How to Tell Teenagers They Need Therapy

No one is perfect and no parent is perfect. Additionally, being a parent is not a popularity contest and at times a parent must make unpopular decisions. Therefore, parents are going to make mistakes and make unpopular decisions as they are raising their children. These are facts every parent has to face, if they want to try to be a good parent. There is no reason to make a big issue about a mistake, it is simply part of life. Parents obviously should try to learn from their mistake and hopefully this will help them if they have more than one child. When 17 or 18 year old, I have many teens come into the office and they are complaining about their parents mistakes, I point out that no parent is perfect and ask what good is it going to do to continue to blame their parents. Yes their parents made a mistake, but at 17 or 18, the teenager needs to resolve the issue. Is this fair, no. But, the world is not fair.

There is one mistake that parents make that they are must make for their children because their children are not physically capable of making the decision themselves. Remember a child’s frontal lobes of their brains are not fully developed until the age of 25. The frontal lobes are the part of the brain responsible for handling abstract reasoning and for making rational decisions. This is why insurance companies charge higher premiums for driving insurance for people under 25. So if their frontal lobes are not developed and insurance companies don’t trust their judgements completely until they are 25, why would parents trust a teenager with the decision about attending therapy? Remember they don’t have the emotional maturity to make such a decision yet, so why let them think they have a choice. We don’t do this with braces, or eyeglasses so why do it with therapy? Obviously, parents should explain therapy, why they feel the child needs therapy and listen to their feelings. You don’t want a child to feel like they are living in a dictatorship. The fact is they are not cognitively mature enough to decide if they need therapy. They are not physically mature enough. However, I see parents make this mistake daily. Parents say well they need their child to feel comfortable with the therapist. Yes, they do need to feel comfortable with the therapist. Therefore, you ask how they like the person. You want the feedback about if they like the person, but you don’t give them the option regarding going to therapy or not. Whether they attend therapy or not depends on what is happening at home, with friends, at school and what the therapist is telling you. You assess all of this information and decide if therapy is appropriate or not, your teenager doesn’t make the choice.

Think about it do you ask your child if they want to get their yearly physical or go to the dentist? Children and teenagers complain all the time about physicals, getting immunizations or going to the dentist. Parents don’t say okay we will wait until you feel you need to go. Parents say it’s important that you go and I said you are going. This is a time as a parent you need to assert your authority as the parent to ensure that your child is healthy. If they needed surgery for appendicitis and they said they didn’t want surgery you would not say okay, you would say I’m your parent and you are having surgery because you need it.

Additionally, the CDC, FDA and recent research studies regarding smartphones have shown 1 in 5 children would benefit from therapy. Additionally, there is an epidemic of depression, anxiety, suicidal ideation, drug addiction and loneliness in children and teenagers in the United States. There was a significant spike in children dealing with these issues in 2010 and has been increasing every year since 2010. We are now running short of psychotherapists who treat children and teenagers. Insurance companies are reaching out daily saying they have a client in need of therapy and does the therapist have room on their schedule. I receive between 5 to 10 emails a day.

Unfortunately, since Trump didn’t keep his word, many of you will be seeing significant increases in your health insurance premiums and copays and you may not be able to afford for the therapy that your child needs. Unfortunately, our government does not seem to think mental health is an important issue, but they are punishing parents for not following through with psychotherapy. If your child needs therapy and you can’t afford it, ask the therapist if they have a sliding scale. Other health care areas, such as your primary care, may not provide a sliding scale, but many psychotherapist do.

As a parent, if you are noticing signs of depression or severe anxiety, why would you ask your child if they want to go to therapy? Most children are going to say no due to the stereotype associated with therapy. Yes a teen needs to feel comfortable with their therapist so asking if they are comfortable with a therapist makes sense. However asking if they want to go to therapy is a mistake. As a parent if you notice or the school notices a mental health issue and you consult a therapist, who confirms that your child needs therapy then it is your responsibility as a parent to get your child therapy.

Recently the Court found a mother and father guilty for a school shooting because they failed to get their son mental health care even though it was obvious that he needed therapy. If you are scheduling a conversation with a psychotherapist to determine if your child needs therapy, they need therapy. As a parent you would not go that far unless you are seeing issues that you are concerned about regarding your child’s behavior. Pick out to therapist that you are comfortable with and have your child select the one they feel most comfortable with talking to. Also follow the therapist’s instructions at the beginning. A psychotherapist needs approximately four assessment sessions before they can provide you with specific information. They may need longer if the teenager is being difficult to work with in therapy.

I understand it might sound harsh telling your child they are going to therapy and you are not discussing it. However, remember their brains are not mature enough to make this type of decision and how many times have you had to tell them they are doing what their primary care doctor or dentist said and you are not discussing it. Being a parent is very difficult in 2026. Also there is plenty of research indicating that children and teenagers need therapy, as I mentioned above. Remember the CDC has reported an epidemic of anxiety and depression in children and teenagers and suicide is the second leading cause of death in children 10 to 18 years old. So give them a choice of which psychotherapist they work with but do not make psychotherapy an option.

Additionally, as I mentioned above, Courts are putting parents on trail when they fail to get their child therapy. Physical and mental health operate together and they are equally important. If you have a problem in one, you will see problems in the other one. For years we have ignored mental health issues, but now when suicide is the second leading cause of death for teenagers and there is at least one mass shooting per day (CDC), we can no longer ignore it. Additionally, this is too big of an issue to place on a teenager. Therefore, as a parent you maybe faced with making the unpopular decision that your teenager must go to therapy. I think you would prefer dealing with the unpopular decision than making the decisions for your child’s funeral. I’m not exaggerating either, remember the send leading cause of death for teens is suicide and the leading cause is a gun shot (CDC). Therapy could help a child avoid suicide or have them tell you if they are in unsafe situations with friends.

Dr. Michael Rubino is a psychotherapist with over 25 years experience working with children, teenagers, trauma survivors including first responders. For more information about his work visit his website www.RubinoCounseling.com or www.Facebook.com/drrubino3