“Help! I Can’t Get My Troubled Teen to Go to Counseling!”

Note: This blog post was originally published 08/23/16 and has been updated and republished on 11/15/17.


 

“Help! I Can’t Get My Troubled Teen to Go to Counseling!”

Commonly, a parent will call me with a challenge they are having with their teenager, and then tell me they don’t know what to do since their teen is refusing to go to counseling.

When that happens, I know that the conversation I’m about to have with the parent is actually the first counseling session.

"Help! I Can’t Get My Troubled Teen to Go to Counseling!"Think about it.

If a parent is saying that they want their teenager go to counseling — and their son or daughter refuses — it’s probably like other parts of their relationship where the parent wants their teen to do something, and their kid resists that as well.

Whether the issue the parent wants their kid to address is…

  • school effort,
  • home responsibilities,
  • personal hygiene,
  • time on the computer,
  • curfew,
  • substance abuse,
  • or any other behavior…

…an underlying issue is that the parent wants a change, and the teenager is refusing.

So when the teen refuses to go to counseling, it’s more of the same.

The parent wants a change, and the kid resists.

I call this relationship pattern, the Parent-Teen Control Battle.

Find Your Parental Voice

So when a parent tells me they can’t get their kid to come to counseling, my conversation with the parent is designed to help them get out of the Control Battle. I base this on the relationship they currently have with their son or daughter, and help them find a positive and empowered parental voice.

Find your positive and empowered parental voice:Click To Tweet

An important first step in making the shift out of a Control Battle-based relationship is for the parent(s) to acknowledge that they too have a problem.

Namely, that they want to help their son or daughter make an important change, and — for whatever reason — have been unable to find a way to be successful. They need help — as parents — knowing the best way to help their teenager.

When parents own their part of the problem, it creates a shift and takes the pressure off of the teenager to have to be the only one with a problem, and it gives them less to resist. And this can be the first step in ending the Control Battle, and getting to counseling.

When parents own their part of the problem, it creates a shift & takes the pressure off the teen.Click To Tweet

Getting Professional Help Is Important

Let’s look a conversation I had with Mary calling about her struggles with her daughter Megan (15).

Mary: Neil, my husband Pete and I have been struggling with our daughter Megan. She’s been holding up in her room all summer and I’m very concerned. She says she can’t stand us (her parents) and doesn’t want to spend any time around us. She says we’re just too creepy and don’t get her. We can’t even get her out of her room to come to dinner.

Neil: Your daughter spending her summer in her room does sound serious. What is she doing in her room?

Mary: Mostly playing video games. We’re concerned because we moved here a year ago and she hasn’t made any good friends. When we tell her she needs to try harder to make friends, she says the kids here are all weird and she has plenty of friends that she plays her video games with. When we try to tell her those aren’t real friends she gets furious with us and she insists they are. She’ll just go to her room and slam the door.

After talking with Mary for a while longer, it became clear to me that this 15 year old girl had issues with social anxiety, self-esteem, and related to that, depression.

Getting her professional help would be very important.

But the underlying problem of the Control Battle in the family exacerbated these issues and was in the way of the solution.

In other words, the more the parents pushed to get Megan to change, the more she resisted. Now the parents felt as if their hands were tied.

  • If they pushed, she dug in her heels and fought back.
  • If they didn’t push, the problem persisted with no solution in sight.

And to make matters worse, they couldn’t even get Megan to go to counseling where she might be able to get some help.

So my first job was to help these parents take initial steps to end their Control Battle and come to therapy with Megan.

Neil: Mary, I’m glad you are seeking help for Megan and yes, she needs to come to therapy. Here is what you can say to her. “Megan, we’re very concerned that you are spending so much time in your room, haven’t made friends in our new town, and won’t talk with us. We know you’re a fabulous kid, you’re extremely smart and talented, and you have a lot to offer. But somehow we’re letting you down and haven’t found a way to support you in moving forward since our move here last year. We’ve made an appointment with a counselor for Thursday afternoon at 4:00PM and we’re all going together.” I’m guessing Megan will respond negatively and say she isn’t coming and that you and her Dad can go if you want, but that’s your problem.

Mary: That’s exactly right, Neil. That’s exactly what she’ll say.

