# Therapy for teenagers: how it works, what parents are told and how to choose > Your teenager barely talks, answers in single words and you cannot tell whether it is their age or something more. How therapy with a teenager works, what parents are told and how to choose. *https://mypsicotest.com/en/blog/therapy-for-teenagers/ · Published: 2026-10-14 · 10 min read · MyPsicoTest team* Your fifteen-year-old daughter has spent weeks shut away in her room. She answers in single words, has dropped basketball and her grades have slipped. When you ask what is wrong, the answer is "nothing" or a slammed door. You cannot tell whether it is her age or something more, and you are afraid that suggesting a psychologist will make her close up even further. If you are thinking about **therapy for teenagers**, this guide explains when it is worth taking the step, what therapy with a teenager is like, what parents are told and what they are not, what the law says about consent, which treatments work, whether it works online, how to bring it up at home and how to choose a professional. ## When to take a teenager to a psychologist It is not a rare problem. According to the World Health Organization, one in seven young people aged 10 to 19 has a mental disorder, and depression, anxiety and behavioural disorders are among the leading causes of illness and disability at those ages. The WHO also points out that stigma holds many young people back from seeking help and that a large share of these problems goes unrecognised and untreated. The hard part is telling what belongs to the age from what needs attention. It is worth getting advice if, for more than two or three weeks, you notice: - Sadness, irritability or anger almost all the time. - Withdrawal from friends and from things they used to enjoy. - A clear drop in schoolwork. - Big changes in sleep or eating. - Use of alcohol, cannabis or other substances. - Talk of nothing making sense or of not caring about anything. We cover the warning signs by age, including those that cannot wait, in [Does my child need a psychologist? Warning signs and what to expect](https://mypsicotest.com/en/blog/does-my-child-need-a-psychologist/). If you see signs of self-harm or your child talks about dying, get help today: **112** if there is immediate danger, or in Spain the **024 line**, free and available around the clock, or the ANAR Foundation helpline for children and teenagers on 900 20 20 10. Elsewhere, call your local emergency number. ## What therapy with a teenager is like Therapy with a teenager is not like therapy with a young child, where play and parents carry a lot of weight, nor quite like therapy with an adult. The young person is at the centre, but the family is still part of the process. It usually looks something like this: 1. **A first meeting with the parents**, to understand what is happening, since when and what has already been tried. 2. **Individual sessions with the teenager**, which are their space. The first one is usually about getting to know each other, without pushing them to tell everything at once, and about explaining how therapy works and what is confidential. 3. **Goals agreed with the young person.** If they feel therapy is something imposed by their parents, it rarely works. 4. **Regular feedback to the parents**, with guidance on how to support the process at home. 5. **Occasional family sessions**, if communication at home is part of the problem. The bond with the therapist matters a great deal. A meta-analysis by Karver and colleagues, covering 28 studies and more than 2,400 children and adolescents, found that a good therapeutic relationship went hand in hand with better results, with a small to moderate effect similar to the one seen in adults. That is why it is worth giving your child a say in the choice. ## What parents are told and what they are not This is the question that worries both sides most. Teenagers fear that everything they say will get back home, and parents fear being left out. Confidentiality is not a whim: it is what allows a teenager to talk. In a [trial by Ford and colleagues](https://pubmed.ncbi.nlm.nih.gov/9307357/), 562 high school students listened to a recording of a medical consultation. When the doctor guaranteed confidentiality, more of them were willing to talk about sexuality, substance use or mental health, up from 39% to 46.5%, and more wanted to come back, up from 53% to 67%. Spain's code of ethics for psychologists states that everything a psychologist learns in their work is covered by **professional secrecy**, and that when the client is a minor, their parents or guardians must be told about the essential features of the intervention: which problem is being worked on, with what goals and with what method. In practice, parents get information on how things are going and guidance for home, but not the content of each session. Secrecy has limits, and a good professional explains them from day one: if there is a serious risk to the life or safety of the teenager or other people, such as active suicidal thoughts, serious self-harm or abuse, the parents will be told. Knowing this from the start builds trust rather than undermining it. ## Consent: what the law says In Spain, the [patient autonomy law](https://www.boe.es/buscar/act.php?id=BOE-A-2002-22188) establishes that from the age of 16, teenagers give their own consent to health treatment. The exception is any intervention that poses a serious risk to their life or health, where their legal representatives give consent after hearing their view. Below that age, when the minor cannot understand the scope of the intervention, consent is given by their legal representatives, also after listening to them. The same law asks that patients take part in decisions about their treatment as far as possible. If you are separated from the other parent, ask the professional which consents they need before starting. ## Which therapy works for teenagers It depends on the problem, but some treatments have strong support: - **Anxiety.** A Cochrane review of 87 studies with almost 6,000 children and adolescents found that after cognitive behavioural therapy, 49.4% no longer met the criteria for their main anxiety disorder, compared with 17.8% of those on a waiting list. The same review admits there is little evidence that it beats other active treatments. We explain how this approach works in [Cognitive behavioural therapy: what it is, how it works and what it treats](https://mypsicotest.com/en/blog/cognitive-behavioural-therapy/). - **Depression.** The [NICE guideline](https://www.nice.org.uk/guidance/ng134/chapter/Recommendations) suggests options such as digital or group CBT for around two to three months for mild depression in 12 to 18-year-olds, and individual CBT for at least three months for moderate or severe depression. If that does not fit, it considers interpersonal therapy for adolescents, family therapy or psychodynamic therapy. - **Repeated self-harm.