Does My Teen Need Therapy? 6 Signs to Watch For and How Counseling Helps

By Stephanie D. Hewitt, LCSW, CSOTP

Key Takeaways

• A teen may benefit from therapy when changes in mood, sleep, school or friendships last more than two weeks or start to get in the way of daily life.
• Talk of self-harm, risky behavior or a sudden, worrying change is a reason to get help right away. You can call or text 988 at any time or call your local hospital.
• Counseling gives teens a safe, private place to talk, increase self-understanding, and practice ways of coping while parents stay involved in the bigger picture.
• Look for a therapist with experience working with teens. If they are a supervisee or resident, check that their supervisor has experience with teens too. Then look for someone who takes your insurance and feels like a good fit.
• Clarity Counseling and Assessment offers counseling for teens at our Roanoke office and virtual sessions across Virginia, and we accept several major insurance plans, including Medicaid.

Your teen may need therapy if changes in their mood, behavior, sleep or schoolwork are persistent, feel intense, or get in the way of school, friendships or home life. Every teen has hard days, and moodiness or time alone is often part of growing up. A rough week after a breakup is different from months of pulling away from everyone.

Additionally, sometimes experiences that teens had when they were younger find new ways of popping up as they grow older: prior family experiences such as divorce or personal experiences such as abuse that they seemed to “just get over” may become more prominent.

It’s a hard call to make, and you don’t have to make it alone. A therapist can help you sort out what’s typical for a teen and when they need support.

6 Signs Your Teen May Benefit From Therapy

Here are 6 signs to watch for. None of them means something is wrong on its own. But if you notice several, or one that won’t go away, talking with a therapist can help you understand what’s going on.

1. Changes in Mood

Watch for sadness that lingers, irritability or anger that seems bigger than surrounding situations, or constant worry. Teens don’t always say “I’m sad.” Low mood in teens often shows up as snapping at family, frustration or boredom with everything.

2. Pulling Away From Friends, Family or Activities

Some time alone is normal. It’s worth paying attention when your teen stops seeing close friends, drops sports or hobbies they used to love, or spends almost all their free time in their room.

3. Changes at School

Falling grades, skipped classes or not wanting to go to school at all can be signs that something is weighing on your teen. So can frequent stomachaches or headaches on school mornings, or a teacher telling you they’ve noticed a change. For some teens, school stress itself becomes too much to manage alone.

4. Changes in Sleep, Eating or Daily Habits

Sleeping much more or much less than usual, big changes in appetite, feeling tired all the time or caring less about hygiene can all point to stress, anxiety or low mood, especially when coupled with other symptoms.

5. Peer Conflict, Bullying or Social Stress

Ongoing conflict with friends, being left out or bullied (in person or online), and pressure from social media can affect how teens feel about themselves. If your teen seems anxious or down after time with peers or on their phone, it’s worth a conversation.

6. Risky Behavior or Talk of Self-Harm

Alcohol or drug use, reckless behavior, signs of self-harm (such as unexplained cuts, or long sleeves in warm weather), and talk about feeling hopeless or not wanting to be here all need attention right away. Don’t wait to see if it passes.

If your teen talks about wanting to die or hurt themselves, or you’re worried about their safety, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or chat at 988lifeline.org. It’s free and open 24/7. If there is immediate danger, call 911. You can also contact your teen’s doctor or a therapist as soon as possible.

How Does Counseling Help Teens?

Therapy gives your teen a safe place to talk with a professional who isn’t a parent or a teacher. That alone can make it easier to open up, and provides them with a neutral party who brings an understanding of psychological processes to the relationship.

In counseling, teens can:

• Put words to their feelings and understand what’s behind them
• Learn practical ways to handle stress, worry and low mood
• Practice expressing their needs and working through conflict with friends and family
• Build confidence in handling challenges on their own
• Build trust and healthy connections with parents and peers
• Understand how past experiences affect them today
• Recognize patterns in their thoughts, feelings, and behaviors
• Work through difficult or painful experiences

Parents are part of the process too. Your teen’s therapist can share ideas for supporting your teen at home. At the first session, they will also explain how privacy works, including when they would need to share information with you, such as a safety concern. This helps your teen trust the process while you stay informed about what matters most.

Ultimately, two summary questions can help you and your teen decide if this is the right time for therapy:

• Are your teen’s emotions, behaviors, or other challenges affecting the quality of their daily life in some way?
• OR Is there something your teen would like to better understand, work through, or change? Counseling isn’t just for when something is wrong. It can also be a space for personal growth, building confidence, understanding oneself, and learning new skills.

