Page 1 of 2 1 2 LastLast
Results 1 to 10 of 11
  1. #1
    twowhat? is offline Red Diamond level (10,000+ posts)
    Join Date
    Feb 2009
    Posts
    14,104

    Default Agreeing to talk to a therapist (teens)

    DD1 had a couple of concerning responses to her mental health screening questionnaire at her annual well-visit and her pediatrician recommend that she see a CBT. The problem is that she doesn't want to. Not because she doesn't think it'll help, but she has such high anxiety around talking to adults - teachers, authority figures... Which she really probably needs therapy for as well.

    What approaches can I take to have her agree to try a therapist? I've already told her that I don't want to force her to see one because she needs to agree to it. I just don't know how to convey to her that she should try. She's almost 15 and SUPER shy. She seems totally normal otherwise, does well in school, is well-liked by peers, makes friends on her own. But she has very high anxiety around speaking up for herself, class presentations, going to a teacher to ask questions...all life skills that she needs to have. And she won't talk to me about it, she gets really upset and starts answering with "I guess. I guess. I dunno. I guess."

    Any tips?

  2. #2
    wendibird22's Avatar
    wendibird22 is offline Red Diamond level (10,000+ posts)
    Join Date
    Jan 2008
    Posts
    10,411

    Default

    Do you think she would be open to a virtual meeting with a therapist...even just a 15min consult? Maybe she'd be more comfortable with this initial approach as it could be done from the comfort of her room (or wherever) from her laptop, iPad, or phone? That might seem more low risk than going to a stranger and meeting face to face. I know my DD1, who is also 15 and sounds a lot like your DD, would probably choose that route.
    Mom to two amazing DDs ('07 & '09) and a fur baby.

    Gluten free since Nov '11 after non-celiac gluten sensitive diagnosis. Have had great improvement or total elimination of: migraines, bloating/distention, heartburn, cystic acne, canker sores, bleeding gums, eczema on elbows, dry skin and scalp, muscle cramps, PMS, hair loss, heart palpitations, fatigue. I'm amazed.

  3. #3
    JustMe is online now Diamond level (5000+ posts)
    Join Date
    Apr 2003
    Location
    .
    Posts
    7,685

    Default

    Would she feel better if you went with her for the first session (or attended with her if online). There are definitely therapists who will allow this, especially at the teen’s request, although there are some who have biases against it. Also, possibly asking dd if there are any circumstances under which she would be willing to go - I(accompanied by you, shorter session, input on choosing the therapist). I did see she has difficulty talking about this, so maybe not the best idea; but also maybe you could ask her to think about it and give her some time to come up with something? Just in case you and she don’t know this, many teen therapists also have activities available (crafts, games) so it feels more natural/less intense. Let her know that therapists work with many shy kids and are used to this, and if she is with a good therapist they won’t push her and will be helpful while respecting her pace/readiness to talk or not. If she is unwilling to go, I agree with not forcing her (not sure which answers on the screener were concerning and while some questions are pretty important, in general i feel the screeners aren’t as good as many think.)

    Finally, I’m a therapist myself and I’m not sure what the Dr means by a CBT? I’m guessing Cognitive Behavioral Therapist? Just hadn’t seen it written in that way before.

  4. #4
    twowhat? is offline Red Diamond level (10,000+ posts)
    Join Date
    Feb 2009
    Posts
    14,104

    Default

    Quote Originally Posted by JustMe View Post
    Would she feel better if you went with her for the first session (or attended with her if online). There are definitely therapists who will allow this, especially at the teen’s request, although there are some who have biases against it. Also, possibly asking dd if there are any circumstances under which she would be willing to go - I(accompanied by you, shorter session, input on choosing the therapist). I did see she has difficulty talking about this, so maybe not the best idea; but also maybe you could ask her to think about it and give her some time to come up with something? Just in case you and she don’t know this, many teen therapists also have activities available (crafts, games) so it feels more natural/less intense. Let her know that therapists work with many shy kids and are used to this, and if she is with a good therapist they won’t push her and will be helpful while respecting her pace/readiness to talk or not. If she is unwilling to go, I agree with not forcing her (not sure which answers on the screener were concerning and while some questions are pretty important, in general i feel the screeners aren’t as good as many think.)