** In a trial by Mehlum and colleagues with 77 adolescents, dialectical behaviour therapy adapted for adolescents reduced self-harm, suicidal thoughts and depressive symptoms more than enhanced usual care. What about medication? NICE advises against antidepressants as the first treatment for mild depression in young people, and for moderate or severe depression it only considers them alongside psychological therapy, never on their own. They are prescribed and monitored by a doctor, not by the psychologist. ## Does online therapy work for teenagers? Yes. A meta-analysis by Bevilacqua and colleagues, with 10 studies in children and young people, compared technology-assisted cognitive behavioural therapy, including video calls, with face-to-face therapy and found it was not inferior for either anxiety or depression. ![Teenager with headphones and a laptop on the sofa at home, as in an online therapy session for teenagers](https://mypsicotest.com/assets/img/blog-terapia-online-adolescentes-1200.webp) Many teenagers feel comfortable talking through a screen, do not have to run into anyone in a waiting room and can join from their own room. The condition is privacy: a closed door, headphones and the certainty that nobody at home is listening. If a session turns into an emergency, the professional needs to know who to call and where you are. If you have never tried **online therapy**, [Online psychologist: how to choose well and what to expect from video-call therapy](https://mypsicotest.com/en/blog/online-psychologist-how-to-choose/) may help. ## How to suggest seeing a psychologist This is the moment parents dread most, and where things can most easily go wrong. A few ideas that help: - **Choose a calm moment**, not the middle of an argument. - **Describe what you see, without labels:** "you have seemed really tired and sad for weeks" works better than "I think you are depressed". - **Present it as help, not as a punishment** or a consequence of bad grades. - **Tell them that what they say will be confidential**, within the limits they already know. - **Give them a say:** let them look at the professional's website, choose between in-person and online, or ask to change if it does not click. - **Suggest a first session as a trial** and agree to decide together afterwards. If they still refuse, you can start yourself. A guidance session for parents helps you understand what is going on and change what is in your hands in the meantime. ## How to choose a therapist for teenagers These checks help you get it right: - **Registration as a health professional.** This comes first. - **Specific experience with teenagers**, which is not the same as working with adults or young children. - **They explain confidentiality and its limits** from the first session, to your child and to you. - **They involve the family** in a clear role: an initial meeting, feedback and joint sessions if needed. - **An evidence-based approach** for the specific problem and a plan with goals. - **Coordination with the school or a psychiatrist**, if needed and with your permission. - **Your child feels at ease.** If there is no connection after a few sessions, changing professional is perfectly legitimate. ## A psychologist for teenagers At MyPsicoTest we recommend [Xènia Capel Salcedo](https://psicologaigualada.es/en/therapist-psychologist-igualada/), a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. She sees clients in Igualada and Sant Sadurní d'Anoia and also through [online therapy](https://psicologaigualada.es/en/online-therapy-online-therapist/), and on her blog she has written an article about online therapy with teenagers. In it she explains how she works: she starts with sessions with the parents to learn the background and set goals, keeps individual sessions with the teenager as a confidential space, gives regular feedback to the family without revealing what the young person has shared, and suggests family sessions when the dynamic at home is part of the problem. She explains the limits of confidentiality from the start and, in the first session, does not push the teenager to talk: she focuses on getting to know them and agreeing goals with them. If needed and with the parents' permission, she coordinates with the school. The issues she mentions include self-esteem, peer pressure, academic stress, social media, self-harm and eating disorders. She works from an integrative, evidence-based approach: on her website she explains that she uses tools from cognitive behavioural therapy, EMDR, systemic therapy and person-centred therapy. The first contact is a free, no-commitment information consultation. She herself points out that in a serious crisis or psychiatric emergency, immediate in-person care is what is needed. ## Frequently asked questions ### At what age can a teenager see a psychologist without their parents' permission? In Spain, from the age of 16 teenagers give their own consent to health treatment, unless there is a serious risk to their life or health. Below that age, consent is given by their legal representatives after hearing the young person's view. ### Does the psychologist tell parents what the teenager says? Not the content of the sessions. Parents get information on how things are going and guidance for home. The exception is a serious risk to the young person's life or safety, such as active suicidal thoughts, serious self-harm or abuse. ### What should I do if my teenager refuses to see a psychologist? Pick a calm moment, describe what you see without labels, present it as help and give them a say in the choice. If they still refuse, you can start with a guidance session for parents. ### Which therapy works best for teenagers? It depends on the problem. Cognitive behavioural therapy has strong support for anxiety and depression, dialectical behaviour therapy for adolescents for repeated self-harm, and family therapy plays an important part in many cases. ### Does online therapy work for teenagers? Yes. A meta-analysis found that technology-assisted cognitive behavioural therapy, including video calls, was not inferior to face-to-face therapy for anxiety and depression in children and young people. It does need a private space at home. ### How long does therapy with a teenager take? It varies a lot. As a reference, the NICE guideline mentions around two to three months of therapy for mild depression and at least three months of individual CBT for moderate or severe depression. ### Does my child need medication? It is not usually the first step. NICE advises against antidepressants as the initial treatment for mild depression in young people and, for moderate or severe depression, only considers them alongside psychological therapy. A doctor decides and monitors it.