When Your Child Is Resistant to Therapy

How You Can Help When Your Child Is Suffering with Depression

If your child is resistant to therapy or she refuses to cooperate with the therapy treatment program for depression, you may wonder how she will ever get better. However it is not uncommon for a child to be quiet during therapy or even refuse to attend sessions.

In fact, it is a well-known reality among therapists and researchers that some children will be resistant to therapy. Fortunately there are measures parents can take to ensure their children follow and benefit from their therapy treatment programs.

Factors That May Make Your Child Resistant to Therapy

It's possible your child may feel some anxiety about speaking to a stranger about her thoughts and feelings. For example, your child may be worried about rejection, judgment, or punishment from a therapist, or be concerned that the therapy sessions may not be confidential.

Parents Have Influence on Kids Going to Therapy

Dr. Pamela Wilansky-Traynor and colleagues published findings on this very circumstance in the Journal of the Academy of Canadian Child and Adolescent Psychiatry in May 2010.

In their study, they found that stressful life events, such as family fighting or financial stress, and headache, stomachache, or other physical complaints related to depression have the potential to overshadow the importance of therapy attendance, even when therapy has been showing success.

In some cases, this may just be in the eyes of the child. But even well-intentioned parents could fall victim to putting a child's therapy sessions aside in order to deal with what may seem like a more pressing issue at the time.

The researchers found that parents have the ability to influence younger children to attend therapy more than older children, which may be something you have encountered yourself, particularly if dealing with a child in or approaching his teen years.

You are not alone, however, if life events are getting in the way of your child attending therapy.

When Your Child Puts Up a Fight 

Psychotherapy aims to change or correct problem behaviors and provide education and insight into internal and interpersonal struggles the child is experiencing. Often, this requires the desire to change. A depressed child, who may already feel misunderstood or angry, may resent being told to change. They can even become defensive.

But therapy isn't just about changing or correcting problem behaviors; it is also about providing education and insight into internal and interpersonal struggles the child is experiencing. Many people are not excited about being told they need to change. They can even become defensive. The same goes for children and especially teens.

Introducing the concept of motivational interviewing in the psychology literature nearly twenty years ago, Dr. Theresa Moyers and Dr. Stephen Rollnick explained then that a therapist who works with this fact is essential. People who have been forced to seek treatment, as is usually the case with children, are likely to be resentful and resist help.

A therapist who shows empathy and support is more likely to encourage change than one who tries to push the child to adhere to the therapy recommendations.

What You Can Do to Help 

At times, you may be overwhelmed with frustration. That's understandable. But there are things you can do to help the situation.

Consider Combination Treatment

According to the National Institute of Mental Health (NIMH), cognitive-behavioral therapy (CBT) in combination with an antidepressant medication is the most effective treatment for depressed children. Given this, you might suggest a combination approach to your child's pediatrician if your son or daughter is in therapy only.

Try a Different Therapist

Very simply, your child may not like his or her current therapist. It is important your child feels comfortable and safe during therapy. Meeting with the therapist before your child begins treatment will allow you to pre-screen the therapist. Additionally, it might be important to your child to have a therapist of the same gender, especially if the two are discussing sensitive topics related to development or sex. Unsure of what your child thinks or would prefer? Sometimes all you have to do is ask.

Lead by Example

Consider family therapy or individual therapy for yourself. Depression affects the whole family. Showing your child that the whole family is committed to mental health allows your child to feel supported but not different from the rest of the family. However family therapy should not replace your child's depression treatment program.

Find the Best Timing

Examine small details of your child's therapy routine, like the time of day or day of the week for sessions. Factors like fatigue, hunger, mood, and stress can affect a therapy session. If your child consistently has a test right before therapy, the child may have a difficult time focusing - on one or the other. Find the best time in your child's schedule for your child to attend therapy and, whenever possible, incorporate something enjoyable into the treatment routine, like going out for a treat afterward.

Finding the Right Treatment for Your Child

It is important to help your child find the right depression treatment. If your child is still not benefiting from therapy despite your efforts, it may be time to try a different treatment option. Depression can have short- and long-term consequences such as poor social and academic performance, poor self-esteem, risk-taking behaviors, substance use, and suicidal thinking and behaviors. Working with your child's pediatrician, school counselor, or psychologist may be helpful in providing guidance for new treatment options.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 (HELP) for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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  4. National Institutes of Mental Health. Questions and Answers about the NIMH Treatment for Adolescents with Depression Study (TADS). Bethesda, MD.: National Institutes of Mental Health 2020.

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