    Finally, I’m a therapist myself and I’m not sure what the Dr means by a CBT? I’m guessing Cognitive Behavioral Therapist? Just hadn’t seen it written in that way before.
    Yes to CBT = cognitive behavioral therapist! Sorry about using an acronym that's not widely known!

    You have some good ideas that I will try on another day...giving her some time to "recover" from this incident! The screening tool was PHQ9 and DD1 had selected "1" for questions 1, 2, and 6. I managed to get out of her yesterday that she selected "1" and not "0" because she didn't want to lie and say "0", but "1" wasn't really appropriate either. She said if there was an option of "1-2 times over the past two weeks" that's what she would have selected. So, the Likert scale isn't the best because there's so much room between 0 (not at all) and 1 (several times over the past two weeks). So that was reassuring to hear from her BUT the fact that she couldn't communicate this to the doctor concerns me...should it? Maybe it's not a big deal? Once DD1 spirals into tears (which I think comes more from her anxiety being comfortable talking to an adult), then there is NO return - she will refuse to answer any follow-up question, or the answers are "I don't know" or "I guess", or simply a shrug of her shoulders. She's otherwise seemingly well-adjusted, and in 5th grade even got student of the year for her class. But middle school and teen ages are a whole 'nother beast. Our pediatrician DID tell her that it is NORMAL to sometimes feel those ways, especially at her age. And he explained that hormone fluctuations at this age cause chemical brain changes that can make you feel bad. And that chemical brain changes can also make you feel GOOD. But that he believes that if you are feeling bad and there is a way to help feel better, that it should be pursued. But by then DD2 was so flustered and already in tears after he asked her to give some examples of what made her feel #2 and #6 on the questionnaire...it also didn't help that there was a female doctor in there shadowing him, and she immediately got all lovey dovey wanting to give hugs and back rubs, etc which are NOT what DD1 is comfortable with from a stranger. In hindsight I wonder if DD1 would have done better if it was JUST our pediatrician?

    And we (including kids) love our pediatrician and he has a VERY sensitive approach to things like this so the fact that DD1 got that uncomfortable that quickly concerns me, but after typing this all out I am wondering if the situation was just set up for DD1 to fail with that extra doctor in there shadowing and DD1's overall and anxiety talking to adults, which probably isn't uncommon...and DD1 HAS forced herself to speak up in situations...like the yearbook fiasco that I have in the BP, LOL, and she DOES participate in class presentations. Things that she HAS to do - makes her SUPER uncomfortable and she avoids it at all cost but she CAN do it.
    Last edited by twowhat?; 06-02-2023 at 11:36 AM.

  5. #5
    mmsmom is offline Sapphire level (2000+ posts)
    Join Date
    Sep 2007
    Posts
    2,976

    Default

    We had the same thing happen with the screening at the annual ped visit last summer. However, therapy was already on my radar for DD (then 13). When I first asked DD about therapy due to some things going on in our family, she wanted to speak to the school counselor instead of an outside therapist. So I touched base with school counselor- she initiated first meeting then let DD come to her when she wanted. At end of school year counselor said she would need an outside therapist for the summer and that was solidified with screening at ped. So thankfully DD was on board but it did take a couple initial visits to find the right fit. I think having a therapist is almost a status symbol to the teens in my area- I have overheard the conversations of how often do you go, my therapist says or does this or that and even how much do you pay for therapy?

    I would just continue to encourage her and offer lots of options. There are also some group options which although may seem more intimidating maybe if she just observes to see what others are sharing it could be helpful.

