Over the past eight weeks, I have written about young people's mental health from every angle - normal versus concerning behaviour, anxiety, shutdown, exams, neurodivergence, social media, and sleep. If you have been reading and recognising your child in these posts, you may be wondering whether therapy is the next step.
This post is about demystifying that step. Because therapy for young people is surrounded by misconceptions, and the uncertainty about what it involves is often what stops parents from picking up the phone.
Let me start with what therapy for young people is not. It is not lying on a couch talking about your childhood (that is barely what adult therapy looks like, let alone therapy for a 13-year-old). It is not someone telling your child what is wrong with them. It is not a fix that happens to your child while you wait in the car. It is not a sign that you have failed as a parent. And it is not only for young people in crisis - in fact, the earlier concerns are addressed, the better the outcomes.
So what is it? Therapy for young people is a safe, confidential space where a trained professional helps your child understand what they are experiencing, develop strategies for managing it, and build the emotional skills that will serve them through adolescence and beyond. The specific approach varies depending on the therapist, the child, and the presenting issue, but the core principle is always the same: creating a relationship in which the young person feels safe enough to explore what is going on for them.
What happens in a first session? With adolescents, I usually have a phone call with the parent or parents first. This gives me context and allows me to understand what you are seeing at home. It also gives the parent space to say things they might not want to say in front of their child. Sometimes I then have a short video call with the parent and young person so that they can meet me too. In the first session itself, I usually offer to see the young person alone if they would like or with their parent if they prefer (and sometimes the parent leaves part way through to give the young person space) – basically whatever feels right for everyone.
The first session with the young person is about building rapport. I do not dive into the deep stuff immediately. I want to know who they are, not just what is wrong. What do they enjoy? What are they good at? What does their day look like? I explain how therapy works, what confidentiality means, and what they can expect. I ask them what they would like to get from coming here. And I listen - really listen - to what they tell me and what they do not tell me.
Confidentiality is one of the most important aspects of therapy with young people, and one of the most anxiety-provoking for parents. The basic principle is this: what your child says in therapy stays in therapy, with one exception - if they tell me something that suggests they or someone else is at risk of harm, I have a duty of care to share that information. I explain this clearly to both the young person and the parent at the outset.
This confidentiality is not about keeping secrets from you. It is about creating a space where your child can be honest without fear of consequences. Teenagers are remarkably good at knowing what adults want to hear. If they know that everything they say will be relayed to their parents, they will tell me what they think I want to hear rather than what they actually feel. The therapeutic space needs to be their space, or it does not work.
I do offer parents updates if their young person would like - usually a brief conversation every few weeks to let you know how things are going in general terms, without disclosing specifics. Most parents find this balance works well. Some young people choose to involve their parents more directly in certain sessions, and that is welcomed when it is led by the young person.
How long does therapy last? This varies widely. Some young people benefit from a short piece of work - six to eight sessions focused on a specific issue like exam anxiety or a friendship difficulty. Others benefit from longer-term therapy that addresses deeper patterns. I review progress regularly and will always be honest with you about whether I think continuing is helpful.
What about CAMHS? CAMHS (Child and Adolescent Mental Health Services) is the NHS service for young people's mental health. It provides specialist support for moderate to severe presentations and is accessed through GP referral. CAMHS is staffed by excellent professionals, and for young people with significant needs, it provides access to specialists (psychiatrists, clinical psychologists, specialist teams) that private therapy cannot replicate. The challenge with CAMHS is waiting times, which can be long depending on your area, and the fact that referrals below a certain severity threshold may not meet the criteria for the service.
Private therapy is another option. The advantages are shorter waiting times, continuity with one therapist, and the ability to work at whatever pace and depth the young person needs. The disadvantage is cost. If you are considering private therapy, look for a therapist who is registered with a professional body (BACP, UKCP, or BPC), who has specific training and experience in working with young people, and whose approach feels right for your child.
The therapeutic relationship matters more than the specific approach. Research consistently shows that the quality of the relationship between therapist and client is the strongest predictor of good outcomes - more important than the modality, the technique, or the number of sessions. If your child does not feel comfortable with their therapist, it is okay to try someone else. This is not failure. It is good practice.
If you are considering therapy for your child and are not sure where to start, I am happy to have a conversation about what might be helpful - even if that conversation leads you to a different therapist or service. What matters is that your child gets the right support, not that it comes from me specifically.