If your child is like most teens, they’re reluctant about seeking help for a mental health or alcohol/substance use problem.
Even if they receive a diagnosis for a disorder like depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), oppositional defiant disorder (ODD), disruptive mood dysregulation disorder (DMDD), attention-deficit hyperactivity disorder (ADHD), alcohol/substance use disorder (AUD/SUD) or another mental health issue, they may not grasp the severity of their disorder or the implications of their diagnosis.
They may not know it’s important to get professional help as soon as possible.
As a parent, you know your teen needs help – but how do you get them to turn the corner, and realize that treatment is the best possible option?
We asked Lisa Faguet, LCSW, Clinical Program Director of Evolve Residential Treatment Center in Agoura Hills, CA, for advice on this topic.
Here are Lisa’s top five tips for encouraging reluctant teens to commit to treatment:
1. They need to know it’s not punishment.
Parents need to emphasize that their teen doesn’t need to get mental health or substance abuse treatment because they’re getting punished. Rather, they have to go because they need help and their life is unmanageable the way they are currently living. To get this message across accurately, don’t bring up the issue of teen treatment when you’re upset at your child. Stay calm and logical. So, for example, if you catch your teen self-harming, using drugs, or engaging in any other maladaptive behaviors, don’t say “You’re grounded, you’re going to treatment.” Instead, wait. Bring up the idea of treatment once you cool down. Of course, mental health treatment can be the logical outcome – a.k.a. a consequence – of maladaptive behavior, but it’s important to emphasize that it’s not a punishment. There’s a difference.
2. Understand and address their resistance.
Many teens have preconceived notions about mental health or drug rehab programs, some of which are outright false. Others resist for logical reasons. Make sure to address all of these concerns. For example, a teen can be reluctant to go to residential treatment because they don’t want to miss school. Or leave their best friend, or their romantic interest. They might be embarrassed about going to rehab because they think everyone’s going to find out. Some teens also think going to mental health or substance abuse treatment is going to go on their permanent record, which is false. Or, perhaps someone they know went to rehab and experienced physical aggression from staff. It’s your job as a parent to clear up any misinformation and respond to logical concerns with logical answers. Here’s a list of possible responses to the common sticking points just mentioned:
You’ll have to miss school, but the program incorporates academics into their daily schedule.
You might be able to talk to your best friend on the phone once a week.
We’re not going to make this public knowledge.
Mental health and drug treatment centers are bound by strict confidentiality laws.
You’re going to a hands-off facility. No one is going to touch your body in any way.
If you listen respectfully, validate and respond to their concerns with clear and rational answers, rather than dismissing them out of hand with no discussion, they’ll be far more likely to consent to treatment.
3. Explain why they’re going to treatment.
Of course, your teen may have an attitude about their disorder.
They may say, “So? This is my issue. Why do you care?”
If this is their position, be clear about the negative impact of their behavior not just on their life, but on the lives of others – including the rest of the family. For example, if your teen is seriously depressed and you need to supervise them 24/7 at home, explain the effect this is having on your life, in addition to their life! If the behaviors related to a defiance or mood dysregulation disorder cause physical or emotional harm to their siblings or peers, mention this. If their anxiety or panic attacks is causing them to miss school, explain how this may affect their academic record. Many mental health issues impact peer relationships, family relationships, and general wellbeing. Express to your teen that it’s because you love them so much that you want them to get help so they can function better in all these areas.
4. Tell them you’re going to get support, too.
Teens often think parents want to ship them off to a mental health or substance abuse treatment center so that they don’t have to deal with them anymore. Teens may think their parents just want to get a break from all the stress. Dispel this notion as soon as it comes up. Inform your teen that you’re also going to seek mental health treatment or support, whether it’s one-on-one therapy, Al-Anon meetings, parent support groups, or once a week family therapy. The message should be clear: “The whole family is getting treatment, not just you.”
5. Explain the consequences of not going to treatment.
Sometimes teens will refuse treatment, despite your good faith efforts to persuade them treatment is the best option. If this happens, you need to spell out what will happen if they don’t go to treatment. Be prepared to implement strict consequences and limits at home. For example, if they don’t agree to treatment, you need to be ready to:
- Take away their car and keys
- Limit money or access to your credit card
- Take away their cell phone
- Remove Internet or social media access
- Limit access to friends, or switch schools
They need to hear all this from you.
Of course, these consequences require advance thought and planning, but if your teen refuses treatment, you have to take action. You need to be as strict as possible, whether it means removing their bedroom door if they keep using substances, changing the locks if your teen continues running away, or removing privileges, as described above, for unwanted behavior. Explain that they’ll start to earn these privileges back after they complete their treatment, whether it’s at a residential treatment center, a partial hospitalization program, or an intensive outpatient program. Additionally, explain to your teen that if they remain unwilling to cooperate during treatment, they may eventually have to go somewhere else for longer, more intensive treatment. (i.e. If they are treatment-resistant to PHP, they may end up in a residential treatment center.)
Authoritative (Not Authoritarian) Parenting
Finally, we want all parents to remember this: avoid getting in a power struggle with a teenager. Yes, they have agency, and yes, they have a say in how they live their lives – but as long as they’re minors, living under your roof, you have authority. You should not wield it like a dictator, but if your teen refuses treatment, you should not be afraid to use the behavior management strategies listed above to keep the peace in your home.
If, however, you convince your teen to consent to treatment, there’s a very good chance that at the end of the day – and at the end of treatment – they’ll realize you were right all along. They’ll appreciate your persistence, and they may even thank you for it. The end of treatment marks the beginning of a new chapter: you, your teen, and the rest of your family will have a real chance at restoring the balance and harmony that allows everyone to learn, grow, and thrive.