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Tips for Talking About Assessment: How to Discuss Mental Health with Your Child or Teen

Families come to the Center for Effective Therapy with a wide range of backgrounds and varied levels of experience with mental health care. Some families and kids have had a long history of engaging with mental health services prior to coming to us, and others come to the Center without having sought out services before. No matter what your experiences with mental and behavioral health care have been like in the past, talking to your child about scheduling an appointment and engaging with an assessment or treatment can seem intimidating. Many caregivers worry about saying the wrong thing to introduce the idea to their kids, and about the reaction their child will have to the idea. To help set you up for success when you’re coming in for your initial appointment, here are some tips for communicating with your child about coming into the Center.  

The most important thing to keep in mind is that honesty and openness are key to setting your child, and your family, up for success. It’s important to communicate to your child where you are going and why, so that they know what the expectations are for them when you arrive. Telling your child, no matter how old they are, about the appointment in advance can help them get used to the idea and can help ease the worry on the day of. If you tell your child in advance and have open lines of communication with them leading up to the appointment, it can help them feel supported and give them space to ask any questions they may have! 

Young Kids 

For young children, an easy way to explain the appointment is by talking about it in terms of a doctor’s appointment. Most kids are used to meeting with their pediatrician and know that going to the doctor is something everyone must do to ensure they are healthy! Kids often go to the doctor for check-ups, not because they are sick but to keep them healthy. 

Before a mental health appointment, you can explain that they are going to see a doctor for a checkup, but this doctor helps people with their feelings. The “feelings doctor” is there to chat with them about their thoughts, feelings, and behaviors so that they can understand how to help. You can tell them that kids come to the feelings doctor for many different reasons, and none of them are bad, it just means that they might need a little help to feel good. Some kids come to the feelings doctor because they worry a lot or feel sad, some kids come because they get angry easily, and others come because they have a hard time paying attention or making friends. It’s super important to be honest with the feelings doctor, because then they’ll be able to help you with what you need to feel good! 

Mentioning that we see many kids every week at the Center for all kinds of reasons can help your child to normalize mental health care. They’re not coming to us because there is something wrong with them compared to other kids, they’re coming because they might just need a little extra help to succeed and be the happiest possible version of themselves. We also emphasize honesty with the clinician. The feelings doctor can only help kids if they tell them the truth, and it’s important for them to know that the truth won’t get them into trouble! 

Teens and Adolescents 

A caregiver’s experience discussing an upcoming mental health appointment with a teen or adolescent can vary widely depending on their motivation to receive help, their familiarity with mental health care, and the nature of the presenting challenges. As you prepare to speak with your child about coming in for an intake assessment, and eventually therapy, try to put yourself into their shoes.  

Going to see a therapist can bring up many kinds of emotions for teens, depending on what they’ve been through and their own experiences with mental health care. For example, teens who are depressed may feel that going to therapy is useless, because they may not be able to imagine a world where they feel better. Teens who have symptoms of social anxiety or selective mutism may be resistant to therapy because it means having to talk to a new person about something serious.  

Generally, they might feel embarrassed about going to therapy and resistant to the idea of getting help. While there has been a lot of progress in dismantling the stigma of mental health care for younger generations, that stigma isn’t gone. Teens might also get defensive about the suggestion of going to therapy, which isn’t an uncommon reaction. It can be hard to admit they need help when they’re already struggling with negative feedback. For other teens, they might not believe that therapy can work. If a teen has had previous experiences with mental health care that have been ineffective, or even damaging, it can be hard to buy into the idea that a different approach or therapist might actually help them. On the other hand, there are many teens and adolescents who actively seek support and therapy, or who are very open to the idea when it is suggested by a caregiver.  

As a caregiver, you know your child best. To help you best prepare for your conversation with your teen, here are some tips for communicating effectively and supporting them in their journey towards engaging with therapy.  

Choose the right moment to talk about it.  

Finding the right time to talk about mental health and therapy with your child may seem impossible. Being thoughtful when you choose to discuss an assessment, therapy, or your concerns for your child’s mental health can be the difference between an ineffective or a successful conversation. Introducing the topic in the middle of a fight, or right after a stressful moment, can set you up for failure. Instead of broaching the topic when tensions are high after a long day at school or work, wait for a time when you both are in a better mood. Rather than bringing it up when you’re in a car together and your child may feel stuck, try to bring it up when you are intentionally spending time together in an enjoyable way. Going on a walk or playing a game can be a great ice breaker!  

Normalize struggling with mental health issues and focus on using positive language.  

Help break down the stigma of receiving mental health care for your child. Framing an assessment and therapy as something normal that lots of other kids do, and that helps all people become the best versions of themselves, can help reduce any shame your child might feel.  

You can even use a healthy amount of self-disclosure to communicate to your child that you understand what they’re going through. If you wish you received help when you were younger, saying that to them can make them realize that all people struggle and that it’s okay to accept help. It can ease some tension to acknowledge that it can be hard to talk to parents about mental health, maybe you even felt the same way when you were a child.  

Discuss confidentiality expectations.  

Setting expectations for confidentiality between your teen and the clinician can help ease any worries about sharing sensitive information. Teens can often have a hard time opening up to parents, but we want to make sure that they know the clinician is a safe person to talk to and their boundaries will be respected. You can communicate to your teen that the clinician will only have to tell you information that they share if there is a safety concern for them. Clinicians and caregivers communicate about safety concerns so that you both can work as a team to keep them safe.  

Encourage motivation by focusing on your teen’s priorities instead of your own.  

Instead of focusing on the symptoms or behaviors that you want to see improve when discussing coming in for therapy, encourage them to think about what goals they have for themselves and how treatment may be able to help them. It’s okay if caregivers and teens have different motivations for coming into treatment, but it can be helpful for teens to feel agency in their mental health care and their goal-setting abilities in treatment. Often, motivations overlap, and symptoms improve across the board.  

Be open to answering their questions and discussing any concerns they may have honestly.

One conversation may not be enough time to fully discuss your teen’s thoughts and concerns about coming in for treatment. Clearly communicating to your child that you want it to be an ongoing conversation can increase the likelihood that they will come back to you to talk about mental health time and time again. If there are questions that you can’t answer, it can be a good moment to mention that the clinician might be able to answer their questions better, or more thoroughly, at the time of the assessment.  

Keep your tone of voice and body language even and calm.  

Communicating calmly and respectfully with your teen about mental health care is important. By keeping your body language and tone of voice under control, you are showing them that you are there for them in a steady and reliable manner. Your teen is more likely to have an honest and open conversation with you if you try to keep tension out of the conversation. Even so, it may take some time for them to be open to the conversation. Make sure that they know you can speak with them calmly about mental health, no matter what they say, and that they can come to you whenever they are ready!  

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