Neil: And then Mary you can respond by first validating her feelings. Say, “I know you don’t want to come. Most teenagers don’t want to go to counseling.” And then continue with, “But this is important. You are important! And things cannot keep going on this way. We need a better way to work together and being on the computer all day and night is not an option. We have the appointment and we all are going to go. Your dad and I know the computer and your gaming friends are important to you, so we don’t want you to lose the privilege of having it. But in order to keep that privilege, you need to cooperate with us.”

Mary: She’ll just have a fit and slam the door.

Neil: I’m sure she will, Mary. But just let it be. Remind her an hour before the appointment and then call her when it’s time to go. If she flat out refuses, just come without her and we’ll talk more about what’s going on and what to do next. If Megan is choosing not to cooperate, you do not want to let that control you and Pete. That’s too much power and responsibility for a troubled 15 year old.

We discussed how she needed to let Megan know that having and using her computer and gaming was a privilege that she needed to earn. And to earn that privilege, she needed to demonstrate a good attitude and manage certain responsibilities.

Mary explained that Megan had threatened to kill herself if she lost her computer and I advised her about ways to keep Megan safe and accountable.

On Thursday, Mary, Pete, and Megan all came. Megan was in a pretty foul mood, but she did reluctantly participate and with enough empathy and support over the course of the session, she opened up about her social struggles, depression, and even specific issues in her family that bothered her.

Her parents and I all gave her a ton of credit for sharing what was going on and we agreed that with the help of counseling and her parents understanding her better, she could start to feel better about herself, resolve her depression, and build a social life at her school in her new town.

Rules of Thumb to Apply:

Over the course of the next six months, with family and individual counseling, Megan grew into a more solid and happier version of herself.

Among other things, she learned to appreciate who she was, and how to deal with her feelings and her emotional needs in healthier ways. In fact, so did Mary and Pete who realized that they didn’t teach many of those skills to Megan because they didn’t have them themselves.

So if you’re struggling with how to get your teenager to counseling, here are some things to think about and rules of thumb to apply:

  1. Not getting your teenager’s approval for your idea to go to counseling is more common than not.
  2. If you are struggling with issues with your teenager, and they are fighting against your parental requests and limits, refusing to go to counseling is simply more of that pattern and your goal is to change that pattern. I call that pattern the Parent-Teen Control Battle.
  3. Start with validating their feelings. Such as, “I understand that counseling is not something you’re dying to do. A lot of kids feel that way so I understand.”
    Start with validating the feelings of your teenager.Click To Tweet
  4. Next, let them know that you, as parents, own part of the problem. For instance, “Mom and I are struggling with knowing the best ways to support you, and right now we aren’t doing a very good job. We need help knowing the right things to do.”
  5. Emphasize how wonderful they are and how important they are to you. For instance, “We know you are a fabulous person and being the right parents to you and helping you discover and develop your potential is our most important job. We won’t let ourselves let you down.”
  6. State that counseling will help you and them to work together to support them in reaching young adulthood ready to be successful in their life. For example, “We all need to go to counseling together so that rather than fighting against each other, we can all work together so that your teenage years are happy for you, and prepare you well for your next stages in life.”
  7. If you still meet resistance, let them know that their privileges are contingent on them cooperating and managing their responsibilities. Do not threaten. Only clarify with a neutral tone of voice. Remember, you control the expectations and the privileges. They control whether they cooperate or not.
  8. Then let go. If they don’t go to the appointment, you go anyway and get the help you need to help them move forward.
  9. Feel good about these actions! You just took your first steps to end your Parent-Teen Control Battle.

What definitive steps have you taken to end the Control Battle in your family?

Leave your thoughts in the comments below:

Posted in Parenting.

15 Comments

  1. Thank you. This article helped me immensely during a time a crisis with my 13-year old daughter. For the past 3 days, she has been melting down, and even scratched the skin on her arm with her own fingernails because she has been so off balance.

    I told her that we needed to go back to her counselor, and while crying and screaming, she declared that, “SHE DIDN”T NEED HELP”!

