How To Know If Your Teen Needs Therapy
Adolescence is complicated. With changes in friendships and school, physical changes, and expectations for the future, it is normal for teens to experience periods of stress or moodiness. So how do you know when your teen is going through a naturally difficult period or when they may benefit from therapy?
There is no specific behavior that automatically points to a need for counseling. Instead, we look at the intensity of the issue, how long it has been going on, and how much it is getting in the way of everyday functioning (like school, friends, or home). If you’ve been wondering whether your teen could benefit from therapy, here are some signs worth paying attention to.
1 . You’ve Noticed Significant Changes in Your Teen
You might notice something seems different before you can put your finger on what exactly is wrong. For example, your normally social teenager might be spending most of their time alone, or your usually easygoing child seems angry all the time. Changes don’t necessarily mean that something is seriously wrong, and some of these reactions can be developmentally normal depending on what life circumstances are going on at the time. For example, it’s normal for a teen to be sad and upset after a breakup, or stressed and a little irritable before a final exam. What matters most is whether the changes are significant, persistent, or affecting their ability to function.
Some changes that may be worth discussing with your child’s pediatrician or a mental health professional include:
Loss of interest in activities they previously enjoyed (e.g., wanting to quit their sport or club seemingly out of nowhere)
Becoming increasingly withdrawn from friends or family
Significant changes in sleep or eating habits (e.g., staying up all night and feeling little need for sleep, sleeping more than 10-12 hours per day over several days, significant weight loss or gain)
Persistent irritability, sadness, or anxiety (lasting over several weeks or months, not just for a few hours or days).
Difficulty concentrating that is affecting school or home life
A noticeable decline in grades
Increased anger, aggression, or emotional outbursts
Use of alcohol or drugs (experimenting with substances is often developmentally expected, but should still be carefully considered).
Avoiding going to school or social functions
Frequently complaining of physical symptoms such as headaches or stomachaches without an identifiable medical explanation
2 . Their Emotions Are Getting in the Way of Everyday Life
Everyone experiences anxiety, gets frustrated, and has bad days. Concerns become greater when emotions begin to consistently interfere with important areas of your teen’s life. For example, anxiety can help us perform well in necessary situations, but if it becomes so great that your teen starts regularly refusing to go to school, avoiding activities they want to participate in, or spending hours worrying about things that could go wrong, it is probably time to seek professional support.
Pay attention to struggles your teen may have in the following areas:
School: attendance, grades, concentration, classroom behavior, or completing assignments. Stay in contact with your child’s teachers or school counselor so you have an open line of communication with your teen’s academic support system.
Relationships: Withdrawing from friends, frequent conflict, or difficulty maintaining relationships (e.g. a lot of breakups or switching friend groups every few months).
Family Life: Escalating conflict, withdrawal, or difficulty communicating
Daily Activities: Sleeping and eating too much or too little, trouble getting out of bed, personal hygiene, chores, homework
Interests: Sudden or persistent loss of interest in previously enjoyed activities
Emotional Wellbeing: Persistent anxiety, sadness, irritability, anger, or feeling overwhelmed, more so than usual over a period of several weeks or months
3 . Your Teen Is Struggling With a Major Life Change or Trauma
Traumatic events or adverse childhood experiences (ACEs) significantly challenge children and teenagers’ abilities to function well because their minds and bodies are focused more on feeling and staying safe in their environment. Traumatic events can include car accidents, abuse or neglect, or witnessing physical violence. ACEs are a set of circumstances identified and thoroughly studied by the CDC and Kaiser Permanente that have been shown to affect one’s lifetime health outcomes and physical and mental wellbeing. ACEs are events that occur within one’s first 18 years of life and increase one’s risk of injury, mental health disorders, maternal health complications, infectious diseases, chronic diseases, and risky behaviors. ACEs are generally identified as various types of abuse, neglect, and household challenges (such as domestic violence, substance use, divorce, or incarceration within household members). Being exposed to these experiences does not automatically mean a child will develop negative outcomes later on in life, but the more of these experiences a child has, the more at risk they are of developing these concerns.
Because of the impacts trauma and ACEs have on developing minds and bodies, it is important to consult a qualified mental health professional if your teen has experienced a highly stressful or adverse event and is showing changes in their mood or behavior. Many therapists have specific training to help address trauma and PTSD in teens.
Even if a change in a teen’s life is not necessarily traumatic, typical adolescent development is still full of change that can be difficult to manage. Changing schools, losing friendships, academic pressure, and preparing for adulthood are major life events in your teen’s world. You don’t have to wait until your teen’s struggles become severe before reaching out for support.
Sometimes the goal of therapy is simply to give teens a place to process what is happening, learn healthy ways to cope, develop emotional skills, and have an adult outside of their immediate family who can help them make sense of their experiences. Group therapy and support groups can also help teens understand that their peers are going through similar changes and stressors, and that they aren’t alone in their struggles.
A therapist can help you determine whether your teen’s reactions seem developmentally appropriate to their age group or whether additional assessment or treatment may be beneficial. Therapists often offer free consultation phone calls to help determine this before scheduling a formal evaluation appointment. Reach out to us any time to discuss your concerns and see if therapy could be helpful for your teen.
4 . Signs Your Teen Needs Urgent or Immediate Support
Some situations call for more than a routine therapy appointment. If your teen is talking about suicide, has made a suicide attempt or plan, is engaging in self-harm (such as cutting or burning), or is at immediate risk of hurting themselves or someone else, seek professional help immediately. Other concerns that warrant urgent professional attention include severe substance use, significantly disordered eating, extreme changes in behavior or functioning, or perception changes such as seeing or hearing things that others do not.
If you learn that your teenager is thinking about suicide, take them seriously and stay with them while you seek help. Anywhere in the USA you can call or text 988 to reach the Suicide & Crisis Lifeline. If you are in the Phoenix Metro area, you can also take your teen to MIND24-7 in Phoenix. If there is an immediate, life-threatening emergency, call 911 or go to your nearest emergency department. When it comes to safety concerns, it is better to take action and have your teen evaluated than to question whether you are overreacting.
If you’re looking for a therapist for your teenager, finding someone who regularly works with adolescents can be an important part of the process. A therapist who works with teens should understand the developmental stage they’re in and be comfortable addressing their concerns. If you’re not sure whether therapy is the right next step for your teen, you don’t have to have all the answers before reaching out. Your teen does not have to be in crisis to deserve support. Sometimes, reaching out early can be an important step toward helping them feel understood and navigate the challenges of adolescence.
About the Author
Marlee Gordon, LPC is a licensed professional counselor and the founder of Meadowlight Counseling LLC, a private practice in Goodyear, Arizona. Marlee has over 13 years of experience working with adolescents in educational and therapeutic settings, including school-based therapy and intensive outpatient programming for teens. She treats a wide variety of mental health concerns but focuses primarily on treating anxiety, perfectionism, life transitions, relationship challenges, and academic/athletic performance concerns.