Substance abuse is an extremely serious situation, one that is devastating to even the most mature adults.

The prospect of your teen struggling with substance abuse can seem overwhelming. Maybe your teen has been open with you about their substance use habits or maybe you have noticed the signs of addiction. Either way, you have come to the conclusion that your son or daughter is struggling with an addiction. Unfortunately, just because addiction is a serious issue does not mean that the person dealing with it will respond in a serious way.

The next step would be for your teen to receive treatment, but what if he or she refuses to go to therapy or refuses to even acknowledge the addiction?

Teen refusal is a fairly common issue, and the advice on how to respond varies. Some parents respond by only “speaking softly” out of fear of their child pushing away from them; but this approach also takes away from the immediacy and seriousness of the situation. On the other hand, many approaches adopt Teddy Roosevelt’s “speak softly and carry a big stick” policy. These caregivers treat the situation as any other act of parent-child disobedience, which belittles the gravity of the situation and could result in further rebellion.

In an interview with Nancy*, she shared her experience of when her teen refused to go to a therapist appointment: “I had no idea what to do; she simply would not leave the house. I looked online for advice and because she was struggling with some self-harm habits, I kept seeing advice like ‘call the police if your child refuses to cooperate with their treatment program.’ I was not about to call the cops to get my daughter out of bed.”

In an FAQ from Dr. Douglas Riley, author of The Defiant Child, a parent asked “My child/teenager refuses to see a psychologist. What do I do?” Dr. Riley’s response was that “You are the parent and he/she is the child…[your child has] come to believe that he or she has equal decision-making power in your family, and can therefore resist you without any consequences. Make the appointment, and then place firm restrictions on the child for making you miserable regarding the appointment.”

These black and white answers might seem like obvious solutions to Dr. Riley and the sites that Nancy found, but teen refusal is likely more complex than simple obstinance. It is commonly said that the more authority you force onto your teen, the more that they will try to push you away. If your teen is old enough to be struggling with substance abuse, then it is likely that they are old enough to be wanting some space. Try to keep in mind that addressing addiction can be a touchy conversation with anyone, especially a defensive teen.

The following are some tips to try if your teen is refusing to receive treatment, and the Roosevelt/Riley “big stick method” isn’t working:

LEAP: Robert Hunt’s article[1] on teen refusal references Dr. Amador’s acronym: LEAP (Listen, Empathize, Agree, Partner). This approach is basically the opposite of Dr. Riley’s, as it focuses on building an open relationship between parent and child. According to Hunt and Amador, an effective child-parent relationship should not be different than any other relationship and therefore will rely on trust and equality.

(Again) Listen: Sometimes it can be hard to get past the initial frustration of your teen’s defiance, which can make it difficult to hear their side of the argument without bias or assumptions. Try to understand their perspective of why they would refuse treatment.

Get On Their Level: Your teen is struggling with an “adult issue” and you are an adult; use this connection to your advantage. If you have any personal experience of addiction, therapy, or teenage refusal and rebellion, share it with your teen. Acknowledge the gravity of what your teen is dealing with and show that you are respectful of their hardships. Make clear that you are not belittling their capability, but that many adults receive treatment for the same situation.

Mix It Up: Think about your first or most frequent way to respond to these kind of situations: do you give advice and opinions, try to problem-solve, just listen, or use the “big stick” method? Compare the current situation to ones in the past and note which ways were the most persuasive. Your past responses might not be the most effective, so next time try to respond in a way that you normally wouldn’t.

As I’ve mentioned, addiction is a very serious situation, which means that its consequences will have equally serious affects on your teen. If you look at teen refusal as simply child defiance, you might be missing the signs that your teen is struggling with a situation that is bigger than anything they’ve dealt with in the past; for that reason, they may not know how to respond in any way other than as a child: refusal. When your teen is struggling with addiction, treat them as an adult, in order to guide them towards adult-like responses.
*Names have been changed for the privacy of the interviewee.

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1. Hunt, Robert. “Teen Treatment Resistance: What To Do When Your Teen Refuses Treatment”. Retrieved from: