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Can you force a teenager to go for therapy?

Posted Mar 23 2013 5:00am

How do you get a teen to go for help?

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The question of getting a teen, or any other person for that matter, to go for mentally health treatment is always problematic. With teens you sort-of can and sort-of cant. Let’s see why.

First it depends on what you mean by “force.” With children and teens no matter what they may think, they are still minors and under someone’s supervisor. So technically yes parents can most of the time require a child to go for any kind of treatment even if the child does not want to go.

From here on out let’s call teens “children” because parents have responsibilities for the child regardless of the child’s wishes and teens are for most legal purposes still “minors” until they turn 18. I will let you know if there are reasons to separate teens from children.

Exceptions to making a child go for treatment would come from legal issues. Are you divorced? What does the custody agreement say? Is there legal involvement? What do the courts and Child Protective services say?

Even if the custody order says you can make those decisions for the child, most therapists will want both parents to sign giving consent for treatment. We professionals like to stay out of court as much as possible and seeing a child without one parent’s permission opens you up to all sorts of legal risks that may not be worth taking if you do not have to. 

One aside here, the child may consent for themselves if there are crisis issues or if they say you are abusing them, then they can seek outpatient treatment with or without parental approval in some places. This all gets complicated and most times the counselor will already be on the phone to someone for legal advice before they start seeing this child. If the child was suicidal whomever has the legal authority to put them on an involuntary hold and send them for evaluation or treatment can also do that whether you want your child’s suicide attempt treated or not. 

Back to our original question. You want this teen to go and they do not want to go. How far can you go to force them?  Physical force is not a good idea. For counseling to work the person receiving the treatment needs to talk and they need to think that there is some reason that this person can help them.

People forced to treatment do not get as much work done and it takes longer. Any good counselor will spend the first few sessions trying to build a relationship with this teen so the teen decides that this might be a good thing. At that point please do not start asking the counselor to betray the teens trust and tell you everything they have been up to.

I hope it does not surprise you that teens who are abusing drugs and alcohol and those who are very violent and oppositional do not show up for treatment a lot of the time.

Rather than call this treatment “forced” I like to think of it as encouraged.

One rule of parenting I like to tell clients about is that “Parents need to be parents and children need to be children.” Letting kids decide if they need counseling or any other treatment procedure may violate that principle. How can an emotional disturbed teen make a good decision about going for treatment?

Do you let drunks drive your car? That would be risky for you regardless of who they were. So if you suspect that your child is abusing drugs or alcohol you may find it difficult to get them to go for treatment but one way to motivate them to attend sessions is to take away or restrict their use of the car, or something else they care about, if they will not go for counseling. This making the cost of not going higher than the cost of going for treatment works some of the time but not all the time.

If they refuse even with the car taken away, you will need to go to more drastic measures. Also if once you take the car keys away and they do take the car and drive you may be forced to call the police and report the car stolen. Either that or explain to your insurance company and the police why you  let a child you suspected of abusing drugs or alcohol take your car and then you did nothing about it.

If you have any reason to think your teen, or younger child for that matter, needs to see a counselor or therapist and it is legal for you to take them in by all means have them go. The best case is that the counselor will tell you they do not see anything out of the ordinary and what your teen is going through is just a normal part of being a teen. So you spend a little money on an office visit for some peace of mind.

But if after that visit they suggest that your child needs to keep coming, make a serious effort to get that teen to the appointment.

If the teen refuses to go you will need to enlist the help of anyone and everyone who can get that kid into treatment before they get in serious trouble.  Try to do this before you need the help of his parole or probation officer and before he has harmed himself or others. 

Ignoring mental health problems does not make them go away. In plenty of cases people saw that there was something wrong with a teen or younger child and yet the child did not get treatment until they did something that ended up on the news.

A few early interventions with teens in distress could save a lot of pain for them and for other people down the road. 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page . For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com


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