Happy family


What to Talk About in Therapy (and How to Get the Most Out of It): A Guide for Parents & Teens

what to talk about in therapy as a teenager

There are a rising number of children, teenagers, and young adults receiving therapy or counseling for their mental health. According to data from the Centers of Disease Control and Prevention (CDC), almost 14 percent of children and adolescents received counseling or therapy in 2022. This has increased from 10 percent in 2019.

However, these percentages just scratch the surface. There are many more young people who are not receiving the treatment they need and deserve. It’s estimated that around 60 percent of youth who struggle with their mental health do not receive treatment. But with close to half of U.S. adolescents experiencing a mental disorder, there is an inherent and ongoing need for therapy.

Many teenagers are afraid to seek treatment for mental health struggles, out of fear of what others might think or concerns about how it will disrupt their day-to-day lives. Some feel that it will be embarrassing, or that it won’t work. Teenagers can be inherently defiant, too, and therefore resistant to therapy altogether. So, if your teen is struggling to open up in therapy, it’s normal! But you may worry whether they’re getting the most out of it. Many people, but teens especially, do not know what to talk about in therapy—this guide is here to help change that.

Turnbridge is a mental health treatment provider for teenagers and young adults. We are trained in the unique experiences of youth, and understand the challenges that teenagers face when starting therapy or treatment. To help your teen get the most out of therapy, and open up to their therapist, we’ve provided some tips below.

What to Talk About in Therapy

When it comes to talking in therapy, there are no hard-and-fast rules. There are not certain topics that you need to talk about, nor are there any topics that you need to avoid. There are also no “wrong” or “right” things you can say to your therapist. What a person talks about in therapy will vary, though, depending on their individual experiences, concerns, and goals. With that in mind, if your teen (or you) are struggling to come up with things to talk about in therapy, our advice is simple: Try to be yourself and be truthful throughout the process. Listen to your heart and, if you are comfortable, talk about anything that is affecting your mental and emotional wellbeing.

Of course, this is easier said than done. In order to be able to open up in talk therapy, your teen needs to be comfortable with (and to have trust in) their therapist. Therapy is meant to be a safe space where you can discuss anything that’s on your mind—whether it’s a problem at school or home, a dream they’ve been having, a feeling they’ve been experiencing, or questions about how they should handle certain situations. Even if your teen wants to talk about music, or a television series they’re watching, their therapist is there to listen and support them. These conversations, no matter how far from the issue they might seem, are important for establishing a bond between a teen and their therapist. 

To help get the conversation moving, we’ve provided some ideas of what teens might talk about in therapy below:

  • Emotional struggles, including feelings of sadness, anger, or confusion
  • Stress and anxiety, and what might be causing those feelings
  • Relationships with family, friends, partners, or peers
  • Academic or athletic pressures, or pressures from peers at school
  • Identity building and exploration (e.g. gender identity or cultural background)
  • Issues with self-esteem and body image, including struggles with confidence
  • Life transitions, whether that’s a divorce, new school, or transition to college
  • Behavioral struggles, including risky sexual behaviors, self-harm, or substance use
  • Past traumas and any associated feelings of fear, shame, or guilt
  • Coping skills and strategies for managing difficult emotions or situations
  • Future goals, including one’s hopes and dreams for the future
  • Anything else on your teen’s mind! 

Remember, therapy is meant to be a safe and non-judgmental space where you can talk about what’s important to you, what’s bugging you, or what’s simply top-of-mind. However, your teen has the right to say as much or as little about themselves as they’d like. A great therapist will work to establish a bond with your teen, by listening to them, supporting their needs, and helping them work through whatever it is that’s affecting them at the time.

How to Get the Most Out of Therapy

Find the right therapist.

Therapy is not one-size-fits-all, and different therapists will have different approaches to the treatment they offer. Additionally, it’s common for teenagers to connect with some therapists but not with others (which, as you might expect, informs whether teens will open up). With that said, one of the most important steps in ensuring your teenager gets the most out of their therapy sessions is to ensure they are seeing the right person.