  6. #6
    JustMe is online now Diamond level (5000+ posts)
    Join Date
    Apr 2003
    Location
    .
    Posts
    7,685

    Default

    Quote Originally Posted by twowhat? View Post
    Yes to CBT = cognitive behavioral therapist! Sorry about using an acronym that's not widely known!

    You have some good ideas that I will try on another day...giving her some time to "recover" from this incident! The screening tool was PHQ9 and DD1 had selected "1" for questions 1, 2, and 6. I managed to get out of her yesterday that she selected "1" and not "0" because she didn't want to lie and say "0", but "1" wasn't really appropriate either. She said if there was an option of "1-2 times over the past two weeks" that's what she would have selected. So, the Likert scale isn't the best because there's so much room between 0 (not at all) and 1 (several times over the past two weeks). So that was reassuring to hear from her BUT the fact that she couldn't communicate this to the doctor concerns me...should it? Maybe it's not a big deal? Once DD1 spirals into tears (which I think comes more from her anxiety being comfortable talking to an adult), then there is NO return - she will refuse to answer any follow-up question, or the answers are "I don't know" or "I guess", or simply a shrug of her shoulders. She's otherwise seemingly well-adjusted, and in 5th grade even got student of the year for her class. But middle school and teen ages are a whole 'nother beast. Our pediatrician DID tell her that it is NORMAL to sometimes feel those ways, especially at her age. And he explained that hormone fluctuations at this age cause chemical brain changes that can make you feel bad. And that chemical brain changes can also make you feel GOOD. But that he believes that if you are feeling bad and there is a way to help feel better, that it should be pursued. But by then DD2 was so flustered and already in tears after he asked her to give some examples of what made her feel #2 and #6 on the questionnaire...it also didn't help that there was a female doctor in there shadowing him, and she immediately got all lovey dovey wanting to give hugs and back rubs, etc which are NOT what DD1 is comfortable with from a stranger. In hindsight I wonder if DD1 would have done better if it was JUST our pediatrician?

    And we (including kids) love our pediatrician and he has a VERY sensitive approach to things like this so the fact that DD1 got that uncomfortable that quickly concerns me, but after typing this all out I am wondering if the situation was just set up for DD1 to fail with that extra doctor in there shadowing and DD1's overall and anxiety talking to adults, which probably isn't uncommon...and DD1 HAS forced herself to speak up in situations...like the yearbook fiasco that I have in the BP, LOL, and she DOES participate in class presentations. Things that she HAS to do - makes her SUPER uncomfortable and she avoids it at all cost but she CAN do it.
    I agree with your assessment of thinking the stuation was not a good one for your dd. Sounds like the situation may have become overwhelming/flooding for her and she shut down. As someone who has been a consultant for doctors, I have found they often have difficulty understanding that many people react in certain ways due to the authority they perceive the dr has, wanting to say the right things, etc. I am not diagnosing your dd, but I would not be overly concerned about the PHQ9 responses (I do know which questions you are referring to). I agree there is a problem with the scale; it is meant to be a screener with follow up questions asked, so your dr did the right thing by asking them, but as you describe the situation it did not work well for accurate answers from your dd. You mention anxiety, discomfort with adult authority figures, avoiding some situations, etc). Given her age, the ways schools are set up, etc, so many kids (and it can be especially true in the way you describe for girls experience these things). The original anxiety can be less of a problem then if secondary anxiety develops (the person feels something is wrong with them and they are hopeless, not good, b/c they experience anxiety). I agree with laying off therapy, keeping communication lines open (maybe bringing up how she is doing when she is calm and in non-intense situations-some parents like to do this while driving, but that never worked for me as I need to concentrate while driving), and not feeling like something needs to be done immediately. Would it benefit your dd to work on these things and is therapy a good way to do that; yes. However, this is pretty common. Does it seem like it has to happen immediately, that therapy is the only way to do it, etc-I don't think so from what you described. I also think it is important for your dd to feel as empowered as possible.
    lucky single mom to 20 yr old dd and 17 yr old ds through 2 very different adoption routes