    I read your article, took a breath and then talked to her. I told her that her father and I needed help because we didn’t know how to get her through this rough patch she’s going through. I told her that she’s a smart, beautiful, talented, and wonderful girl who is going through a hard time. I said that at 4:00pm we were all getting in the car and going to the appointment. I said that I cannot make her go, but if she chose not to, then her dad and I would not be able to support her in her sport and dance activities until she was willing to cooperate. I said that we all have to do things that we do not want to do from time to time–that’s just life, and that’s part of growing up. Surprisingly, she stopped screaming long enough to listen to me–then grumbled the word, “OK” when I told her that we needed to leave at 4:00pm. She sat on the chair holding our dog and looking sad. Her dad explained that the stress hormones caused her to loose control, and I told her that we had to work on things that she can do when she starts to feel out of control, and I hugged her. Soon after she actually smiled because our young dog started biting her socks. She laughed—we all did. And we’re going to counseling today. I am glad that I stopped and read this article, because prior to that, I we were in a power struggle with our kids and it had escalated to a pretty uncomfortable place. I also reminded her that I know that she would change her behavior if she COULD change her behavior, and that we all need help sometimes to be our best selves…it’s okay to get help–even if we don’t want it.

    • Dear Hopeful,
      You and your husband did a fabulous job. You validated your daughter’s feelings, saw through her bad moment to the beautiful wonderful young woman she is, and shared that with her, and you held on to your parental authority. You did not waver from your decision that we are all going to counseling. Now that’s talented, empowered parenting! When parents are clear about where things need to go, and they stay positive as you did, they get results.
      Thanks for sharing your inspiring story with us.

  2. Hi Neil, My 17 years old is not listening to me or my wife for most of the time. She is smart in study with above 4.50 GPA, but she is very quite when she get out of the house. When home, she try to control us by asking for food she want, etc. Every time I have to remind her for some important college application/essay writing deadline, or ask admission counselor any questions or concerns she may have, or push her for the college visit / open house, etc. We tried to take her to LCSW but she resist to go and if she go then she go without any interest and after 2-3 sittings, she don’t go. She has no desire to go out and make friends, no desire to make her body beautiful, she don’t talk with any guest comes to our place. It is very hard for me, my wife, and my elder daughter. When she is good mood, she talks like a very smart and helpful person. At the last minute, when time to go for an appointment (For example, driving lesson appointment, or registered college open house appointment, or doctor’s appointment) she backs out and give no reason. We don’t know what to do to help her do day to day responsibilities her own. She don’t even wake up her own to go to school in the morning. She don’t eat fruits or meat or vegetable (with a few exceptions). She don’t brush properly, and she don’t comb her hair properly. Can therapist come home for the session/s because my daughter is very stubborn. We are very concerned about her future growth. Thanks in advance!

    • Hello Dennis P,
      I can relate to your concerns very well. I have a daughter with similar problem. Go bring your daughter to see a Psychologist as soon as possible. Get a professional help and diagnosis. Trust me you will glad you did. Ask questions and search in the net about Aspergers Syndrome articles by Tony Atwood, My daughter was diagnosed wth Severe Asperger Syndrome and she is doing very well now even though the dr said that there is no cure for AS. Good luck.

  3. PS he was taking Amilify, but the Psychiatrist at the group therapy facility is now switching him to Zyprexa bec I am told this med will help more with paranoia…TY

  4. Hi Neil, I am not sure what to do with my 17 yr old son, he has GAD and is falling into a state of depression. we have been seeing different Psych Doctors for a few yrs now, Psychologist, Psychiatrist, he will not speak in school, has no friends. My question is, do I force him to go to the Adolescent therapy or allow him to see his recent therapist for ind’l therapy and then maybe go back to adolecent group therapy when he is ready? he is in an emotional fragile state right now and I certainly don’t want to make it worse…he is definitely receptiv to goin to individual weekly therapy with his recent therapist. I am not sure if I am making his anxities worse by forcin the issue. ach time we have to take him for the group therapy he tells us that he only wants to stay for the 1st hr…..my husband and I keep telling him to try to jump in with both feet…TY

    • Thanks for your question Anna,
      I’ve answered your question in a podcast titled “Should I Push My Anxious and Fragile Son To Try Harder?” For a full answer to the question, you can listen to the podcast from my website or Healthy Family Connections on iTunes. But very briefly, while your son clearly has a serious anxiety disorder, it’s not going to get better unless he takes responsibility for dealing with it. Avoiding the adolescent therapy group is not trying to deal with his problems. So yes, he must go to group and deal with his discomfort in order to gain the skills to get comfortable in healthy ways.
      My best wishes to your family,
      Neil

