Think Your Partner Needs Therapy?

Do you know someone who, in your opinion, really needs therapy? Are you trying to get them to go, but they’re just not interested?

Not uncommonly, I find myself on the phone with someone who is deeply concerned about their adult child, partner, friend, or some other loved one. The caller is usually anxious, often frustrated, and always wants to know two things: Does this person need therapy? How can I convince them to go?

Does my Loved One Need Therapy?

First off, let’s assume that you are not concerned with their immediate safety. (If you are worried about this, call a crisis line or 911, or the NAMI helpline).

Without specifics, this is a difficult question to answer. It’s like asking if your car needs repair. If you’ve got a reason to ask, you probably want to at least call a mechanic.

I know that’s kind of a glib answer, and I’m not trying to punt. But it’s true. It’s rarely clear that therapy is not indicated, because psychological interventions (like CBT) can be tailored to help people with a range of problems, from the severe (such as full-blown major depression) to the mild (such as feeling down, “stuck”, or “in a rut”).

Now, I know that therapy, like car repair, is an investment.  That’s why I offer free phone consultations before seeing someone in person, and I strongly recommend that you choose a therapist who does these. In my experience, I have turned away a number of potential clients based on these calls, because they clearly had issues (such as eating disorders) that were out of my area of specialization. In those cases, I always make a referral to another trusted practitioner.

How do I Persuade my Loved One to come to Therapy?

This is a great question, and another one with no easy answer. But here’s what I tell people:

Clarify your concerns. What exactly are you worried about? What outcome are your trying to prevent? This is important to know because, for one, you’ll need to communicate this to your loved one.

Also, it helps you check your own reasoning and motivation. Are your concerns really warranted, or you trying to manage your own anxiety by controlling them? Is their behavior is not meeting your standards, or their own? These can be very different. For example, I’ve spoken with parents concerned that their adult child’s apparent lack of career direction was a sign of depression. In some cases, the adult child was not depressed, but rather, simply had different ideals and ambitions.

Let them know--directly. People often skip this step. If you think therapy might be good for someone, tell them, and be direct. Dropping hints is rarely helpful. If they are open to therapy, then there is no reason not to bring it up. And if they are not open to therapy, it can be helpful to understand their reservations.

If their problem affects you, tell them how. In doing this, you’ll want to use non-accusatory, plainspoken, language. This is the classic, “When you do X, I feel Y” formulation. Be sure that X is the behavior itself--not your interpretation of what the behavior means.

Don’t say, “It drives me crazy when you shut me out.” Instead, you might say, “When you come home from work and spend hours without saying anything to me, I feel confused and hurt. ”

Share your own positive experiences in therapy. If you’ve been to therapy and found it useful, you might as well them about it. Although it is less prevalent here in the Bay Area, mental health stigma remains. And, some people may interpret a recommendation for therapy as a criticism or judgment.

Frame therapy in terms of your loved one’s goals. Ultimately, your loved one is the decision maker. Even if you can “force” them to go to therapy, they are not likely to benefit unless they buy in to the process. If you can explain how therapy might help them achieve their goals (such as succeeding at work, or being a better partner) you can increase the odds that they’ll give it a try.