How Do You Engage a Resistant Adolescent Client in Therapy?
Engaging resistant adolescents in therapy can be a challenging task for mental health professionals. This article presents innovative strategies, backed by expert insights, to help therapists connect with their young clients. From creative play frameworks to utilizing music for emotional regulation, these approaches offer fresh perspectives on building trust and fostering communication in the therapeutic setting.
- Step Out of the Therapist's Chair
- Create Therapeutic Playlists with Teens
- Use Side-by-Side Dialogue for Comfort
- Transform Therapy into Comic Strip Storytelling
- Engage in Parallel Activities for Communication
- Encourage Experiential Learning Through Metaphors
- Start Simple: Ask About Favorite Foods
- Incorporate Creative Play Frameworks
- Exchange Song Lyrics for Deeper Understanding
- Acknowledge Reality to Build Trust
- Connect Through Shared Interests
- Utilize Music for Emotional Regulation
Step Out of the Therapist's Chair
I've worked with many adolescents who entered therapy with crossed arms, rolling eyes, and the preconceived notion that "This won't help me." What has worked best for me is stepping out of the therapist's chair—both literally and figuratively. I've experienced some of my most significant breakthroughs while shooting hoops in a parking lot, walking around the block, or even sitting on the floor and playing video games with them.
I believe that when I stop trying to "be" the therapist in the traditional sense and simply present myself as a genuine person, that's when I engage in authentic conversations. I had one teenager who refused to talk during sessions—exhibiting complete shutdown behavior. So, I introduced a deck of "Would You Rather?" cards. We began joking around with them, and suddenly, he was talking, laughing, and engaging—and eventually, opening up.
I always say, "Connection first, conversation second." That's where the healing begins.
Please let me know if you'll feature my submission—I'd love to read the final article.
I hope this was useful, and thank you for the opportunity.
Create Therapeutic Playlists with Teens
One creative approach I've found effective with resistant adolescent clients is using "therapeutic playlist building." Music often serves as a powerful emotional outlet for teens, and it creates a bridge that feels safe, personal, and non-threatening.
Instead of jumping into emotional dialogue, I invite the client to curate a playlist that reflects different moods--songs they turn to when they feel angry, misunderstood, calm, or hopeful. We explore lyrics, tone, and themes together, asking questions like, "What does this song say that you wish people understood about you?"
This strategy not only gives the adolescent a sense of control but also helps them express complex emotions that may be difficult to verbalize. Over time, it opens doors to deeper conversations about identity, relationships, and self-worth, without forcing vulnerability too early.
For many adolescents, especially those who feel unheard or invalidated, music becomes a shared language. This approach respects their defenses while still encouraging emotional exploration.
Building a connection before intervention is key. When teens feel you see them, not just their problems, they're more likely to engage.
Use Side-by-Side Dialogue for Comfort
As an educational psychologist, I've found that resistance in adolescents is rarely about defiance--it's often about not feeling safe, seen, or in control. One of the most effective methods I use is what I call 'side-by-side dialogue.' Instead of a traditional face-to-face conversation, I'll set up the space so we're sitting next to each other, working on something together--like a puzzle, a drawing task, or even organizing a tray of sensory items. This parallel positioning eases tension, reduces the intensity of direct eye contact, and allows the conversation to unfold more naturally. I also use metaphor-rich prompts like, 'If school were a video game, what level would you be stuck on?' This opens the door to self-expression without putting them on the spot. When we meet teens with curiosity rather than correction, even the most guarded ones often begin to open up.
Transform Therapy into Comic Strip Storytelling
One unique method I've successfully employed is what I call "Comic Strip Therapy." This approach transforms therapy into a creative, storytelling process, which can be especially effective with adolescents who resist traditional talk therapy.
I once worked with a 15-year-old patient—let's call him Alex—who was very resistant to conventional therapy sessions. Alex was often withdrawn and shared only minimal details about his emotions and daily challenges. Recognizing his interest in art and storytelling, I introduced him to creating comic strips as a means to express himself.