  5. My 15 year old son has a diaper fetish. I was aware of this three years ago and talked to him about it. I put parental controls on WIFI and hoped the problem would go away…if only. His 17 year old sister found soiled diapers in his wardrobe. He is generally anti social and spends an inordinate amount of time in his room. He resists all attempts to get him to engage in sport etc. He comfort eats sweets,biscuits,ice cream etc and plays computer games. I addressed the diaper issue with him and he said he was glad I was aware of the issue. He appears to have researched the problem and feels its incurable and something he’s “come to terms with”. He refuses to go to therapy and says he’s “fine”. I am so sad and worried for him. He doesn’t want to talk to me about it anymore.

    • Dear Susan,
      Thanks for checking in. Clearly your 15 year old son needs professional help. In addition to his diaper fetish and storing soiled diapers, his social isolation and lack of healthy habits and activities all point to profound emotional / behavioral issues. He is not developing through his teen years. I hear that you have talked with him about these issues but can’t get through. With many kids and particularly with kids with serious issues, talking will not be enough, it will take action. I recommend you make an appointment with an experienced and qualified mental health professional in your community for you, his father if he’s in the home, and your son. If your son refuses to go, you go without him.
      One problem here that needs to be addressed is your sense of helplessness as a parent. You need to be empowered and have the confidence that you can take reasonable actions when problems arise and be effective. Right now, your son’s inaction has all the power and you are letting it disempower you.
      Getting your son into intensive treatment should be your number one objective. Turn off the wifi and if necessary, take his computer and all devices away until he is cooperating with you. Of course, do it with an attitude of needing change not punishment. I’m sure he will strongly resist, since he has been getting his way for a long time and is afraid of addressing his issues. But with an empowered parent your son will have the opportunity to see hope in his situation.
      My best wishes you you and to your son,
      Neil

  6. Hi Neil – My daughter is suffering from anxiety, depression and an eating disorder. She became suicidal after starting a low dose of Prozac last November, and has continued to be so. She has also begun to gouge her arm with her nails on a regular basis when she’s upset. Until last November, she was a model, straight A, high achieving 9th grader, and then we hit severe crisis mode very quickly last November/December after she stopped eating and drinking for two months. We’ve struggled ever since.

    Once I realized she had anorexia and had been periodically restricting her food and fluids for some time, I took steps to get her help in an excellent inpatient facility. She has complied with meal completion and her weight and health have normalized, but she continues to adamantly resist all therapies offered at the facility (group, individual, family), and continues to talk about wanting to die, feeling hopeless, not trusting any care provider, and feeling like a “worthless piece of sh*t.” She is also on SSRI meds.

    Her care team wants to step her down to PHP in the next few weeks. My concern is that her treatment facility is in another state and for me to accommodate an 8-week PHP program there means taking my second child out of high school, and taking an 8-week unpaid leave of absence from my job. These are both risky sacrifices to make, especially for a teen who is 100% resistant to participating in any aspect of therapy or learning any new coping skills. It seems she’ll go through the motions to get out of PHP, then likely remain suicidal, or begin restricting her food again, and we’ll be back to square one. However, by then, I’ll also be in a precarious place with my job and my second child will have sacrificed a significant amount of her own normal high school life.

    There are some more limited PHP programs in my own city, but with new care providers and different formats and approaches. The current ED facility strongly recommends we find a way to stay with them to continue to work with her for the sake of continuity.

    The bargaining chips I have with my teen are her continued enrollment in an alternative high school she loves and her phone. However, I can see her make a suicide attempt if I tell her these will not be available without her participation in therapy. Quite honestly, it’s not possible to watch a teen 24/7 – there are many, many ways for them to do something very dangerous in an impulsive moment, and this is a terrifying prospect. I feel completely stuck.

    Thank you for any advice you can offer.

    • Dear Lin Ann,

      Thank-you for your comment and sharing your quite challenging situation with us. Obviously your daughter is struggling with serious mental health and behavioral issues and you are struggling to know the right way to help her.

      Since I have not evaluated your daughter or your situation in depth, I can only share general principles as they might apply to your situation.

      As long as your daughter is non-compliant with treatment or in any other way is unwilling to cooperate, privileges should be off the table.

