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Key points
- Approach the conversation from a place of care and concern. Avoid making judgments about behavior.
- Couples can use the “carrot-and-stick” approach with emphasis on the benefits of seeking therapy.
- Ultimately, people have to make the decision to accept help on their own.
Seeing a loved one struggle with their mental health can feel scary and overwhelming. It’s natural to want to help by bringing in a professional, but while some people are open to therapy, many others are hesitant or resistant. Here’s how to broach this sensitive question with purpose, care, and respect.
Note: This advice pertains to people who are generally stable and not in immediate crisis. If you are concerned for someone’s safety, call 911 or go to the hospital.
1. Choose the right time.
Pick a time when the person is likely to be receptive. For example, don’t pounce as soon as they wake up or walk in after work. Make sure that you have ample time and a place to speak privately. You can also ask about timing directly, for example, “I have something I’d like to discuss with you. When would be a good time?”
2. Approach the conversation with care and concern, not judgment.
When you broach the topic of therapy, begin by expressing that you want to help because you care about the other person. Ask questions and listen to the person’s answers carefully and patiently. Listen for ways that therapy could address specific concerns. Affirm that you’re raising the topic because you want them to be healthy and happy.
When explaining specific concerns, be descriptive about what you’ve observed and how you think therapy would help, explains psychologist Monica Johnson, Psy.D. You could say something along these lines: “I’ve noticed that for the last several months, you’ve appeared to be really sad based on X behavior, and I think therapy could be beneficial for Y reasons.”
Avoid coming from a place of anger or judgment, both in tone and content. An angry stance, for example, might take the form of stating that the other person has made life hard for you or how they should have been working on their problems themselves.
3. For couples therapy, take the carrot-and-stick approach.
Often, one partner leads the charge for couples therapy and must convince the other to come along, says David Woodsfellow, Ph.D., who encourages partners to adopt an assertive approach. Use “I” statements rather than “you” statements, he suggests, state the problem, and explain how your relationship would benefit from therapy. A carrot-and-stick framework lays out what could be gained and what could be lost. The carrot explains how your relationship would change for the better. It might sound something like this: “As you know, I don’t like it when you raise your voice at me. I think that if we changed the way we fought, I would feel calmer, happier, more loving.”
The stick, on the other hand, might sound like this: “What I’m worried about is that if this can’t change, I think I’m going to feel more discouraged, distant, maybe hopeless.” And if it’s true, let them know: “Sometimes I worry it could lead to us splitting up.”
“This isn’t a threat,” Woodsfellow says. “It’s informing someone of the best understanding of yourself.”
4. Share your own experience with therapy.
Put simply, show don’t tell. Rather than lecture the person about the value of therapy, share how it helped you. Stories are powerful.
This approach has the additional benefit of destigmatizing therapy; it moves the focus away from something being “wrong” with the person to an experience that is normal, natural, and that others have navigated as well.
5. Be aware of common fears and misconceptions.
There are several common reasons why people refuse to see a therapist, explains clinical psychologist Loren Soeiro, Ph.D. These include:
- "It costs too much."
- "I don’t have time."
- "I’d rather talk to my friends."
- "I saw a psychologist once and it didn’t help."
- "What good is talking going to do?"
- "I’d feel weird talking about this stuff to a stranger."
- "Therapists don’t say anything; they just sit there and judge you."
- "Therapists don’t really care about you; they do it for the money."
It’s reasonable to have concerns about therapy. Don’t shut these fears down. Instead, validate your loved one’s concerns and then address them. Do some research ahead of time so that you can respond effectively. For example, if your loved one is concerned about privacy, explain that all information patients share is strictly confidential (unless a patient or someone else is in immediate danger.) If your loved one doesn’t believe that therapists really care, explain that the process works best when the therapist and patient forge a positive relationship and understand one another over time.
6. Offer to help with logistics.
The process of finding a therapist can be time-consuming and overwhelming, especially for those who haven’t done it before. Tasks like this can feel especially daunting for people who are already struggling with stress, anxiety, or depression.
Offer to help the person with logistics, such as finding a list of therapists who take their insurance or driving them to an appointment if it’s in-person. Some may appreciate the help, while others may prefer to do it themselves. Follow your loved one’s lead.
7. Know when to stop.
You can’t force someone to go to therapy. And in the context of individual therapy, it probably won’t be effective if the person doesn’t genuinely want to change.
If someone rejects the suggestion of therapy, the trajectory will be different based on the relationship and the context. If the relationship is too damaging to continue, and the person is unwilling to seek treatment, you may decide to draw a boundary or end the relationship. But if the person is someone who will continue to be in your life, you have to recognize when to set the suggestion aside. You’ve already done what you can, by offering encouragement and information. People have to make the decision to accept help on their own.
“You want to make sure you preserve your relationship with this person,” Soeiro says. “If they need help, you’re in their support network. You don’t want to become oppositional to them if you could help them.”
Being opposed to therapy now doesn’t necessarily mean being opposed to therapy forever. Sometimes a stressful period or time of transition shifts a person’s perspective and they’ll give it a try. This certainly isn’t guaranteed, but it can happen. Having discussed therapy in the past may propel them forward when the time comes. Says Johnson: “You may have to throw a series of breadcrumbs and just see where it takes you.”
To find a therapist, visit the Psychology Today Therapy Directory.
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