Therapeutic Relationships: Parental Involvement in Adolescent Treatment

“Families and societies are small and large versions of one another. Both are made up of people who have to work together, whose destinies are tied up with one another.” ~ Virginia Satir

Worldwide, one in seven 10–19-year-olds are diagnosed with a mental health disorder.[1] Among adolescents, the most common mental health issues are anxiety, depression, ADHD (attention-deficit-hyperactivity-disorder), eating disorders, and behavioral disorders, with suicide being the fourth leading cause of death in this age group.

Some parents may feel unsure about how to best support their teen’s treatment and to what extent they should get involved. Research demonstrates that the families who fully and openly engage with the child and their treatment plan see the best results. Teenagers whose families do the work see long-term success, improved participation, higher levels of attendance, and overall family satisfaction.[2]

Adolescence is a uniquely formative time in our lives. Physical, emotional, cognitive, and hormonal changes lead to a vulnerability in the formulation of neural pathways and the creation of habits. Additionally, at this time, teenagers are likely to experience or become aware of social changes, including poverty, violence, or abuse, which can trigger a variety of mental health conditions.

Teenagers suffering from mental health issues are vulnerable to a range of detrimental factors including discrimination, physical ill-health, educational difficulties, exclusion, risk-taking behaviors, and stigma. These factors can affect their openness to seeking help, and so many of these adolescents remain unrecognized and untreated.

Early intervention and treatment are essential to allow these individuals to grow into independent, empowered, and positive members of society. Failing to address their needs enables the mental health disorders to extend into adulthood, impairing their physiological and psychological health and inhibiting their ability to lead happy and fulfilling lives.

Protecting our teens from adversity, promoting education and awareness, and ensuring access to appropriate mental health care are critical for their well-being.

The role of the family is therefore paramount in ensuring that our adolescents have the help, support, and successful outcomes they deserve.

Adolescent Vulnerability

Adolescence is a crucial period for constructing the following social and emotional habits that are vital to mental well-being:

  • Adopting healthy sleep patterns
  • Developing crucial skills such as problem solving, coping strategies, and interpersonal skills
  • Finding an exercise routine
  • Making healthy food choices
  • Learning how to manage emotions
  • Forming close bonds outside of the family
  • Managing expectations
  • Achieving financial aptitude
  • Planning for the future

Adolescents are particularly vulnerable to external risk factors that may impact their mental health. It is widely understood that the greater the number of risk factors individuals are exposed to the higher the potential impact on their psychological health.

Stress factors during adolescence that are contributory to poor mental health include:

  • Exposure to adversity
  • Peer pressure
  • Exploration of identity
  • Media influence / social media use
  • Gender norms
  • Quality of home life
  • Discrimination
  • Witnessing or experiencing violence and/or abuse (including bullying)
  • Conflating parenting styles
  • Poverty and socioeconomic problems

Ensuring the adolescent operates from within a protective, supportive, and stable home environment is key for the formation of self and for optimum physical and mental health. 

Recognizing the Signs

It is a natural part of a teenager’s development to experience strong emotions such as anxiety, frustration, anger, or sadness. However, mental health disorders are distinguished from normal developmental experiences by persistent symptoms that negatively affect how a teenager feels, thinks, and acts. Disorders can also interfere with day-to-day activities such as sleeping, eating, having healthy relationships, and managing schoolwork.[3]

According to the National Institute of Mental Health (NIMH), a teenager may need therapeutic support if they:[4]

  • Lose interest in activities previously enjoyed
  • Have low energy, difficulty sleeping, or eating problems
  • Isolate themselves from others
  • Adopt excessive exercise or dieting habits and/or binge eating
  • Engage in self-injurious behaviors
  • Misuse alcohol, tobacco, cannabis, or other substances
  • Engage in risky behaviors
  • Experience suicidal ideation
  • Hear or see things that others cannot

Although an estimated 49.5% of teens experience a mental health disorder at some point in their lives, early intervention, appropriate treatment, and parental support are proven to significantly lessen the impact.[5]

The Role of the Family

In an ideal world, our families serve to support us, provide strength, give love and affection, and enable a safe space where we can build our self-esteem through openly and comfortably sharing thoughts and feelings. However, in reality, this is too high of an expectation, as no family will maintain this ideal 100% of the time. In some cases, the family environment is one of dysfunction, disconnection, fear, stress, or toxicity.

