[Reprinted from the book The Bipolar Teen by David J. Miklowitz, PhD, and Elizabeth L. George, PhD; copyright © 2008 The Guilford Press; published by The Guilford Press. Reprinted with permission of The Guilford Press. This article may not be reproduced for any other use without permission.]
Teens who are in the midst of identity development and moving toward independence usually resist parents' attempts to have them "get their head shrunk." If you're wondering how you can possibly get your teen to attend therapy sessions, here are some strategies you can use.
How to Make It to the First Session
Your teen might have a number of reasons for resisting therapy ("I'm not the problem," fear of being teased by friends, fear of the unknown, "I can do it on my own," etc.). There are several avenues for motivating your teen. First, although teens may resist going to therapy for themselves, they may be open to the idea that the whole family needs therapy. Many teens will go to therapy for a parent or other family member.
Second, you can try offering rewards. For example, some parents make therapy part of the required weekly responsibilities for a teen to get an allowance or to use the car. Michelle allowed her 12-year-old son, Alex, to go on sleepovers if he would first see a therapist to address not only a plan for getting more sleep at sleepovers but also how to manage his irritability the next day. The therapist then helped Alex identify an extended list of goals to work on. You may want to have a discussion with your teen about potential reinforcers for attending therapy.
You may have to be creative to get your teen to the first session through enlisting the help of a school counselor, best friend, coach, or peer support group. Jackson, age 17, had been suspended from school on a number of occasions and made several trips to the emergency room because of his impulsive and risky behavior. He denied any need for treatment, arguing that "if I need therapy, then so do all my friends." He finally compromised by attending a peer support group. When he recounted to others in the group some of the things he had done (for example, getting thrown out of a shopping mall for disruptiveness; cursing at a teacher who had asked him to settle down in class), he was surprised that several group members considered his behavior "over the top" and "uncool." This feedback helped convince Jackson to see his own therapist and, eventually, a psychiatrist who diagnosed his bipolar disorder.
Parents will often go to a therapist by themselves to strategize how to get their teen into treatment. Unknown to Maria, her mother and father attended therapy for months before they were able to get Maria to go to her first session. They spent their time discussing (1) various tactics for having Maria attend therapy and the pros and cons of each plan and (2) ways to support healthy change in the home in the meantime. She finally agreed when a respected and trusted family friend told Maria that she had been helped by seeing a therapist during her adolescence.
Finally, some parents get so frustrated with their teen's behavior that they resort to ultimatums. Although we generally discourage this tactic, some families decide that their teen is either going to therapy or to a therapeutic boarding school. A teen who is faced with these choices typically opts for going to therapy and continuing to live at home.