Commitment Strategies: How to get your unwilling teenager to engage in treatment

Commitment Strategies: How to get your unwilling teenager to engage in treatment

The transition from summer to fall schedules can be a grueling one.  Any sort of change can be a trigger for stress. This is especially true for an over-scheduled teenager.   High School students these days are expected to engage in a multitude of extra-curricular activities, maintain their grades, do their homework, show up for school and for family life, foster social and perhaps romantic relationships, and stay healthy physically and mentally; and, on top of it all, eventually get into college.

Seems nearly impossible.  The standards are high, the days aren’t long enough, and burn out is on the rise.

For a teenager who either is engaged in therapy, or needs to seek treatment, fitting in a weekly session can seem like an insurmountable task.   How do you fit in a session between sports practice, debate team, dance classes and SAT tutors, and get hours of homework done?  They have a point:  It’s difficult AND it is something that they need to make work.

Here are some tips on how to have a rational conversation with your teen about prioritizing therapy:

  1. Validate the struggle and their opinions.  Listen to them complain and vent.  Explain to your teenager that you understand their point of view and the immense stress they are under to juggle it all.
  2. Maintain that mental health comes before all and that is the foundation upon which a healthy life is built.  Although a weekly therapy session may seem silly or unnecessary to a teenager, especially if that teenager feels they are doing well, remind them that part of the reason they are doing so well is because they are taking care of their mental health.  
  3. Use a medical analogy if necessary, especially if the teenager doesn’t see the need for treatment or says treatment is pointless, useless or “not working”.  Explain that progress in talk therapy can be slow and builds over time.  You may also explain that if there was a medical issue, you would need to attend follow up appointments or take medication, even if not in immediate crisis.   
  4. Prepare to negotiate.  Some teenagers may shut down in treatment if they feel like it isn’t necessary or they don’t want to be there.   They may not share their struggles with their therapist because they want to prove everything is okay.  In this case, a middle path may need to be found, such as sessions every other week.  
  5. Ask your teenager to commit for a set amount of time.  Many teenagers may think of therapy as something they must be in forever.  Have the therapist speak to your teenager about how long they are willing to commit. Perhaps the teenager will be willing to attend for a month, and needs to know that a family meeting will then be held to assess progress.  You’ll be surprised- in that month, the teenager will build more rapport with the therapist, start to see positive change and benefits, and may decide on their own to continue.
  6. Prepare to reward.  Validate how hard it is to fit therapy into the schedule, and reward attendance with something small but meaningful- a massage, a nail appointment, a favorite dinner out.  It doesn’t even have to be something physical.  Rewarding your teenager verbally by acknowledging their hard work and attendance can be of utmost value.
  7. Speak to the school, sports coaches, etc.  For example, many teenagers and their parents fear their son or daughter will be kicked off of a team if they have to leave early one practice.  Communication is key.  You will be surprised at how flexible and understanding people can be, especially in support of the mental health of a teenager.
  8. Assert your power as parent.  As hard as it is to have a resistant teenager, if your teenager needs treatment, the teenager must get treatment.  You do have the final say as a parent to do what is best for your child.  

Therapy is an important part of many teenagers’ lives.  It can provide a safe space for them to talk about how they are feeling and managing all of the pressures in their lives. Supporting them as they may struggle with their commitment may be what is needed to actually get them to commit.

Authored By:  Jaime Gleicher, LMSW