Parenting teens: When to consider therapy and how to begin

Signs your teen may need extra support

It can be difficult for parents to distinguish between typical adolescent moodiness and genuine signs that a teenager is struggling and could benefit from professional help. However, certain persistent or severe indicators should prompt consideration of therapy.

Common indicators that therapy might be helpful include:

• Withdrawal from family and friends: A sudden or prolonged disinterest in spending time with loved ones, preferring isolation over social interaction, or cutting ties with established friend groups.

• Persistent sadness or hopelessness: Expressing feelings of sadness that don't lift, a lack of interest in activities they once enjoyed, frequent crying spells, or comments about feeling worthless or empty.

• Sudden drop in school performance: A significant and unexplained decline in grades, increased absences, difficulty concentrating, or a loss of motivation for schoolwork.

• Increased irritability or anger: More frequent, intense, or uncharacteristic outbursts of anger, aggression, or a generally short temper.

• Significant changes in sleep or appetite: Difficulty falling or staying asleep, sleeping excessively, or noticeable changes in eating habits (e.g., eating much more or much less, expressing concerns about weight or body image).

• Risk-taking behaviors: Engaging in new or increased risky behaviors such as substance use (alcohol, drugs), self-harm (cutting, burning), reckless driving, or promiscuous behavior.

• Expressing suicidal thoughts or intentions: Any mention of suicide, death, or self-harm should always be taken seriously and warrants immediate professional attention.

• Physical complaints with no medical explanation: Frequent headaches, stomachaches, or fatigue that don't have an underlying physical cause.

Consider a relatable scenario: A previously outgoing and academically strong teenager suddenly becomes withdrawn, spends most of their time in their room, and their grades plummet. They seem anxious and irritable, snapping at their parents, and refuse to discuss what's bothering them. This shift began subtly after a major life event, such as their parents' divorce, a move to a new town, or the loss of a close friend. These changes indicate that the teen is struggling to cope and could greatly benefit from a safe, neutral space to process their feelings and learn new coping mechanisms.

How therapy helps teens thrive

Therapy for teenagers is distinct from adult therapy, designed to engage adolescents on their own terms and address their unique developmental needs. It provides a confidential, structured environment where teens can grow emotionally and develop essential life skills.

Therapy offers significant benefits that help teens thrive:

• A safe, confidential space to talk without fear of judgment: This is paramount for teenagers, who often feel misunderstood or judged by peers and even family. A therapist offers an unbiased, non-parental adult who is legally bound by confidentiality (with specific limits, like risk of harm) and dedicated to their well-being.

• Tools to manage stress, anxiety, or depression: Therapists equip teens with practical, evidence-based coping skills. This might include mindfulness techniques for anxiety, cognitive behavioral therapy (CBT) strategies to challenge negative thought patterns, or dialectical behavior therapy (DBT) skills for emotional regulation.

• Strategies for improving communication with family: While the therapist's primary client is the teen, improved communication skills learned in individual sessions often ripple out to family interactions. In some cases, therapists may also suggest family sessions to directly address communication breakdowns and help family members better understand each other.

• Healthy coping mechanisms for difficult emotions: Teens learn alternatives to unhealthy coping strategies like withdrawal, anger outbursts, or substance use. They develop constructive ways to process frustration, sadness, and fear.

• Enhanced self-awareness and self-esteem: Therapy helps teens explore their identity, values, and strengths, leading to a stronger sense of self and increased confidence.

• Problem-solving skills: Therapists guide teens in identifying problems, brainstorming solutions, and evaluating consequences, empowering them to make more informed decisions.

To make sessions engaging and comfortable for teenagers, therapists often use creative and interactive approaches:

• Art therapy: Using drawing, painting, or sculpting to express emotions that are difficult to put into words.

• Play therapy (for younger teens/pre-teens): Utilizing games or toys to facilitate communication and explore feelings symbolically.

• Role-play: Practicing difficult conversations or social scenarios in a safe environment to build confidence and refine communication skills.

• Interactive digital activities: Incorporating online games, apps, or videos that support therapeutic goals and align with teens' comfort with technology.

• Storytelling and metaphors: Using narratives to help teens understand complex emotional concepts.

By providing these tools and fostering a safe space, therapy helps teens not just manage their struggles but truly thrive emotionally, socially, and academically.

Benefits of online therapy for teens

The rise of online therapy has created a remarkably accessible and often preferred option for adolescents. Its characteristics align particularly well with teenage comfort levels and logistical needs, making it a powerful alternative to traditional in-person sessions.

Here are the key advantages of online therapy for teens:

• Teens often feel more at ease communicating online: Growing up in a digital world, many teenagers are highly comfortable with video calls, messaging, and online interactions. This familiarity can reduce initial awkwardness and make it easier for them to open up to a therapist than they might in a new, unfamiliar office environment.

• Sessions can be scheduled around school and activities: Adolescent schedules are notoriously packed with classes, extracurriculars, sports, and social engagements. Online therapy offers significantly more flexibility, allowing sessions to occur during a lunch break, after school, or in the evening, without interrupting their already busy lives or requiring parents to navigate challenging logistics.

• Eliminates travel time and coordination: For busy families, online therapy removes the need for parents to drive to appointments, saving valuable time, fuel, and reducing scheduling stress. This also means fewer missed sessions due to transportation issues.

• Parents and teens can participate together or separately as needed: Online platforms make it seamless for the therapist to include parents in joint sessions when family communication is a goal, or to switch to individual sessions with the teen as appropriate, all within the same virtual framework.

