Does My Teen Need Counseling? 15 Signs to Know

Is It Just Normal Behavior?

It’s no secret that the teenage years can be a vulnerable time for your child, and they may profoundly struggle with their changing feelings, identity, body, and relationships. They may withdraw from you and become more combative than usual.¹ Unfortunately, This can make adolescence tumultuous for everyone in the family.

Just as babies, toddlers, and children transition through certain phases and milestones, teenagers do as well. While every child is unique, the teenage years are generally characterized by teen issues such as hormonal changes, spending more time with friends, valuing independence, increased novelty-seeking tendencies, showing interest in romantic relationships, and considering future plans more thoughtfully.²

15 Signs Your Teen Needs Therapy

Some mental health problems begin to emerge adolescence, and certain symptoms may indicate that your child is struggling. Even though change is constant right now, parents should be aware of particular behavioral symptoms during these years, especially with the rise of social media. Regardless, as a general rule, issues related to self-harm or suicide typically necessitate immediate attention.

Here are 15 signs your teen needs therapy:

1. They’ve Withdrawn Dramatically

It’s normal for teenagers to become more secretive or guarded around their parents. But sudden withdrawal–and avoidance of family–may represent a deeper problem. For example, it may indicate issues related to bullying, self-esteem, depression, or trauma. Therapy can offer a safe place to further explore this change in behavior.

2. They Aren’t Engaging in Their Usual Hobbies

Anhedonia refers to a diminished ability to experience pleasure. It is one of the symptoms of depression, and it can make teens withdraw from their usual activities or passions. Sometimes, it comes with a sense of hopelessness and despair.³ Therapy can help your teen recognize this symptom and decide how they want to approach it, such as with coping skills and cognitive restructuring for managing anhedonia.

3. They Suddenly Lack Motivation

If your driven child now lacks motivation, it could indicate issues with depression, anxiety, substance use, or transitional stress. They may feel overwhelmed with getting their lives back on track. Therapy can help explore barriers preventing motivation and develop a realistic roadmap for achieving goals.

4. They Constantly Seem Angry

While everyone experiences frustration, chronic anger can be a symptom of many mental health conditions, such as:

• Depression
• Borderline personality disorder (see personality disorder in teens)
• Eating disorders
• Anxiety
• ADHD
• Substance use
• PTSD

Explosive anger, in particular, often requires intervention, as it can lead to significant problems with school and relationships. Therapy can help teenagers with anger management by teaching them how to better understand and regulate their emotions.

5. They Are Drinking or Using Drugs

It can be unnerving for parents to discover drug or alcohol use. And while some experimentation may be normal, habitual use may spiral into addiction. A therapist can provide a substance use assessment, help your child cope with triggers and stress, and discuss other treatment options if needed, such as medical interventions.

6. They Have Changed Their Eating Habits

Eating disorders often emerge in adolescence. If you notice significant weight changes, secretive eating, evidence of bingeing or purging, or comments about their body, your teenager may be struggling. A therapist can help with recovery–along with additional resources and referrals if a higher level of care is needed.

7. They Seem Overly Anxious

Everyone gets worried, but chronic anxiety may signify a mental health problem such as an anxiety disorder, PTSD, or having trouble coping with the expectations of people around them. If your teenager seems particularly distressed about certain situations (social interactions, test anxiety, athletic performance), they may benefit from professional support. A therapist can offer relaxation exercises and cognitive interventions for managing anxiety and related disorders, like OCD.

8. They Are Getting Into Legal Trouble

While it’s normal for teens to exhibit defiance during this time, legal trouble can cause significant problems. Whether your teen gets into legal trouble as a bid to get attention, or due to a deeper issue, such troubles may result in permanent consequences. Therapy can help your child explore the motives behind their behavior and introduce them to alternative coping strategies.

9. They Have All New Friends

New friends can be a good thing, but if the change seems sudden or impulsive, it could be a sign of a deeper issue. Some teenagers change peer groups due to bullying–others might hang out with a new crowd to justify engaging in illicit, risky, or self-destructive behaviors. A therapist can review and assess potential signs of distress.

10. They’re Grieving a Significant Loss

Whether it’s the death of a loved one or a significant break-up, grief can profoundly impact teenagers. Some of them may open up to their families about their feelings, while others may isolate themselves and become more withdrawn. Regardless of the situation, therapy can help your child cope with their loss and have a safe space to share their feelings.

11. They Are Coping With Divorce

Teenagers can react in numerous ways in response to their parents divorcing. Some feel a sense of relief. Others may feel enraged, guilty, or afraid. Furthermore, it’s common to experience a combination of intense feelings. Therapy can help your teen come to terms with the situation without blaming themselves.

12. They Are Failing School

While grades aren’t the only measurement of a child’s success, failing classes can be a sign of undiagnosed mental health issues or learning problems. If the grades dropped out of nowhere, that’s also a cause for concern. A therapist can help them with the underlying issues and strategize steps to improve their academic performance.

13. They Talk About Death or Dying Often

Repeatedly discussing death–even via jokes or snark–could indicate suicidal thoughts. Often, signs of passive suicidal ideation are overlooked; while you don’t want to overreact, you don’t want to overlook signs of distress. A therapist can provide a proper assessment during this time. If your child is struggling with the motivation to live, they can help facilitate hope and connect your family to appropriate intervention resources.

14. They Aren’t Taking Care of Basic Needs

By the time your child is a teenager, they should be relatively self-sufficient. Therefore, if you’re constantly reminding them to brush their teeth or change their clothes, it could mean they’re struggling with their mental health. Depression, in particular, can make everyday tasks feel daunting. A therapist can help teenagers with depression by helping them recognize their setbacks and implement life skills to set them up for success.

