How to Talk to Your Teen About Starting Therapy

In crisis or thinking about suicide? Call or text 988 now (in Colorado it reaches the 988 Colorado Mental Health Line). If you are in immediate danger, call 911.

Before you bring it up

You have noticed something: more time alone, more blowups, slipping grades, or a teen who seems flat. You want to suggest therapy, and you are bracing for a slammed door. That worry is normal, and a little planning can make the first talk go better.

SAMHSA's family guide suggests picking a private setting with few distractions, such as at home or on a walk, and being direct about why you are concerned. With teens, side-by-side settings like a drive or a walk often feel less intense than a face-to-face sit-down. Avoid raising it in the middle of an argument or right after a consequence, when therapy can sound like part of the punishment.

Decide ahead of time what you will say about why. Name two or three specific things you have seen, such as "you've stopped going to practice" or "you've seemed really tired and down for a while." If you are not sure yet whether what you see is more than ordinary teen stress, signs a teen may need support can help you sort it out first.

If your teen has another parent or caregiver, talk with them first if you can. A shared, consistent message is easier for a teen to hear than two adults who seem to disagree about whether anything is wrong.

Words that tend to help

Your goal is not to win the conversation. It is to make therapy feel like an offer of help that your teen can shape. SAMHSA's guidance on talking with someone about help recommends open-ended questions, pointing out strengths instead of focusing on what the person is doing wrong, and repeating back what you heard.

• Lead with care: "I love you, and I've been worried about you. Can we talk for a few minutes?"
• Describe, don't diagnose: "I've noticed you've been staying in your room most nights" works better than "I think you're depressed."
• Normalize it: "Lots of people see a therapist when things feel heavy. It's someone whose whole job is to listen and help you figure things out."
• Ask, then listen: "What has been the hardest part lately?" Then let the silence sit for a moment.
• Name a strength: "You've handled a lot this year. This is about giving you backup, not fixing you."
• Own your part: "I might be part of what's hard at home. I'm willing to work on that too."

Give your teen a real say

Teens are more likely to engage with something they helped choose. Decide in advance which parts are open to their input and which are not. For many families, the open parts include which therapist, video or in person, appointment times, and whether a parent joins the first call.

You can look at therapist profiles together and let your teen pick who seems easiest to talk to. You can also explain the main styles in plain words. CBT tends to focus on thoughts, feelings and actions, and CBT for teens describes what that looks like. DBT focuses on skills for strong emotions, and teen DBT vs adult DBT explains how the adolescent version involves families. NIMH suggests asking any provider whether they use approaches supported by research and whether they involve parents in treatment, so ask those questions with your teen beside you.

Mountainside works with teens and adults, offers a free 15-minute consultation, and sees clients by secure video anywhere in Colorado as well as in Greenwood Village. Your teen can be on that first call if they want to be. The teen therapy page explains how the practice involves parents.

What to say about privacy

Many teens worry that anything they say will go straight back to you. Be honest: you do not know every detail of how their therapist will handle it, and the therapist will explain the ground rules at the start. Therapists who work with teens usually keep the content of sessions private, share general progress with parents, and bring parents in when there is a safety concern.

Try: "What you say in there is mostly between you and your therapist. If they ever think you're not safe, they'll make sure I know. We'll hear the rules together." Do not promise total secrecy, because no therapist can offer that when safety is at risk. If your teen asks something you cannot answer, write it down so they can ask it in the first session.

Colorado has its own law on when teens can consent to outpatient therapy and when parents are told. Our guide on how to support a teen in therapy explains that law and how to set ground rules on day one, so it is not repeated here.

When the answer is "I'm not going"

A first no is common, and it is rarely the final answer. Start by validating the feeling behind it: "It makes sense that this feels weird. Talking to a stranger about private stuff is a lot." Then ask what specifically bothers them. Sometimes it is a fixable worry, such as missing a class, being seen at an office, or fear that you will hear everything.

Offer a trial with a clear end point, such as a set number of sessions, after which you will talk again about whether it is helping. Keep the tone calm and avoid long lectures, bribes or threats, which can turn therapy into a power struggle. SAMHSA notes that it may take many conversations before someone gets help, so if today is not the day, tell your teen you will come back to it and that you are on their side.

If you are dealing with mornings when your child will not get out the door for school, the scripts in what to say when your child refuses school cover that moment in detail.

When to start with parent sessions, or get help now

If your teen talks about wanting to die, hurting themselves or hurting someone else, do not wait for the right moment. Call or text 988 for the 988 Colorado Mental Health Line, or call 911 if there is immediate danger. NIMH advises seeking help immediately when a child's behavior is unsafe.

If your teen keeps refusing and there is no immediate danger, you can still start. CDC says engaging parents and caregivers in treatment is important for children of all ages, and many therapists will meet with parents first to plan next steps. Teen therapy vs family therapy vs parent training explains when sessions for parents alone are a reasonable first step, and parent training describes that work.

Frequently asked questions