My child says they don't want therapy. Should I force it?

Forcing a reluctant older child rarely produces good work. Negotiate a single trial session, and in the meantime take up parent-focused support yourself — it changes the home environment they live in either way.

Is our GP the right first step?

In most systems, yes — they can rule out physical contributors, make referrals, and document the timeline. School counsellors and pastoral leads are also a legitimate front door.

How long does child therapy usually take?

For a focused anxiety or behaviour difficulty, often eight to sixteen sessions. Trauma or long-standing patterns take longer. Anyone who cannot describe a rough plan after a few sessions is worth questioning.

Mental Health

Does My Child Actually Need Therapy?

The honest answer from someone who assesses children for a living — including the times I say no.

Reviewed by Sian Trombley, CCCFounder, Thrive Family Company

9 min read

AgesAll AgesMental Health9 min readTherapist Created

Best for parents of children who are…

needing extra emotional support at the moment
going through a change at home or at school
showing more upset than usual and not saying why

The question that matters is function

Distress on its own is not a diagnosis. Children are allowed to be sad, furious, frightened and unreasonable; those states are part of growing up. What clinicians look at is whether the distress is interfering with the ordinary machinery of a life: sleeping, eating, going to school, seeing friends, doing things they used to enjoy.

Signs that warrant a conversation now

Any talk of not wanting to be here, self-harm, or hurting themselves — always, immediately, regardless of duration.
School refusal that has lasted more than two weeks.
Loss of interest in everything, not just one thing.
Eating changes: restriction, secrecy, rigid rules, or distress around meals.
Panic attacks, or avoidance that is spreading from one situation to many.
A significant change following a specific event — a loss, a separation, an accident, a frightening experience.
Distress that is invisible at school and enormous at home, sustained over months.

And the times I say wait

Not everything difficult is clinical. A child who is miserable for a fortnight after a friendship ends is grieving, not unwell. A child who is dysregulated in the six weeks after a house move is adjusting. A tired teenager in exam season is a tired teenager.

In these situations the most useful things are unglamorous: earlier bedtimes, predictable meals, less pressure, more time with you, and a parent who is not visibly frightened. Therapy offered too early can accidentally teach a child that ordinary hard feelings require a specialist.

What to do while you wait

01
Stabilise sleep first
Nothing else responds well until sleep does. Consistent times, screens out of the bedroom, light in the morning.
02
Protect one daily connection point
Ten unhurried minutes with no agenda. This is a clinical intervention, not a nicety.
03
Reduce demands temporarily
Drop the optional commitments. Recovery needs capacity.
04
Keep a simple log
Dates, triggers, duration. Any clinician will thank you, and patterns often show up on paper before they show up in conversation.

How to raise it with your child

Therapy is not for children who are broken. It is for children carrying something heavier than their years can hold alone.
Sian Trombley, Canadian Certified Counsellor

What you can try this week

Step 01

Do a two-week function check

Note sleep, appetite, school attendance, friendships and interest in things they used to enjoy. Change in two or more, sustained, is worth acting on.

Step 02

Ask the school what they see

Children often present very differently at school. Two data points beat one.

Step 03

Start the referral while you decide

Waiting lists are long. You can always decline an appointment; you cannot recover the months.

Key takeaways

The test is function: is this stopping them living their normal life?
Duration matters more than intensity — four weeks of change is a signal.
Some distress needs time and routine, not treatment.
Waiting rarely makes things easier; earlier work is usually shorter work.
Parent-only sessions are a legitimate and often effective route.

Reflection

Is my child unhappy about something specific, or unhappy across their whole life?
What has changed in the last month that would not have been true a year ago?
Am I looking for therapy for my child, or for reassurance for myself? Both are legitimate.

Printable resources

Companion worksheetA printable page to use alongside this article.Family conversation cardScripts you can read straight from the page.

Recommended Thrive courses

PathwayMental Health & Wellbeing

This article is educational and is not a substitute for individual clinical advice. Comments are closed so the Journal stays a calm place to read.