what you’re using to hurt yourself with. That way you can’t hurt yourself anymore, even when you have urges to.
About the Author
Robyn Williams (she/her), M.A., LPC is a Licensed Professional Counselor who specializes in dialectical behavior therapy. Robyn works with teens and adults in a compassionate judgment-free manner to meet clients where they are in life. Robyn helps her clients develop the tools they need in order to live their life worth living, and find what means most to them. Robyn believes that while therapy can be intimidating at times, it can be a conduit for personal growth. Click here to learn more about Robyn’s experience and therapeutic approach.