• Online therapy can feel less intimidating than going to a clinic: The idea of walking into a "therapy clinic" can carry a stigma for some teens. Attending a session from the comfort and privacy of their own bedroom or a designated quiet space can feel less formal, more private, and therefore less intimidating.

• Increased access to specialized therapists: Families are no longer limited by geographical location. Online therapy expands the pool of available therapists, making it easier to find a professional who specializes in specific adolescent issues like LGBTQ+ affirming care, eating disorders, ADHD in teens, or complex trauma, ensuring the best possible match.

• Consistency of care: If a family travels or relocates, online therapy can often continue with the same therapist, providing crucial consistency and stability during times of change.

These advantages often translate into greater compliance, more consistent attendance, and ultimately, more effective therapeutic outcomes for teenagers.

How parents can support the process

While therapy is ultimately for the teen, parental support plays a crucial role in its success. Your approach can significantly influence your teenager's willingness to engage and their overall comfort with the process.

Here's practical advice for caregivers:

• Normalize therapy by comparing it to other forms of health care: Frame therapy as a proactive and healthy way to take care of one's mental well-being, just like visiting a doctor for a physical ailment or a coach for athletic development. Say something like, "Just like we go to the doctor when our bodies aren't feeling well, sometimes our minds and feelings need a little extra support, and a therapist is like a coach for your emotions."

• Respect the teen's privacy—avoid pressing for details after each session: This is paramount for building trust. While it's natural to be curious, bombarding your teen with questions like "What did you talk about?" immediately after a session can make them feel interrogated and less likely to open up in therapy. Instead, offer gentle, open-ended support: "How are you feeling after your session?" or "Is there anything you want to share, or anything I can do to help?"

• Stay available and open for conversations: Let your teen know that you're always there to listen if they choose to share, without judgment. Create opportunities for casual conversation.

• Encourage consistency with appointments: Remind your teen about upcoming sessions and help them find a private space. Emphasize that regular attendance helps them get the most out of the process.

• Help set up the technology: For online therapy, ensure your teen has access to a reliable internet connection, a quiet and private space, and a functioning device (laptop, tablet, or smartphone). Help them test the video and audio before the first session.

• Communicate with the therapist appropriately: Understand that while the therapist will keep specific session details confidential (unless there's a safety concern), they will generally communicate with parents about overall progress, goals, and strategies parents can use at home to support the teen. Clarify communication protocols with the therapist at the outset.

• Model healthy coping: Show your teen that you also engage in self-care, manage your own stress, and are open to growth. Your actions speak volumes.

By demonstrating trust, respect for privacy, and consistent support, parents create an environment where their teen feels safe to engage in the therapeutic process and truly benefit from it.

Choosing a therapist for your teen

Selecting the right therapist is a crucial step for your teenager's successful therapeutic journey. A strong rapport and specialized expertise can make a significant difference in how your teen engages with the process.

Here's how parents can guide their search for a suitable therapist:

• Look for licensed professionals with experience treating adolescents: Ensure the therapist is licensed in your state or country (e.g., Licensed Professional Counselor, Licensed Clinical Social Worker, Psychologist). Crucially, confirm they have specific training and a proven track record of working with teenagers. Adolescent therapy requires a different approach than adult therapy.

• Ask about their approach and how they build rapport: During an initial consultation (many therapists offer a free brief call), inquire about their therapeutic style. Do they use approaches known to be effective with teens, such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or art/play therapy? How do they typically engage reluctant teens? A good therapist will prioritize building trust and a strong connection with your child.

• Check their specializations: Look for therapists who have expertise in the specific challenges your teen is facing, whether it's anxiety, depression, ADHD, trauma, eating disorders, LGBTQ+ issues, substance use, or family conflict. A specialized therapist will have more tailored strategies.

• Inquire about parental involvement and communication: Discuss how the therapist typically involves parents in goal-setting and provides updates on progress. A good teen therapist will maintain appropriate confidentiality with the teen while also collaborating with parents on overarching goals and offering guidance for support at home. Clarify boundaries around what will be shared.

• Consider gender or other identity preferences: Some teens may feel more comfortable with a therapist of a particular gender or someone who shares a similar cultural background. Online platforms make it easier to find a match based on these preferences.

• Schedule an introductory consultation: If possible, have your teen participate in a brief introductory call with a couple of potential therapists. This allows your teen to feel involved in the decision and assess if they feel comfortable with the therapist's personality and style. Their buy-in is incredibly important.

• Verify insurance and logistics: Confirm fees, whether they accept your insurance, cancellation policies, and their availability for sessions that fit your family's schedule.

Finding the right therapist is a process, and it's okay to "interview" a few before making a decision. The goal is to find someone with whom your teen feels safe, understood, and genuinely connected.

Conclusion

Parenting a teenager is undeniably one of life's most demanding yet rewarding journeys. While the adolescent years are marked by significant growth, they can also bring profound emotional shifts that necessitate professional support. Recognizing the signs that your teen may need extra help and taking action early can genuinely prevent problems from escalating and significantly strengthen their emotional resilience. Online therapy offers a uniquely accessible, comfortable, and effective pathway for teens to navigate these complexities. By thoughtfully choosing a therapist and providing unwavering support, parents can take that crucial first step toward safeguarding their teen's mental health and fostering their well-being, helping them thrive not just through adolescence, but for years to come.