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When Your Teen Refuses Help: Navigating the Challenges of Resistance to Treatment

Author:
Jemma Strain
Jemma Strain
B.S. Psychology
Editor:
Emma Loker
Emma Loker
B.S.
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One of humanity’s biggest fears is that of the unknown – so change can feel scary to a teen. Talking about treatment can make a teenager feel like they’ll lose their independence and sense of control, and can jolt them into having to accept uncomfortable aspects of life. For these reasons, it’s common to encounter teen resistance to mental health treatment. 

If your teen is showing signs of a mental health condition, this is an inevitably distressing time for you both. You may fear for their well-being, want to make steps to protect their happiness and future, and wonder what to do if your child refuses help. 

Overcoming resistance to mental health treatment can be tricky, but it’s also normal for a teen to react this way initially. With patience, understanding, and unconditional love, you can help them come around to the idea of treatment. 

Seeking professional mental health support and guidance is never a misstep when worried about your child’s well-being. A professional can advise you on what to expect, explain the most suitable forms of treatment for your child’s symptoms, and ease your concerns. 

This page can also help by explaining:

  • What teen resistance to mental health treatment is
  • The reasons why a teen might refuse treatment
  • How to help a teen who refuses therapy
  • Strategies for getting your teen to agree to therapy
  • Therapy options for overcoming resistance to treatment
  • How to find solutions when teens won’t seek help

What Is Teen Resistance to Mental Health Treatment?

It can be difficult for a teen to accept that they need mental health treatment. In fact, teen resistance to mental health treatment may be one of the biggest stumbling blocks parents face when striving to get their child the support they need. Despite often feeling overwhelmed by negative emotions, teenagers typically just want to be seen as “normal” by the people around them. And, due to stigma, they might try to bury or deny their feelings so that others don’t judge them.1

For mental health treatment to work, teenagers have to be open to the idea of it. In other words, they have to accept that there’s a problem and want to get help. Teen resistance to mental health treatment can be quite normal in the early stages of conversations around their mental health. Yet, understanding why they feel this way can go a long way towards helping them get the support they need.

Resistance to treatment

Understanding Teen Resistance to Treatment

As a parent, you’ll likely understand that every teenager is different, with unique personality traits and reactions to situations. However, there are a few commonalities between teens, which can lead to certain reactions when faced with the prospect of mental health treatment. 

For example, a teen might resist mental health treatment if they…1-3

  • Are in denial that they need help:     A lack of understanding of mental health issues, or a refusal to admit they have a problem, can lead a teenager to believe that they don’t need treatment.
  • Don’t believe that treatment will work for them: Unfortunately, certain mental health conditions, such as depression, can cause teenagers to feel hopeless. Therefore, they might not feel optimistic about the future or motivated enough to seek support. 
  • Feel ashamed or embarrassed: Teenagers typically strive to feel socially accepted. So, stigma around mental health issues can create a barrier for them in accepting treatment as they may think that others will judge them. 
  • Are defensive: Teens may become defensive if they’re trying to protect themselves from hurt or embarrassment, so they may resist the fact that they have a problem. 
  • Tried treatment before: If a teenager tried treatment before and it didn’t work for them, they might believe that it won’t work again. There are many reasons why therapy might not work first time round, including not feeling ready, the bond with the therapist, or not sticking to a treatment plan. 
 

In addition to these reasons why a teen might resist treatment, teens who accept treatment but still feel unwilling may be more likely to drop out of it. It’s, therefore, important to know how to help a teen who refuses therapy or is entering into it unwillingly.4

How to Help a Teen Who Refuses Therapy

Most people have a natural resistance to change. So, your teen initially refusing therapy isn’t really a surprising response. Yet, this doesn’t change the fact that it will nevertheless be a disappointing and distressing one. It’s important to remain in control of your emotions if this happens – neither you nor your teen are to blame for these circumstances.

Also, it’s good to keep in mind that resistance to therapy may be a symptom of a teen’s mental health issues. For example, depression is associated with a sense of hopelessness, so they might feel like therapy would be a waste of time. Remind them, consistently, that treatment can restore a sense of optimism. They can and will get better with the right support.5

Aside from reminding them that therapy can help them feel better, the following strategies can also increase the chance that your child will agree to therapy. 

Strategies for Getting Your Teen to Agree to Therapy1,4,6

1. Don’t Give Up:

Even if your teen says “No,” it’s important not to give up on the idea of treatment. They may need time to process the idea and come to terms with the fact that they may be experiencing mental health difficulties. Continuing to gently approach the topic of their mental health can also help them realize that they have your support and can turn to you when they feel ready to accept help. 

2. Reframe the Idea:

Talking to a teen about their mental health can be tricky. Often, despite best intentions, it’s easy to say the “wrong” thing and trigger a negative response. If a teen doesn’t respond well to the idea of treatment, perhaps consider approaching the topic again from a different angle. If you need guidance, our article “Approaching Your Child About Mental Health Treatment” could help. Either way, it’s good to remind them that you’re concerned and want to be there for them when they’re ready. 

3. Give Them a Voice:

Teenagers have a high need for freedom and self-rule. So, being told that they “have to” get treatment or deciding every step of the process for them may increase resistance. Allowing them to have a voice and a role in what type of treatment is best for their needs can give them a sense of empowerment and independence. Therefore, they might feel more open to the idea of treatment. 

You can also increase a sense of autonomy by encouraging them to have a say in lifestyle changes, such as improving self-care for better well-being. For instance, let them select meals in a healthy eating plan, the type of exercise they want to do, and forms of relaxation.

