My Teen Doesn’t Want to Go to Therapy or Mental Health / Substance Abuse Treatment, What Should I Do?

Your teen needs mental health treatment for a certain emotional, behavioral, or substance abuse problem. It could be depression, anxiety, trauma, ODD, DMDD, ADHD, prodromal psychosis, addiction, substance use, or any other mental health issue. The problem is, your teen does not want to go to treatment.

Your teen could have a number of reasons why they don’t want to get mental health treatment. They could say they don’t need the help. Or that therapy won’t help anyway. Whatever it is, they are either refusing to go, or are physically going but not engaging with the therapist or professional staff.

How to Respond to a Treatment-Resistant Teen

If your teen is being resistant to residential treatment, outpatient therapy, or even an IOP/PHP program, it’s important to know how to address their concerns or excuses about not wanting to seek treatment.

Your teen could have a number of reasons for being anti-therapy. Here’s how to respond to each of them:

1. “I don’t need mental health/substance abuse treatment.”

Many teens will downplay their mental health symptoms, or simply deny that they are struggling. When this happens, don’t immediately argue with them. Don’t get too worked up, either.  Though of course, this is easier said than done. Try your best to listen calmly and carefully to what your teen is saying. Validate their feelings… but remember not to validate the invalid! At a later point, when both of you are calm, bring up some previous statements or behaviors your teen has made, and address how therapy could help. For example: “Remember when you told me that day “I just feel like nothing is worth it anymore?” And you know how you’ve been feeling kind of down lately? Many teens are in your situation…and they find that, when they talk about these feelings with a professional/go to residential treatment/go to an intensive outpatient program, they end up feeling much better.”

Try to avoid using words like “depression” or “disorder” if you think your teen might bristle at the labels. Also helpful is bringing up some goals of your teen – whether it is to succeed at a certain sport, go to a certain school, work in a certain field – and explain that therapy might be necessary in order to achieve that goal.  For example: “If you want to graduate from high school next year, you’ll need to go to a teen treatment center this month so you can get the help you need and come back to school a healthier person.”

2. “Therapy won’t help anyway.”

If your teen does realize they might have a mental health or substance abuse problem but doesn’t think therapy will help, which is often the case for teens with depression, there are a few ways you can approach this. First, you can ask them how they know it won’t help if they’ve never tried it. Or, even if they’ve tried therapy in the past, explain that every therapist and every teen treatment center is different. Therapists have different approaches, and mental health treatment centers do too. For example, there’s Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Motivational Interviewing, Relapse Prevention, and Trauma-Informed approach. Perhaps CBT didn’t work for them, but DBT will.

Or perhaps they saw a therapist in the past, but did not attend a fully immersive teen mental health or dual diagnosis treatment center.  Intensive outpatient or partial hospitalization programs (IOP/PHP), or 24/7 residential treatment centers (RTC), are more intensive options than just regular once-a-week therapy.  Also, inform your teen that certain therapy modalities are actually evidence-based. Meaning, science shows that they really do work for teens (and it’s not just the placebo effect). For example, there are hundreds of research studies using randomized-controlled trials that show the efficacy of DBT in treating depression, anxiety, PTSD, borderline personality disorder, suicidal ideation, self-harming behaviors, and more.

3. “Therapy is for crazy people, not me.”

Unfortunately, the stigma against mental health treatment still exists. On a side note, there are many nonprofits which seek to reduce this stigma against mental health disorders in youth and teens, such as NAMI, the Trevor Project, Ok2Talk, Crisis Text Line, etc. Check out these websites and encourage your teen to check them out as well. Give them the statistics about teens with mental health issues. (According to the NIMH, about 1 in 5 teens is struggling with a mental health condition.)Respond to them that therapy is for anybody who needs it, and that people are not “crazy” for having a mental health issue.

Many high-profile, successful celebrities freely admit to going to therapy, including Brad Pitt, Katy Perry, Demi Lovato, and Selena Gomez (who is an enthusiastic advocate of DBT teen treatment centers). Additionally, note that many successful professionals and individuals around the world seek therapy, even if they don’t have a diagnosable mental health or substance abuse disorder! These people go to therapy to help them make decisions in their life or to help them solve problems. Tell your teen that therapy, and mental health treatment centers, are not just for teens with intense psychological issues. They’re for all teens who want to improve their mental health and life.

4. “Therapy is a waste of time and money. Therapists don’t even care about you.”

Many teens will say therapy is a waste of money, especially when they know how much it costs. “If my therapist really cared about me, they wouldn’t be so nitpicky about the time,” is also a common complaint. However, try explaining to your teen that just like a physician gets paid for helping someone get physically better, a mental health professional also gets paid for helping teens recover from their mental health, behavioral, or addiction issues. And that there are certain professional boundaries that must be put into place to secure the therapeutic relationship. Also, explain to your teen that most therapists wouldn’t go into this profession if they didn’t genuinely care about their patients and/or want to make a difference in their lives.