Dear GoodTherapy.org,
I am under 18 and live with my dad and stepmom. I’ve been cutting for almost a year from depression and anxiety and basically not feeling like I want to be here. I HATE the idea of seeing a therapist and “talking about my feelings,” but apparently the school counselor told my dad I needed to see someone outside the school for help. The school counselor doesn’t know about the cutting, but I’ve talked to him a bit because apparently I have “anger issues.”
So now my dad and stepmother are looking up therapists for me to go see. I really don’t want to talk to anyone about my “issues,” but it’s getting hard to cover the marks on my arms and legs and I don’t know how to stop cutting. And also I know they’re just going to keep me in therapy longer if I refuse to talk. But I REALLY don’t want my parents to know about me cutting myself or the suicidal thoughts I sometimes have. Can I get through counseling without my parents finding out about it? How much is the counselor going to tell my parents about what I say in therapy? —Under Rage
Dear Under Rage,
These are good questions to ask any therapist you see. Find out from them what their policies are regarding confidentiality with people in therapy under 18. Much of what they say will depend on legal and ethical guidelines based on where they live and what kind of license they have. When I work with people under the age of 18, I discuss in great detail with both the young person and the parents what those guidelines are. That allows everyone to have the same understanding and expectation about how the process works. It also allows the young person to decide how much to share with me and to be aware of what my responsibilities to report are.
Most professionals are obligated to report when a person in therapy, regardless of age, is in imminent danger. That danger could be significant risk of suicide or conditions of abuse/neglect. Thoughts of suicide alone, however, do not necessarily trigger a mandated report—it depends on the circumstances. There are many people who have such thoughts but no intention or plan on following through. What is essential, however, is that anyone who is struggling with thoughts of suicide finds sources of support with whom they can talk. A trusted therapist is a great option. There are also national hotlines where you can reach out for support 24/7.
I hear the frustration in your message about all that the adults in your world “apparently” believe to be true for you. Instead, look at what YOU can get out of this experience. You can have a voice and share your truth with someone.
I’ve worked with a number of people who also HATED the idea of talking about their feelings. Usually that stems from a place of fearing they would be judged, a massive discomfort with feeling vulnerable and exposed, and a reluctance to trust someone they don’t know well. All of those feelings are natural. I can share with you that all of those people, in their own time, came to trust me and the process. When you find a therapist you can work with, who allows you to share at your own pace, who offers you a safe place to speak your truth without fear of being judged, counseling can be an amazing experience.
If I can offer you a suggestion, don’t reject therapy completely because it feels like something being “done” to you. I hear the frustration in your message about all that the adults in your world “apparently” believe to be true for you. Instead, look at what YOU can get out of this experience. You can have a voice and share your truth with someone. You can get support for the anger, anxiety, and depression you say you’ve been feeling for a year now. You can have support in finding alternative strategies beyond cutting to cope with the intensity of the feelings you have. You can be seen. You can be heard.
Nobody can make you share what you aren’t willing to share. You are right, though, that refusing to talk or engage will likely limit your choices and your control over your situation. So, how can you engage in ways that work for you? Ask your potential therapist the tough questions about confidentiality and how they manage those issues. Find out if your parents are willing to let you take part in the process of choosing a therapist. Many professionals have directory profiles and websites that can tell you a bit about what they might be like to work with. I’ve had people meet me first before deciding to work with me. Many therapists are very willing to meet to assess fit, as we know a good fit leads to more positive outcomes. You might just find someone you can open up to who can offer relief from what you’ve been feeling.
Best of luck,
Erika
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