  7. #7
    Liziz is offline Emerald level (3000+ posts)
    Join Date
    Sep 2011
    Posts
    3,685

    Default

    I don't have specific ideas or advice about encouraging your DD to try seeing a therapist, but I also have a DD who often shuts down with difficult conversations. We have found that writing notes to each other can be incredibly helpful. She's often able to process what I'm trying to "say" better if she reads it, and will often write to me feelings/thoughts she can't verbalize. With tougher discussions we often write a note or two back and forth, then after I have a better picture of what's going on in her head I'll ask if we can talk and often it'll be an easier conversation at that point.
    Lizi

  8. #8
    3isEnough is offline Platinum level (1000+ posts)
    Join Date
    Jun 2011
    Posts
    1,417

    Default

    I haven’t read all of the responses but when we were trying to get my DS to see a therapist a few years ago when he was 15, the therapist recommended to me that we tell him “You don’t have a choice in seeing a therapist because we believe you need it, but you DO have a choice in selecting who you’d like to see”. I provided 2 options of people he could see and said he could consider more if he wanted, but he selected 1 of them and actually went without argument.

  9. #9
    acmom is offline Emerald level (3000+ posts)
    Join Date
    Oct 2011
    Posts
    3,587

    Default

    Quote Originally Posted by Liziz View Post
    I don't have specific ideas or advice about encouraging your DD to try seeing a therapist, but I also have a DD who often shuts down with difficult conversations. We have found that writing notes to each other can be incredibly helpful. She's often able to process what I'm trying to "say" better if she reads it, and will often write to me feelings/thoughts she can't verbalize. With tougher discussions we often write a note or two back and forth, then after I have a better picture of what's going on in her head I'll ask if we can talk and often it'll be an easier conversation at that point.
    Yes to this. I have also found writing notes and texting with my DD very helpful. She just seems to feel more comfortable opening up if I give her time to think/process and then write it out vs. being on the spot and talking about it. I have found when we do talk about tough stuff in person, the car or a walk is helpful so there isn't as much intense eye contact.

    My DD had some similar results on a screener and did see a therapist for a while. We tried 2 - the first was not a good fit (wissh I had stuck with my gut on that and switched sooner!), but the second one was very helpful. 2nd therapist really helped with planting the seeds that 1) the type of anxiety/stress she was feeling was very normal and 2) strategies that could be healthy coping mechanisms for her. While her anxiety/stress still ebbs and flows for her, DD now seems to be able to identify it, talk/write about it with me and handle it better.

    I agree that the screeners aren't perfect by any means...she got elevated scores again at her most recent appt but after talking through it with her therapist, dr and her, it was a lot of what you described that she didn't feel like any of the choices reflected exactly what she was experiencing. DD is a rule follower and she didn't feel like she could honestly mark "0" for it, but the next choice up was more than what she was experiencing. By marking all the next choice up, she wound up with what they felt was an inaccurate elevated score that didn't really reflect her current state.

  10. #10
    anonomom is offline Diamond level (5000+ posts)
    Join Date
    Jun 2011
    Posts
    5,104

    Default

    Quote Originally Posted by 3isEnough View Post
    I haven’t read all of the responses but when we were trying to get my DS to see a therapist a few years ago when he was 15, the therapist recommended to me that we tell him “You don’t have a choice in seeing a therapist because we believe you need it, but you DO have a choice in selecting who you’d like to see”. I provided 2 options of people he could see and said he could consider more if he wanted, but he selected 1 of them and actually went without argument.
    This is similar to the tack we took when DC needed therapy. I put it as "You know that I respect you and don't like forcing you to do anything, but this is a situation where I need to insist you get help even if you can't see that you need it." Fair warning, tho: it took DC a good year before they actually started participating honestly in therapy.
    DC1 -- 2005 DD -- 2009 DS -- 2011

Page 1 of 2 1 2 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •