How to Talk to a Young Adult About Starting Therapy

The best way to raise therapy with a young adult is a calm, private conversation that starts with what you have noticed and how much you care, offers one concrete next step, and leaves the decision with them. Ultimatums, lectures and surprise meetings usually make people dig in. This guide, from Blackburn Clinical Services in West Los Angeles, is for parents, grandparents, siblings, trustees and anyone else who is worried about a young adult. If you would like to talk it through first, call (888) 870 7405.

At a glance

Pick the moment: private, sober, not in the middle of a fight, and with time to listen.
Lead with what you see: specific changes in sleep, mood, school, work or drinking, said without labels.
Offer one easy step: a name and number, an offer to sit with them while they call, or a ride to the first appointment.
Respect the answer: an adult decides whether to start care. A no today is often a yes later.
In an emergency: if someone talks about wanting to die or is in danger, call or text 988, or call 911.

Before the conversation

Write down what you have noticed. Two or three specific, recent examples are better than a list of everything that has gone wrong.
Decide who talks. One or two people they trust most. A whole family, or a family plus a trustee, can feel like an ambush.
Have a next step ready. Know which therapist or practice you would suggest and how a first appointment works, so the conversation can end with something real.
Check your own state. If you are furious or frightened, wait a day or get support first. Our family services can help families prepare.

What to say

SAMHSA notes that friends and family can make a major difference when someone is struggling with their mental health (SAMHSA). In practice, short and specific works best. Some ways to start:

“I have noticed you have not been sleeping and you stopped going to class. I am worried about you, and I am not angry.”
“You seem like you are carrying a lot right now. Do you want to tell me about it?”
“A lot of people your age talk to someone. I found a place that sees young adults. Would you be willing to try one appointment?”
“You do not have to decide tonight. Can we talk again this weekend?”

Then listen more than you talk. Reflect back what you hear (“so school feels pointless right now”) before offering an opinion.

What to avoid

Diagnosing. “You are depressed” or “you are an alcoholic” invites an argument. Describe behavior instead.
Money as a threat. Tying an allowance, rent or a trust distribution to therapy can turn care into a punishment. Whether a trust can or should connect anything to treatment is a question for the trustee and the trust’s attorney. See helping a young adult trust beneficiary start mental health care.
Comparisons. Siblings, cousins or friends who are doing well.
Promising secrecy you cannot keep. If safety is at risk, you will need to act.

If they say no

A first refusal is common. Stay connected, keep the door open and come back to it. When substance use is part of the picture, families have good evidence on their side: in Community Reinforcement and Family Training (CRAFT), family members learn to reward sober behavior, stop shielding a loved one from natural consequences and pick the right moments to suggest treatment. A review found CRAFT engaged about two-thirds of treatment resistant loved ones in treatment, roughly three times as many as referral to twelve step family groups and about twice as many as a confrontational intervention (Roozen and colleagues, 2010). A later review of 14 studies again found CRAFT about twice as effective as comparison approaches (Archer and colleagues, 2020).

Whatever they decide, you can get support for yourself. Our family services include one-on-one family coaching, whether or not your loved one is in treatment with us.

When it is urgent

Talk of wanting to die, of being a burden, of having no reason to live, or giving away belongings are warning signs that need action now (NIMH). Stay with the person, call or text 988, and call 911 if they are in immediate danger.

When they say yes

Move quickly while the willingness is there. At Blackburn Clinical Services, care starts with an assessment and continues one-on-one with a licensed therapist in our office at 12326 Venice Blvd, Los Angeles, CA 90066, or by secure video for clients located in California. If medication may help, our psychiatrists and psychiatric nurse practitioners can evaluate them; when you call, we explain how psychiatry appointments are arranged. An adult patient decides what is shared: anything we share with a parent, relative or trustee happens only with their written permission, and a trustee receives only attendance and general progress. Trustees and fiduciaries can also see our page for trustees and fiduciaries, and parents of college students can see help for parents of a struggling college student.

Questions

Can I make my adult child go to therapy?

Usually not. An adult chooses whether to start care. What you can do is make it easy, keep the conversation going and get support for yourself. Many young adults agree once the conversation is about concern rather than control.

Should I tie money or a trust distribution to therapy?

Treatment framed as a condition or a punishment is often harder to engage in. Whether a trust can or should connect anything to treatment is a question for the trustee and the trust’s attorney, not for a clinic.

What if they refuse?

Stay connected and raise it again later. If substance use is involved, family approaches such as CRAFT have good evidence for helping loved ones enter treatment. You can also get family support for yourself.

Can I make the first call for them?

Yes. You can call to ask questions and learn how a first appointment works. It usually helps if the young adult makes or joins the call to book.

Will you tell me what happens in their therapy?

Only with their written permission, and only what they agree to share.

Worried about a high schooler instead? A teen under 18 is a different conversation. See my teen won’t go to therapy: how to help a reluctant high schooler.

Get started

Call (888) 870 7405 (Monday to Friday, 9 AM to 5 PM), email info@blackburnclinical.com or contact us. Blackburn Clinical Services is at 12326 Venice Blvd, Los Angeles, CA 90066.

If you or someone you love is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911 in an emergency.

How to Talk With a Young Adult About Starting Therapy