During our first session, I provided Alex with blank comic panels and colored markers. I explained that he could create a comic about "a hero navigating a challenging day," leaving the content entirely up to his imagination. At first, he was skeptical, but he gradually began drawing a character who faced obstacles resembling his own struggles.
As sessions continued, Alex's comic strips evolved. He started to incorporate symbolic elements—like a shadowy figure representing overwhelming stress, or a beam of light symbolizing moments of hope. Through his drawings, Alex was expressing emotions and situations that he hadn't been able to articulate verbally. Over time, these visual narratives not only broke down his resistance but also paved the way for deeper conversations. For instance, when Alex added a recurring villain that mimicked his inner critic, it opened up discussions about self-esteem and peer pressures.
By externalizing his internal world through art, Alex was able to view his problems from a new perspective. The comic strip became a bridge between his internal experiences and our therapeutic dialogue. This method ultimately led to increased engagement in therapy sessions, a clearer understanding of his emotions, and the development of personalized coping strategies.
The "Comic Strip Therapy" provided a non-threatening avenue for Alex to explore his feelings creatively and safely—a vivid example of how tailoring interventions to a patient's interests can transform resistance into active participation.
Engage in Parallel Activities for Communication
I've found that traditional talk therapy often hits a wall with resistant adolescents, especially those who've been mandated to treatment. One approach that's been remarkably effective in my practice is what I call "parallel engagement." Instead of sitting across from a teen demanding eye contact and answers, I arrange activities side-by-side--whether it's shooting hoops, working on a simple woodworking project, or even just walking outdoors. The physical positioning alone removes the confrontational dynamic that many teens react against.
This side-by-side approach taps into something developmentally significant: adolescents often communicate more freely when not under direct observation. I remember working with a 16-year-old who had been caught selling prescription medications at school. For our first three sessions, he barely spoke beyond one-word answers. During our fourth session, while working together to fix an old skateboard deck, he spontaneously began talking about the pressure he felt to be the "provider" for his friend group--how dealing had given him status and purpose he couldn't find elsewhere. This breakthrough came precisely because I wasn't staring him down or forcing disclosure.
The technique works on multiple levels--it respects the adolescent's autonomy while indirectly modeling healthy relationship dynamics, creates natural pauses in conversation that reduce pressure, and associates therapy with capability rather than vulnerability. I've found that once this initial resistance barrier breaks down, we can gradually transition to more traditional therapeutic approaches as trust builds. But even then, I keep elements of parallel engagement in our work, especially when approaching difficult topics. The goal isn't just to make them talk--it's to help them discover they have something worth saying, and that I'm genuinely interested in hearing it, not just fixing or changing them.
Encourage Experiential Learning Through Metaphors
As an experiential therapist, I believe that clients process best with hands-on interventions and by having direct experiences. Teenagers' brains are still partial to experiential learning, and often experiential interventions feel a little safer as we're processing through metaphors. The bottom line is that the teen doesn't need to find the words to describe their thoughts, feelings, and perceptions with experiential interventions. This is particularly effective with resistant adolescents. If they don't want to or can't talk about it, I encourage them to show me. They can show me through art, music, sculpture, storytelling, sand tray, etc. Many resistant teens are mad, frustrated, ashamed, and maybe even scared to be in therapy. I don't want to be another adult in their life with an adult agenda, so I'll meet them where they're at and invite them to show me their world.
Start Simple: Ask About Favorite Foods
Getting a child to open up can be challenging. Often, their moodiness stems from a variety of reasons—some simple, like being hungry or tired, and others more complex, such as feeling sad or anxious. They might be dealing with family conflicts, struggling academically, facing peer rejection, experimenting with drugs or other risky behaviors, or even grappling with questions about their sexuality.
Understanding the different aspects of an adolescent's world—home, school, work, and personal life—can help guide more meaningful conversations. Once you have a sense of what their world looks like, you can begin to ask more specific questions tailored to each area. For instance, when exploring their home life, you might ask about their relationships with parents, siblings, or other family members, and whether there are any difficulties at home.
