How to Talk to Your Child About Therapy
Tell your child about therapy plainly, at a calm moment, in words that fit their age. Young children need one or two simple sentences. School-age children want honest answers to their questions. Teenagers need a real two-way conversation and some say in the plan. In every case, present therapy as help, not punishment.
Key points
Be direct and brief, and match the amount of detail to your child's age.
Choose a time when your child feels safe and comfortable, not the middle of an argument.
Describe therapy as help with feelings, never as a consequence for behavior.
Ask the therapist how information from sessions is shared with parents, then explain it to your child.
Reluctance is common. Listen to the reason before you respond to it.
When and how should I bring up therapy with my child?
Guidance from the Substance Abuse and Mental Health Services Administration and from the American Academy of Child and Adolescent Psychiatry points the same way. Communicate in a straightforward manner. Speak at a level that fits your child's age and development. Have the conversation when your child feels safe and comfortable. Watch how your child reacts, and slow down or back up if they look confused or upset.
In practice, that rules out a few common moments: the heat of a meltdown, the car ride to the first appointment, or a discussion in front of siblings. A quiet moment at home, with time left over for questions, gives the conversation a better chance.
Start with what you have noticed and why you care. "You have seemed really worried at bedtime lately, and I want that to get easier for you" opens a door. "You need to see someone about your attitude" closes it.
What to say to a preschooler or young child
Preschool-age children need less information and fewer details than older children. One or two sentences is enough, tied to something concrete your child can picture.
You might say: "We are going to meet a helper whose job is to help kids with big feelings. You will get to play and draw while you are there, and I will be close by." That description is accurate. Therapists who work with young children often use play therapy, which relies on toys, drawings and games to help a child recognize, express and talk about feelings.
If the word "doctor" makes your child think of shots, use "helper" or "counselor" and explain that this visit is for talking and playing.
What to say to a school-age child
Children in elementary school tend to want more specifics and will ask direct questions. Answer them directly and honestly, and reassure them about the worries behind the questions. Common ones are "Is something wrong with me?" and "Am I in trouble?"
A possible script: "Lots of kids see a therapist. A therapist is a grown-up who is trained to help kids with worries, sadness or anger. You are not in trouble. You and the therapist will talk and do some activities, and over time it can make hard feelings easier to handle."
If your child asks how long it will take or what exactly will happen, it is fine to say you are not sure and that you will ask together. Our article on what happens in a first therapy session can help you answer.
What to say to a teenager
Teenagers can handle more information and will ask more specific and harder questions. They respond better to an open dialogue with give and take than to anything that sounds like a lecture. They may also have picked up mistaken ideas about therapy from friends or online, so ask what they have heard.
Try something like: "I have noticed you are not sleeping much and you have stopped seeing your friends. I am not angry. I think talking to someone who is not your parent could help, and I would like you to help pick the person."
Then offer real choices where you can: in person or telehealth, which clinician, what time of day. Having a say in the plan gives a teenager a reason to give it a fair try.
What should I tell my child about privacy?
Children and teenagers often want to know one thing before they agree to go: who will find out what they say. It is a fair question, and the honest answer depends on your child's age and situation.
So ask the therapist, at or before the first appointment, how information from sessions is shared with parents. Ask what you will be told, what stays between your child and the therapist, and how you will be kept informed about progress. Then explain the answer to your child in simple words, or ask the therapist to explain it with both of you in the room.
One part does not vary. Sessions are confidential, with legal exceptions for safety: a risk of harm to your child or to someone else, and suspected abuse of a child or vulnerable adult, which clinicians are required to report. Our patient privacy page has more.
What if my child does not want to go?
Find out what the no is about. Ask calmly. A child may fear being in trouble. A teenager may fear being labeled, or may simply not want to talk to a stranger. Each of those calls for a different answer.
Acknowledge the feeling. You can agree that meeting someone new is uncomfortable without dropping the plan. Let your child finish before you answer.
Ask for a short trial. Suggest a first visit to meet the therapist and see what it is like, and agree to talk afterward about how it went.
Offer choices inside the plan. Let your child choose what to bring, what to do afterward, or, for a teenager, which clinician and format to try first.
Do not wait when safety is involved. If your child talks about hurting themselves or is in crisis, call or text 988 (the Suicide and Crisis Lifeline) or call 911. Our office does not provide emergency services.
How Balanced Life can help
Balanced Life Counseling Services offers counseling for children and counseling for teens at our offices in Salisbury and Bethesda, Maryland, in person and by telehealth. Our guide on what to expect from therapy describes a first visit so you can describe it at home.
If you are still deciding, read about the signs your child may benefit from counseling, or contact us with your questions.
Frequently asked questions
How far in advance should I tell my child about a therapy appointment?
There is no set rule, and it depends on your child. Younger children need less information and fewer details, so a short, simple heads-up close to the visit is often enough. Older children want time to ask questions. Teenagers should be part of the conversation from the start, including the choice of clinician and format where that is possible. You can also ask the therapist what they suggest.
Should I tell my child why they are going to therapy?
Yes, in simple and honest terms. Name what you have noticed, such as trouble sleeping or a lot of worry, and say that therapy is a way to get help with it. Leave out blame and long explanations. If your child seems to think they are in trouble, say clearly that they are not, and that going to therapy is a way of getting support.
Will the therapist tell me what my child says in sessions?
Ask the therapist directly how information is shared, because the answer depends on your child's age and circumstances. You can ask what you will be told, what stays private, and how you will hear about progress. Sessions are confidential, with legal exceptions when there is a risk of harm to your child or someone else, or suspected abuse.
What if my teenager flatly refuses to go to therapy?
Stay calm and ask what the objection is. Offer choices, such as telehealth or in person, and suggest a single first visit before deciding anything further. If your teenager would sooner talk with another trusted adult for now, that can be a start. If there is any talk of self-harm, do not negotiate: call or text 988 or call 911.
Sources
If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline). In an emergency, call 911.