Our family dynamics help us to develop our character traits, independence, expectations of others, coping skills, ability to receive or give love, and interpersonal skills. 

In challenging situations, such as an adolescent with a mental health disorder, the family structure may break down when it is needed most. These problems can manifest even in the healthiest of families and can result in chronic dysfunction, leaving its members isolated and unsupported.

Hand in Hand

As children get older and become teenagers, they will naturally spend more time alone evaluating themselves and their worlds while building their own identities. To parents, it might appear like they are no longer needed by their child or that they are exhibiting strength and independence beyond their years. However, it is essential that a teenager suffering with a mental health disorder accepts their condition and receives support from their parent(s) or primary caregiver.

Numerous studies evidence that child and adolescent therapy is more effective when the parents are involved. It has also been proven that parental involvement improves treatment observance and attendance.[6] Research also shows that combined parent-adolescent and family therapy treatment plans demonstrate far better outcomes than teenagers who only received individual therapy.[7]

It can be a confusing process when an adolescent first starts engaging with therapeutic treatment. However, the parent’s support, availability, and continuity of presence are vital for treatment to be successful.

It is natural for a parent to have such concerns as:

  • What is my role?
  • What is expected from us?
  • Will we be kept in the dark?
  • Should we tell the therapist things we observe?
  • What if the teenager does not want us involved?
  • What if family dynamics worsen?

All of these questions are worthwhile, and in many cases beneficial, as they can be discussed by the parent during the family therapy sessions or one-on-one. These situations can be worked through, and the therapist can teach the parents the same skills that they’re teaching the child. This results in a shared understanding between parent and teenager and allows for the therapy to continue outside the therapist’s office.

Being involved in a teenager’s therapy also means that problematic family dynamics can be brought to the forefront, discussed, and resolved far more quickly and easily than outside of treatment. While the issues that arise may be difficult to hear, if they are contributing to the child’s mental health issues they are worth tackling head on and in the company of understanding experts.

It is vital for a parent to recognize that their child’s mental health needs do not exist in a sphere outside of the family. These needs are individual and collective and require significant change within the family structure in order for the child to be free from their mental health issues.

Taking That First Step

The extent of a parent’s involvement in their child’s therapy will depend on certain factors like their age and the type of treatment needed. However, it is important for every parent, and those in the wider family unit, to be involved as much as they possibly can.

It is likely your consent will be needed for the teenager to start therapy sessions, and at this stage it is best to take the initiative and start forming the parent-therapist alliance. Raise concerns, ask for direction and resources, and allow yourself to enter a non-judgmental zone forged out of care for the child’s wellbeing.  

When you’re involved in your child’s therapy, it shows the teenager that they are a part of a team. They are not a singular component facing what may feel like insurmountable challenges; rather, they have the strength, unity, and love of their family at their side.

 If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates – call 800-335-0316 or email today.


[1] “Adolescent Mental Health”. Who.Int, 2022,

[2] Crowe, A., & Lyness, K. P. (2014). Family Functioning, Coping, and Distress in Families with Serious Mental Illness. The Family Journal, 22(2), 186–197.

[3] U.S. Department of Health and Human Services, National Institute of Mental Health. (2019). Child and adolescent mental health.

[4] “Child And Adolescent Mental Health”. National Institute Of Mental Health (NIMH), 2022,

[5] Department of Health and Human Services, National Institute of Mental Health. (2021). Mental illness. b

[6] Radez, Jerica et al. “Why do Children and Adolescents (Not) Seek and Access Professional Help for their Mental Health Problems? A Systematic Review of Quantitative and Qualitative Studies”. European Child &Amp; Adolescent Psychiatry, vol 30, no. 2, 2020, pp. 183-211. Springer Science And Business Media LLC, Accessed 22 Sept 2022.

[7] Dowell, Kathy A., and Benjamin M. Ogles. “The Effects of Parent Participation on Child Psychotherapy Outcome: A Meta-Analytic Review”. Journal Of Clinical Child &Amp; Adolescent Psychology, vol 39, no. 2, 2010, pp. 151-162. Informa UK Limited, Accessed 22 Sept 2022.

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