      The treatment program she is in appears to be focusing solely on her individual treatment and not family treatment. In order for your daughter to be out of inpatient and in outpatient, even intensive out patient therapy, there needs to be a realignment of the parent-teen relationship.

      You are absolutely correct, you cannot watch your daughter 24/7 and if that’s what she needs, then she isn’t ready for outpatient or even intensive outpatient.

      I’m hearing that you are concerned that if you don’t give her the privileges she wants, in this case use of a phone and going to the school she wants, she will become suicidal and self destructive. That is a profound Control Battle and your daughter should not come home if she is going to act out to get what she wants. She has to earn what she wants and the way to earn her privileges is to manage her responsibilities and cooperate with her parents and other authority figures. Family therapy can support you in getting there.

      So Lin Ann, one suggestion I would make is to contact a residential treatment placement professional and think about a longer-term residential treatment program. One that would include education, perhaps a therapeutic boarding school. I refer to my colleague Dr. Mark Burdick, info@drburdick.com . A placement professional knows of hundreds of placements and will be able to find the right one for your daughter.

      The bottom line for your daughter coming home or under your care, is that she is able to keep herself safe. That will require her being accountable to your parental authority. Loving parental authority, but authority all the same.

      I hope this is helpful and thanks for sharing your situation with us.

      Our best wishes,

      Neil

  7. I wish I read before i brought my son to counselling without telling him I Linda just hijacked him and brought him there. I was feeling quite helpless as I had just found out that he’s been cutting himself. Now he is completely angry with me and does not trust me anymore…. and I totally understand. Sigh. He has another appointment with the therapist and I’m not sure if I should just cancel it.

    • Dear Linda, While it would have been great if you approached the situation with my guidance, not all is lost. What you did, you did out of concern for your son’s welfare, you didn’t take him to a butcher, you took him to someone who can help him. So he has a parent who cares deeply and is doing her best. Apparently he is not mature enough to realize that. Most importantly, you need to realize that you two are in a Control Battle. You try to help, he rejects your help and he obviously needs your help. The more you try, the more he resists. When a parent is feeling helpless over a serious problem, the first thing to think is Control Battle.

      Going forward I would make it clear to him that his cutting behavior indicates he has serious emotional issues that he is dealing with and he needs to learn how to deal with them in positive ways. Going to a therapist is an important step in learning to understand and address his feelings in self-valuing, not self-destructive ways. Make sure you’ve got the “right” therapist; someone who deals with resistant teens and their parents. If not, find out who in your area has a reputation for this population. Yes you acted in a way that wasn’t “up front”. But his behavior was extreme and required intervention. Trust is a two way street and he violated your trust with his self-destructive behavior. Definitely follow through with the therapy and it will help to pick up a copy of Ending the Parent Teen Control Battle. Read the chapter titled, What if My Teenager is Depressed.
      My best wishes,
      Neil

  8. I absolutely will try these steps as this describes perfectly what my husband and I are dealing with. My one major concern is that my 13 year old daughter is so, so stubborn. No one understood just how much so until a nurse at the hospital experienced it with her refusal to take her medication and then commented to us about it.

    She is no longer on meds right now (not saying that we won’t have to try something new), but the battle continues with the refusal to go to counseling. My husband and I have “owned” up to having our own “issues” (for lack of a better word and are doing the family, couple, and trying to do individual therapy for her; however she fights us every step of the way. No matter what she can and will NOT take responsibility for anything!!

    • Thanks for checking in and utilizing the advice on my post. I’m sure it will help. Here are a few of things to keep in mind:

      >> Your 13 year old daughter is just starting her adolescent journey, so there is plenty of time for her to learn and grow.

      >> Her stubbornness belongs to her, and she needs to and will address it as she moves forward; at her own pace however.

      >> Her stubbornness is related to her basic temperament, but also to a Control Battle with her parents. So if you both take action to “Starve the Beast”, not participate in the Control Battle that is, her stubbornness will diminish. This will include identifying the behaviors that you each do that feeds the beast.

      As you stay out of the Control Battle, stay focused on your daughter’s strengths and let her know you have faith in her, set appropriate standards and let her earn her privileges, things will turn around. Each situation is different, but if you use these basic tenets, you’ll be going in the right direction.

      My best wishes to you.

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