I remember once speaking with a particularly resistant adolescent who refused to talk about anything—home, school, work, or personal matters. So, I changed my approach and simply asked what their favorite food was. They lit up and started talking about mangoes—what types they liked, whether they had a mango tree at home, and what other fruits they enjoyed. That five-minute conversation about mangoes opened the door to deeper conversations about their life.
Incorporate Creative Play Frameworks
Adolescents who resist therapy often feel misunderstood, powerless, or fearful of being judged. One technique I've found especially effective is incorporating therapeutic play frameworks that prioritize emotional safety, creativity, and autonomy, allowing adolescents to participate without feeling pressured.
Why Creative Play Enhances Engagement
The adolescent brain, still developing its executive functions, responds positively to interactive and reward-driven experiences. Activities rooted in creative play stimulate the prefrontal cortex and limbic system, encouraging emotional expression while bypassing cognitive defenses often triggered by direct questioning.
Methods That Work
I've utilized a structured yet imaginative approach that includes:
Emotion Trail Cards: A customized deck where each card explores a feeling, thought, or behavior, and invites the teen to respond through storytelling or drawing.
Perspective Roleplay: Teens are invited to act as counselors for a fictional peer, subtly projecting their struggles through the lens of empathy and problem-solving.
Coping Skill Builder: An activity that lets clients 'unlock' new skills like power-ups in a game, based on their reflections and participation.
Observed Benefits
This strategy often transforms resistance into curiosity. Clients begin revealing their concerns and emotions indirectly, which leads to deeper therapeutic alliances and more meaningful clinical progress—especially in cases involving trauma, identity issues, or personality dynamics.
Exchange Song Lyrics for Deeper Understanding
It's different for everyone, so I'm always searching for and trying new approaches with teens who don't want to talk. I've tried using "music-based dialogue," where we exchange song lyrics or playlists instead of engaging in direct conversation. I ask them to pick a song that reflects their mood. Then we discuss the lyrics, why they chose that particular song, and what it means to them. This approach is easier for them than simply answering my questions, and it helps me understand them better. Sometimes, small steps like this can lead to more substantial conversations later. The key is flexibility, meeting them where they are, not where I expect them to be.
Acknowledge Reality to Build Trust
At Truth Center for Health & Healing, we understand that adolescence is a uniquely complex time—where brain development, identity formation, and a flood of emotions collide. When therapy is something a teen feels *required* to do, resistance is often a natural response.
When we encounter a resistant adolescent, we start by acknowledging what's real. We recognize that they might not want to be here, that they may feel misunderstood, unheard, and like nothing in their world can truly change. That honesty becomes the first bridge.
Instead of leading with professionalism that feels cold or scripted, we lead with humanity. We let them see us—flaws and all—because most of the adults in their lives are likely just telling them what to do. We choose instead to listen. We meet them in their isolation and reflect back their attempts to be seen, even if those attempts come out sideways.
What we've found is that the moment we validate their experience—not fix it, not rush past it—is the moment the resistance begins to soften. From there, trust can grow. And in that trust, healing becomes possible.
Connect Through Shared Interests
As a male therapist, one method I've found especially effective with resistant adolescent clients is using indirect engagement through shared interests. Instead of diving straight into emotional topics, I'll start with something they care about—whether it's gaming, music, sports, or a show they're into. I might ask, "What's in your playlist right now?" or "Do you play any video games?"—and just follow their lead.
Once they realize I'm genuinely curious and not just checking a box, they start to loosen up. From there, I'll use metaphors or references from those interests to talk about emotions or struggles in a way that feels less threatening. For example, comparing stress to being stuck on a tough level in a game and needing the right tools to get through it. It's about building a connection first—when they feel respected and not analyzed, they're more likely to open up on their own terms.
Utilize Music for Emotional Regulation
I have enjoyed using music to connect to emotional identification to build additional language for learning about identity, expressive therapy alternatives to previous experiences, and find a foundational way to continue building rapport. Through a trauma-focused therapist lens, music can regulate the nervous system and help one feel grounded when a fight/flight instinct arises. The importance of knowing how the body can respond positively to music has also assisted me in my previous workplace at a therapeutic school. It allowed us to quickly de-escalate complex and intense emotions in a way that adolescent clients could buy into.
