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How do I get my 14-year-old who has ADD to participate in counseling?

Question:

​I need help getting my 9th-grade son to participate in counseling. I'm a single mom and for this whole pandemic (plus the previous year), we have had too many power struggles. He's not medicated but was diagnosed with ADD in May and I believe it's compounded by other things like sleep difficulties, anxiety and depression. He's ornery and foul-mouthed with me more days than not. I found a counselor and my son sat through the first half hour last week. Now, the next session is the assessment where he should talk to the counselor by himself via phone or telehealth. We did a little of the same thing over the summer, but he'd often walk out of the room if he felt frustrated or bored and leave me to finish the session alone. I think it's imperative that a professional help me figure out what is going on to help reduce the stress we're both experiencing in our home. I'm getting my own counseling separately and some parenting advice. But, in this situation, I can't “force" him just like I couldn't force him to go to the psychologist's or psychiatrist's office for an evaluation. But, it's really quite obvious to me that we have to do something. The situation was compounded by us changing health insurance plans and having to start with a new counselor. I'm thinking of giving him the choices of meeting with the counselor in the a.m. or p.m. and by phone or video. But I don't want him to think he can just not participate. He's 14 and so far not using any substances and is doing okay in online school.

Answer:

Boys Town - Therapist

Thank you for your email. Parenting teens can be a challenge, especially as a single parent. It sounds like you are doing a lot of things right. Giving choices can help teens feel more in control. But it is true that you are the parent and can make the rules and guidelines for the home. If going to counseling is not negotiable, let your son know this. Then be prepared to follow up with a consequence if needed. For example, you can say, “Counseling is at _____time and ____place. We will be leaving at ____."  Don't give him the option of not participating.  If he then refuses, you remove privileges as a consequence. No arguments. Just explain that counseling is an expectation at this time. Keep in mind that you can't make him talk when he gets there. Sometimes it helps to talk beforehand about why you are going to counseling. Frame it as an opportunity for both of you to work on your relationship. He might surprise you and be willing to work on your relationship. Teens usually want things to go well between themselves and their parents.   

It might help your relationship if you identify some things that can be adjusted or changed. For example, would a later bedtime on weekends be okay? Can you agree to change other things that might be to his liking? Compromise can go a long way toward helping change happen. Just make sure that you are okay with those areas he wants changed. Hang in there, parenting teens can be a challenge. But in the end, most teens appreciate a parent who sets rules and follows through with consequences. They may not recognize it now, but they will appreciate it in the future.

Here are some additional articles on setting rules and consequences that you might find helpful:

When Kids are Too Old for Timeouts
https://www.boystown.org/article/Pages/job-cards-as-effective-consequence.aspx

Dealing with Defiance in Tweens and Teens
https://www.boystown.org/article/Pages/dealing-with-defiance-in-tweens-and-teens.aspx