A large part of the refusal or resistance is the fact that the child/adolescent is attempting to gain control. Even though it sounds strange, it is important for the therapist and the parents to work together to give the child a healthy sense of control in the treatment process.
If I meet with a parent initially and they are reporting that their child is refusing to come into therapy, my approach is to gain information from them. The parent(s) may report struggles they are having with regard to boundaries. These struggles may include parental enabling and/or overcompensation. In this case, I can work with the parent on their approach in order to decrease these dynamics and increase a healthier relationship with their child.
Similarly, another clinical intervention is that I ask the parent(s) not to “beg” or force their child to come to therapy. As part of giving some control to the child, we want to encourage them to decide that therapy might not be that bad so that they come in on their own.
When I meet with the parent, the reluctant child or adolescent usually becomes curious about therapy and what the therapist is like. This curiosity will often encourage them to come through the door, which is the most difficult part of getting them to engage in the therapeutic process.
Once the child or adolescent has come into therapy, it becomes easier for the therapist to establish a rapport with them and again, most of the time, the child builds their own therapeutic relationship with the therapist.
In addition, once trust and a rapport is established, it allows the therapist to validate the child’s concerns, giving them a healthy sense of control. This also allows the therapist to address behaviors that are unhealthy and provide them with healthy approaches toward their parents or family members. Once this is established, I continue to engage parents in the treatment and work on their approaches so both parties can come to a “happy medium” and develop a healthier relationship with one another.
If you are struggling to encourage your child or adolescent to attend therapy, know that it is not hopeless! Talk with your therapist. There are approaches that work without making the children feel that they are being forced into a situation that they don’t want.
Brittany Starrantino, LMSW, CASAC
CBT Psychological Associates
2171 Jericho Turnpike, Suite 345
Commack, NY. 11725