Every teen is different, and therapy moves at their pace.

What If My Teen Doesn’t Want to Go to Therapy?

It’s common for teens to push back at first. A few things can help:

• Pick a calm moment. Share what you’ve noticed and that you care, rather than starting during an argument.
• Frame therapy as support. Make it clear it isn’t a punishment or a sign that something is wrong with them.
• Give them a say. Let your teen help choose a therapist through a mutual search process. Websites like Psychology Today can be a good place to start your research.
• Suggest a short trial. Ask them to try a few sessions before deciding.
• Ask the therapist for help. When you call, mention that your teen is hesitant. The therapist can share ideas for making the first session easier.

Teens are sometimes hesitant about counseling, especially when they feel it means they are the problem. In reality, many factors usually shape what they’re going through. With time and support, many teens find concerns they’d like help with, even if these differ from what first brought them in. When therapists and parents stay flexible, and therapists take an active role in building rapport, many teens gradually come to trust their therapist and invest in the process. Therapy with teens can also be more creative than adult therapy, with writing, art or media alongside traditional “talk therapy.”

Some parents also find it helpful to talk with a therapist themselves first, to get guidance on next steps.

How Do I Find the Right Therapist for My Teen?

When you’re comparing therapists for teens, keep these points in mind:

• License: Look for a licensed clinician, such as a licensed clinical social worker (LCSW), licensed professional counselor (LPC) or licensed psychologist. If you find a supervisee or resident who looks like a good match, this can be a great option too! Just take a little additional time to learn about their supervisor as well, who will be a licensed clinician with supervisory experience.
• Experience with teens: Ask which ages the therapist works with and whether they help teens with concerns like yours.
• Insurance and cost: Ask whether the practice accepts your insurance, or call your insurer to check your mental health benefits.
• In person or virtual: Think about what will work best for your teen’s schedule and comfort. That being said, most teens are more engaged in person!
• Fit: The relationship matters. If your teen doesn’t feel comfortable after a few sessions, it’s okay to try someone else.

Teen Counseling in Roanoke and Across Virginia

At Clarity Counseling and Assessment, our licensed therapists work with teens facing anxiety, depression, school stress and peer conflict as well as teens who have faced a recent or past traumatic experience. We see clients at our office at 816 Franklin Rd SW in Roanoke, and families visit us from Salem and Christiansburg. We also offer virtual counseling for clients anywhere in Virginia if virtual counseling will meet their needs.

Our team also includes newer therapists who work under the supervision of our licensed clinicians, and they often have openings for new teen clients sooner.

We accept Anthem, Aetna, Sentara and UnitedHealthcare, plus Medicaid plans through Anthem, Sentara and UnitedHealthcare.

Learn more about our counseling services, or call us at 540-339-7575 or send us a message to schedule a first appointment.

Frequently Asked Questions

Where can I find therapy for teens near me in Roanoke?

If you live in or near Roanoke, Salem or Christiansburg, Clarity Counseling and Assessment offers therapy for teens at our Roanoke office, with virtual sessions available across Virginia. When you search for therapists for teens near you, look for licensed counselors for teenagers, then call to ask about their experience with teens and their availability.

How much does teen counseling cost?

The cost depends on your insurance plan, and your plan may cover part or all of it. We accept Anthem, Aetna, Sentara and UnitedHealthcare, plus Medicaid plans through Anthem, Sentara and UnitedHealthcare. Coverage varies by plan, so please contact us to confirm your benefits before your first session.

How long does therapy for teens take?

It depends on your teen and what they’re working on. Some teens come for a few months, and others for longer. Your teen’s therapist will check in with you both about progress and goals along the way.

Do parents take part in teen therapy?

Yes. Parents usually join the first appointment to share background and goals. After that, your teen’s therapist will talk with you about how you’ll stay involved and how your teen’s privacy works. Some teens benefit from regular parent sessions or occasional joint sessions. Other times, a parent’s most important role is to accept their teen’s feelings and give them time to work through things in therapy.

Can my teen have therapy online?

Yes. We offer virtual counseling for clients anywhere in Virginia if virtual counseling will meet their needs. Your teen joins from a quiet, private space at home, and your therapist can help you decide whether virtual or in-person sessions are the better fit.

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