So you want your teen to see a psychologist...

I've seen many an adolescent who doesn't want to be on my couch but for some (good) reason their parents do. Maybe the adolescent is telling everyone she's miserable but in the next breath says therapy can't help her because her depression is "chemical", or perhaps she identifies as a "tortured soul". Regardless of the severity of an adolescent's symptoms, if they're unwilling to be in therapy, it's probably going to take more than the 10 sessions available under Australia's Medicare Better Access Scheme to get them to actively participate in the process, if at all.

In these cases, my preferred approach is to focus on what can be changed. Typically this means working with parents, and the school if relevant - looking for what triggers the adolescent's symptoms, where and when problem behaviours arise, and identifying what the adolescent gains from continuing to suffer from, for instance, depression (this is called secondary gain and may include having an unusually close relationship with a parent, or school avoidance). Most importantly, this approach aims to help parents understand the emotional system that exists in their family, and how interactions between family members may lead to an escalation in symptoms, or help to maintain them. Parents then have the opportunity to understand what changes they have the power to make irrespective of their adolescent's desire to keep the status quo. Obviously this runs counter to the commonly held assumption that the problem is "in" the individual, and that it's only a matter of time before the therapist "fixes" the teen - but this assumption is often not reflected by reality; we are significantly affected by our closest relationships, and at no time is this greater than during childhood and adolescence. While working on understanding our role in unhelpful family dynamics can be confronting, it is almost always worthwhile if we have the courage to do it. But more importantly, it creates a much better chance for change than dragging an unwilling adolescent to therapy hoping an hour a week will "fix" them.