Effective parenting involves modeling by taking action, in addition to being mindful about what is verbalized to the child. Parents can model “seeing a therapist” by meeting with a therapist to work on their own skills, listening to mental health skills-based podcasts and videos, and practicing mental health techniques in their own lives. By modeling effective behaviors for children, the suggestion to a child that they could benefit from therapy too will not sound surprising. Young children follow their parents to the grocery store, to the post office, to the mall, and to doctors’ appointments. Mental health appointments can be a part of the family system, and may even be introduced by a parent bringing their child to a family therapist who can teach them skills together. The key is for the first experiences with therapists to be positive and engaging for the child. Unfortunately, if these experiences are associated with punishing a child for behavioral issues, or if the therapist’s office has too many items that can be broken if the child touches them, these difficulties can classically condition negative responses to therapy. DBT therapy can be an important part of this process. Learn more in our DBT for adolescent depression guide.
How do you tell your child they need counseling?
Although there are a variety of techniques to tell a child that they need counseling, including informing children in an age-appropriate way about the benefits of therapy and connecting therapy to the child’s goals, it is best to avoid power struggles surrounding therapy altogether. The first step is to be mindful of when you are in a power struggle with your child. If you are trying to convince them, and they are pushing back, screaming, and crying, then you are in a power struggle. This type of exchange is not necessary to tell your child that they need counseling. First, consider an appropriate time to talk with them about the therapy appointment. Make sure that they are not emotionally dysregulated prior to discussing the therapy appointment. Then, frame the counseling as a normal aspect of being a part of the family. Mom goes to therapy, dad goes to therapy, and the child goes to therapy. This type of framing will work well for younger children. For adolescents, the framing can be similar, but with an emphasis on increasing the adolescent’s autonomy. For example, a parent may say that all family members go to therapy, but the adolescent gets to select their therapist. Or, the parent may describe the specific ways that the adolescent going to therapy will improve family relationships, promoting more peace and cooperation in the household. As a last resort, parents can motivate by offering to provide specific material rewards (e.g., “we will buy you ice cream”), but often social and intrinsic rewards are more effective at influencing behaviors in a healthy and sustainable way. Sometimes resistance to therapy comes from underlying struggles like depression. Learn more in our blog on understanding depression in teens
How to encourage kids to go to therapy?
In addition to the power of modeling, children also benefit more from techniques like story-telling, rather than direct education. In this regard, a mother may tell her daughter a fictional story about another child in therapy. For example, the mother might say, “There once was a little girl named Jane. Jane loved playing with her friends. She played with her friends by riding bikes, traversing the monkey bars, and swinging as high as she could. Sometimes, Jane would have a fight with her friends. When Jane got angry, she threw dirt, pulled her hair, and cried for an hour. When the fight was intense, Jane’s mother had to take her home, and she had to play alone the rest of the day. Jane loved her friends, but she did not like her intense anger. One day, Jane’s mother took Jane with her to therapy. The therapist was a kind woman who was younger than her mother. Jane noticed that the therapist had chocolates and gave her stickers. Jane liked that. Jane’s therapist also taught her how to manage anger. She practiced deep breathing and putting cold water on her face. Now, when she got angry at the park, Jane went to her mother to do deep breathing and put cold water on her face. Jane then happily returned to play with her friends. The end.”
Humans evolved to pay attention to stories, and storytelling can also be disarming, leading to increased cooperation and less of a power struggle. For younger children, it may also be helpful for a parent to tell stories about their own childhood, if the parent went to therapy as a child.
What do I do if my child refuses to go to therapy?
If a child refuses to go to therapy, do not force them to go. Forced therapy does not work. Parents will benefit from noticing when they are engaging in power struggles with their children, and trying more creative and cooperative techniques to work together as a family. Sometimes refusal is tied to coping struggles. Learn about why teens self-harm and what it means. In extreme circumstances, such as a teen seriously harming themselves or someone else, then the mental health field has a certain threshold whereby people are forced to receive mental health services, typically in a hospital setting. In these cases, parents may need to call mobile crisis services or even the police. However, despite the benefit of the child potentially not harming themselves or other people after emergency services are called, there is certainly a long list of consequences from having to use emergency services, including the child’s negative association with the mental health system which can make it difficult to seek effective therapeutic services in the future. Thus, it is crucial to work toward preventing an argument about the child or teen going to therapy from escalating to a psychiatric emergency or physical altercation. If the child curses at the parent and slams the door, it is in the parent and child’s best interest for the parent to regulate their own emotions and approach the conversation at a different point in time. Parents can keep in mind phrases like, “not all means justify the ends,” and “do what is needed for this moment” to remain grounded and prevent further escalation, which can be costly for relationships and for the health of the family.