4. Tell Them About Confidentiality:

A big barrier which can often make teens resistant to treatment is the highly personal nature of what they will be expected to talk about. Your child may fear that the things they tell their therapist will be repeated to you or someone else. It’s good to let them know that a therapist is ethically and legally bound to protect what they tell them – so they can’t share personal information. The only time a therapist will break confidentiality is if they’re concerned about your child’s safety or that of someone else. 

5. Think About What Worked and Didn’t Work in the Past:

If your child has tried treatment before and didn’t respond to it, it can be good to help them figure out what worked, what didn’t, and why. Ask them questions about what they liked about therapy, why they discontinued it, and what they were hoping to gain from it in the first place. Therapy isn’t a one-size-fits-all approach, and the fit between a therapist and teen might not always mesh the first time around. For instance, your teen might prefer a more active conversationalist than a passive listener. So, encourage them to try again and let them know you can both try a few approaches and therapists until they find one they feel comfortable with. 

6. Encourage Them to Talk to a Therapist:

Meeting a mental health professional can help a teenager understand that what they’re going through isn’t part of the typical teenage experience. What’s more, during an initial assessment, a teenager can also “interview” a therapist, ensuring there’s a connection between them both. The therapeutic relationship is key for successful mental health treatment, so when there’s a fit, it can put a teenager’s mind at ease. 

Each of these steps can be beneficial when trying to get your teen to agree to therapy. However, another useful strategy which can ease the fear of the unknown, is understanding the types of therapy commonly used in mental health treatment. We detail these next. 

Overcoming Resistance to Mental Health Treatment

Knowing what to expect when going into treatment can help a teen feel more willing and open to the idea of change. Also, a trained mental health professional can help a teenager understand that they’re not to blame for what they’re going through – reducing shame and stigma. A professional can also talk a teen through the most appropriate forms of therapy for their needs and situation, including the following evidence-based options. 

Therapy Options for Teen Mental Health:

Cognitive Behavioral Therapy (CBT)

A professional will likely talk to your child about the option of CBT, as it is proven to be effective in treating many teen mental health conditions. It works by targeting teens’ thoughts and actions, identifying negative patterns, and helping them build healthy ways of coping. 

Eye Movement Desensitization and Reprocessing (EMDR)

A teenager’s previous experiences, such as trauma, could be contributing to their mental health difficulties. EMDR is an effective way of treating trauma as it changes how these memories are stored in the brain, helping a teen move past trauma and form more positive beliefs.

Transcranial Magnetic Stimulation

TMS can be effective in treating treatment-resistant mental health conditions. It’s a non-invasive therapy that uses magnetic fields to activate nerve cells in targeted areas of the brain – improving outlook and mood.

Interpersonal Therapy

A teen’s relationships with family members or friends can contribute to mental health difficulties. Interpersonal therapy can help them work through these issues and figure out better ways of coping to improve their mental health.

Mindfulness-Based Therapy (MBT)

MBT combines elements of CBT with non-judgmental mindfulness techniques to help teens combat negative emotions and moods. Through MBT, your child can learn how to not fall into a negativity cycle and build more positive self-beliefs.

Based on your teen’s symptoms, a mental health professional may also discuss the option of delivering therapy as part of a residential mental health program. While the thought of inpatient treatment might initially be daunting, a professional can put your child at ease by explaining the benefits and describing the supportive environment. 

a teen who has overcome resistance to treatment

How to Go About Finding Solutions When Teens Won’t Seek Help

Coping with teen mental health conditions can be difficult to do by yourself – and you don’t have to. If your teen is refusing mental health treatment, professional support and guidance are available to you. Mission Prep can help. 

Mission Prep’s team of licensed, empathetic professionals are well-experienced with teens who are initially resistant to treatment. However, we can help them understand the causes behind their issues, accept that there’s a problem, and learn ways to heal and cope. Often, the relationship between a teen and their therapist is the most important part of therapy, and we always aim to make a child feel listened to, cared for, and supported. 

Mission Prep offers outpatient and residential treatment options for a variety of teen mental health conditions in various locations, tailoring each program to each teen’s unique needs. What’s more, our team is available 24/7 to answer any concerns – even if you decide that our programs aren’t suitable for your child’s needs. Contact us to learn more. 

References

  1. Wisdom, J. P., Clarke, G. N., & Green, C. A. (2006). What Teens Want: Barriers to Seeking Care for Depression. Administration and Policy in Mental Health and Mental Health Services Research, 33(2), 133–145. https://doi.org/10.1007/s10488-006-0036-4
  2. Radez, J., Reardon, T., Creswell, C., Lawrence, P. J., Evdoka-Burton, G., & Waite, P. (2020). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European Child & Adolescent Psychiatry, 30(2), 183. https://doi.org/10.1007/s00787-019-01469-4
  3. Stige, S. H., Barca, T., Lavik, K. O., & Moltu, C. (2021). Barriers and Facilitators in Adolescent Psychotherapy Initiated by Adults—Experiences That Differentiate Adolescents’ Trajectories Through Mental Health Care. Frontiers in Psychology, 12, 633663. https://doi.org/10.3389/fpsyg.2021.633663
  4. Van Dijk, A., Brummelman, E., & De Castro, B. O. (2023). “I’m not here to push you:” raising adolescents’ treatment engagement via autonomy support. Behaviour Research and Therapy, 164, 104304. https://doi.org/10.1016/j.brat.2023.104304
  5. Breden, T. M., & Vollmann, J. (2002). Depression and competence to refuse psychiatric treatment. Journal of Medical Ethics, 28(3), 151–155. https://doi.org/10.1136/jme.28.3.151
  6. Ehmke, R. (2024, February 15). Helping resistant teens into treatment. Child Mind Institute. https://childmind.org/article/helping-resistant-teens-into-treatment/

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