15. They Ask to Go

If your teen asks to speak to a therapist, you may panic that something is seriously wrong, but this isn’t always the case. Your child may have read or heard about therapy as a good intervention, and may actually be trying to proactively combat more serious issues. Try to listen and praise your child for their willingness to get help. They need your support–setting them up with a therapist shows that you care about their well-being.

What Issues Can Therapy Help Teens With?

Therapy can help teenagers with many issues, including anxiety, depression, peer pressure, angst, trauma, and self-esteem issues. Even if a teenager doesn’t exactly know their treatment goals, therapy offers a safe place for processing feelings and enhancing self-awareness.

Therapy can help teens with the following issues:

• Addiction (i.e., substance use disorder, video game addiction)
• Social skills
• Bullying and Cyberbullying
• Body image
• Academic pressure
• Family tension
• Transitional changes
• Grief and loss
• Anxiety and fear
• Depression
• Impulse control
• Body-focused repetitive behaviors

Who Should You Talk to About Your Teen’s Behavior?

Some parents feel alone and confused when parenting their teenager. That’s why it can be important to seek collateral support from other figures in your teen’s life. Coaches, school counselors, teachers, your child’s friends, and your child’s friend’s parents may provide insight into various behavioral changes.

Questions to ask about changes in your teen’s behavior include:

• What concerns, if any, do you have about my child?
• Have you noticed any recent changes in my child’s behavior? What are they?
• I’m sensing my child is struggling with ____. What are your thoughts about that?
• Has my child said or done anything that has worried you lately?

Is Therapy Effective for Teens?

Research shows that therapy can be effective for teenagers, particularly when they report having a strong therapeutic alliance with their provider.⁴ People who engage in treatment may learn how to regulate emotions better, manage mental health symptoms, navigate relationships, cope with stress, and increase their capacity to function in everyday life. Therapy may also be a launchpad for additional mental health services. For example, if your child needs a psychiatric evaluation, medication, or inpatient treatment, a therapist can help them navigate those options.

Although it’s relatively new, online therapy for teens shows similar therapy benefits to face-to-face sessions. This option may be especially attractive to clients who live in rural areas or who prefer virtual meetings with their therapist. Online therapy also has a greater reach, as you can usually meet with any provider licensed within your state. This offers more opportunities for meeting with a specific specialist. You can start your search for a teen therapist using our therapist directory.

How Do I Know If Therapy Is Working?

Therapy is a complex process, and change doesn’t happen overnight. Therapy is likely working if your teen seems engaged in treatment and begins making behavioral changes (even if they seem small) in daily life. It’s also helpful to ask your teenager directly. If they don’t feel like they’re getting much from their therapist, they’ll probably tell you.

How to Talk to Your Teen About Getting Therapy

It’s important for parents to be direct when talking about therapy. Try to be objective in stating your concerns without being accusatory. A good way to do this is by sharing what you’ve observed while stating how it makes you feel. For example, you might say, I’ve noticed that your grades slipped significantly this last semester and that you’ve missed a lot of soccer practice. I love you, and I’m worried that you’re having a hard time right now. 

Try to avoid assuming you know how they feel, and be mindful of dismissing real emotions as being temporary or overdramatic. Even if you’ve experienced similar struggles in your life, your teenager is a unique person, and is dealing with most of these things for the very first time. If they sense your judgment, they may withdraw from you even more.

What If They Don’t Want to Go?

It’s normal for teenagers to balk at the idea of therapy. They may feel anxious about talking to a stranger, and they may not understand how confidentiality works. They may also have a specific idea of what therapy is like in their minds. If they’ve had negative experiences with healthcare providers in the past, they may be even more apprehensive.

If your teenager resists therapy, consider making it a more collaborative process. Ask them if they’d be willing to find a therapist themselves. Or, ask if they’re willing to give a potential provider at least two sessions before dismissing the idea altogether. You might also broach the possibility of family therapy if they refuse to go alone.

How to Get Therapy for Your Teen

Ideally, you should find a therapist who specializes in adolescent, teen, or young adult therapy. After locating a potential match, it’s important to know what to expect when you send your child to therapy.

Some therapists will consult with you and your teen together, but others may conduct these intakes separately. This gives the therapist a chance to get a more complete picture of your child’s life from different perspectives. Your child’s therapist might also recommend that you participate in family or individual therapy for yourself.

Factors to Consider

It’s important that your teenager feels safe and supported by their therapist. It may be helpful to ask them what they want in a provider, including gender, age, type of therapist, and different therapeutic approaches they practice, such as CBT and DBT for teens. Some parents prefer picking the therapist, while others engage in a more collaborative process with their child. There is no right or wrong way to start the process, but it’s a good idea for everyone to maintain open communication.

Remember that therapists have varying laws and ethics regarding your child’s confidentiality. This refers to what they disclose (and what they omit) to parents during the treatment process. Therapists will outline these guidelines during the consent process. However, if you have questions or concerns, it’s important to address them immediately.⁵

Final Thoughts

As a parent, it’s important to be an ally for your teenager. However, that doesn’t mean that you can “fix” their problems or “solve” their pain, and your child may be resistant to opening up. Therapy can provide invaluable support and reassurance during this challenging time in your child’s life. If you’re concerned–or if the situation continues worsening–don’t just wait and see if things get better on their own. Reaching out for support may be one of the best decisions you make for your family.