Of course, there are certain boxes you can check off right away: Is this person qualified and reputable? Does this professional have experience with teenagers? Is their therapeutic approach based on evidence—and specifically what works for teens?

However, some things might require trial and error, to ensure you find the best possible fit: Is this therapist a good match for my child’s personality? Do they make my teen feel safe and comfortable? 

It can help to get your teen involved in the decision, too. As psychologist Stephanie Dowd, PsyD, suggests to The Child Mind Institute, “Finding a therapist who is a good fit is extremely important, and making the choice your child’s, will help them feel ownership over their own treatment, which is extremely important to teens and sets the stage for effective therapy.”

Encourage openness and honesty.

No matter your age, therapy is most effective when there is a level of trust between a therapist and client. In order to build a trusting relationship, both parties must be open and honest with one another. 

For teenagers in therapy, openness can happen when safe spaces are provided in therapy. Teenagers are at a stage of development in which they are establishing independence and discovering their identities, separate from their family circle. While it can be difficult for parents, they often need space from their family to work through feelings and find their sense-of-self. With that said, therapists can often establish trust by creating “zones of privacy” for teens—zones in which conversations are kept completely confidential (unless the information threatens one’s safety). These zones offer teens a safe place to open up and communicate in therapy.

Additionally, if your teenager is still struggling to open up (or if you are a teen reading this), it’s important to remember that therapy can be hard. Opening up to a new person, especially an adult, is a process that can take time. Encourage your teen to try their best, and try not to get hung up on saying the “wrong” or “right” things. All they need to do is be themselves, and be open to the process. Then, the open conversations can begin. 

Set goals.

As your teen enters therapy, they will likely be asked the questions like “Why are you here?” and “What are you hoping to get out of this program?” As you might expect, the answers to these do not always come easily. As a parent, you can help your teen think more about these questions—and their hopes—at home. 

You can help your teenager set specific goals for therapy, no matter how big or small. A good therapist will also help your teenager do the same. As a parent, though, try hard not to push your own agenda. Instead, really listen to your teen and what they are hoping to accomplish. Perhaps they struggle with social anxiety, but desire to make new friends. Maybe they deal with symptoms of depression, and want to develop some better ways to manage their emotions. They may desire to learn more about themselves, their triggers, or things that make them happy. These are just a few examples, but the options are limitless.

Having goals in mind can help your teen take advantage of all that therapy has to offer. By setting goals, your teen will be more informed going into therapy and more motivated throughout the process. 

Therapy is all about giving individuals the tools and skills they need to lead happier, more productive lives. Coupled with other evidence-based treatment methods, therapy can have an incredible impact on the lives of teenagers. According to the American Psychiatric Association, about 75 percent of people who enter therapy show some benefit from it. And in a recent study of teenagers, respondents said that therapy helped them to “open up,” “feel more connected to others,” “name emotions,” “know themselves better,” and “adapt to challenges in life.”

Of course, in order to really get the most out of therapy, teens need to put in the work. This often means opening up, talking about difficult things like emotions, fostering more communicative relationships at home, and changing negative thinking patterns or behaviors in their everyday lives. This takes time and dedication, but the end result is often worth it. For reluctant teens, choosing the right therapist or treatment program—and involving them in the process—is a great place to start.

Turnbridge offers personalized care, support, and therapy for teenagers struggling with mental health disorders. Whether your teen is battling depression, anxiety, trauma, or another mental health problem, we can help discuss your treatment options and, if needed, work to create a treatment plan for your loved one. Turnbridge utilizes a range of evidence-based therapy methods to help teenagers overcome their struggles, and we’re always adjusting to ensure they are getting the most out of our program. Click here to learn more, or call 877-581-1793 to speak with a treatment specialist today.