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Autumn Quiles, LCSW

My Kid Doesn't Want Therapy


This has been a subject for discussion for me lately. The scenario goes like this: a parent calls me because their child is defiant or angry. Usually, this is because they are unhappy. The parent is out of solutions, so they call me and they want me to see their child. We talk about the problem and talk about the logistics of me meeting the child.


It is not until I am sitting with the child that I learn that the child doesn't understand, or want, therapy. If it is an older child, the child will tell me directly: "I didn't pick you and I didn't ask for this." If it is a younger child, they simply refuse to join me in the play area. Sometimes, there can be a lot of yelling at the parent and a lot of anger directed toward me. In this situation, no one wins; the parent feels embarrassed, the child feels threatened and I am sad because a mistake has been made that has hurt the parent-child relationship.


Therapy, regardless of whether or not the patient is an adult or a child, is a voluntary experience. Any adult, if forced to sit with a therapist and "talk", would thwart the process- the adult would shut down, feel resentful and, ultimately, undermine the process. The same happens with children. The difference is that parents, because of their position as an authority figure, feel they have the right to "force" a child into therapy. Though they may have that power, the child has the ultimate power to choose to participate.


I am a fantastic therapist. I'm great with kids and adults. I have a lot of experience and I can't think of a problem behavior that I am not comfortable addressing. But I am utterly incapable of making anyone, child or adult, want to sit with me and want to work through the things that are bothering them. I can serve up my skills and services on a beautiful platter, but it is up to the child to choose to take a bite.


This point is critical if you are a parent who is considering therapy services for your child. If your child balks at the idea of a therapist, it is critical that your child be (at the bare minimum) willing to try out the experience- willing to sit and see what the experience will be like- before you commit to the first therapy appointment. They don't have to be willing to "tell all" or "bare their souls" or even trust the person sitting across from them, but they do have to be open-minded about the idea that this process could be helpful.


A very important question that I ask my families before I begin work is: what is the child's understanding of therapy and do they want therapy? This is not a process that you can "sneak into" their weekly routine like broccoli in a smoothie. This is not a process that will go as un-noticed as a weekly housekeeper. If a child does not want therapy and you try to surreptitiously sneak it into your family's life, the child will immediately see this and feel betrayed and hurt by your choice- regardless of the quality of the therapist.


If you are in a place where you know therapy could be a good option but your child is not on-board, the solution is to help your child take control and have power over the process. Explain the benefits of therapy. Explain what it "looks like" in real life. Explain that there are hundreds of us and you need your child's help to choose the right person. Give your child the option of at least three different therapists. Research those therapists together. Talk about the pros and cons of their style and method. Interview the therapists together. Then, ultimately, reach an agreement about what therapist works for the both of you. When your child feels that they have enough information and power to choose what they think is best for themselves, there will be less discussion over the necessity of therapy and more discussion about the mechanics of it. And (this is the best part) you will have had an opportunity to connect with your child- to understand and respect them better- through this vetting process.

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