How Do You Talk to Someone About Starting Therapy?

As a therapist, the most common question I am asked by clients, family, and friends alike is, “How do I effectively encourage my friend or loved one to see a therapist?” 

Over the past several years, we have collectively experienced loss, uncertainty, isolation, and hardship due to the global COVID-19 pandemic and its many ripple effects. These notable stressors, along with others, have resulted in increased rates of psychological distress for people of all ages. 

According to the National Institute of Mental Health (NIMH), in 2021, one in five Americans (an estimated 57.8 million individuals) met criteria for a mental health condition. 

People who do not have a mental health condition can still benefit from talk therapy, whether for support with relationships, parenting, identity, grief, financial or work stress, or other concerns. 

While some people initiate therapy themselves, others may not pursue it without the encouragement and support from family or friends. Suggesting therapy can be delicate, as you want to express care without judgment. 

Here are four strategies to guide you when talking about therapy with a loved one: 

1. Frame therapy as a deserved opportunity for support 

When someone is going through a difficult time, they may be particularly sensitive to criticism on how they’re struggling to cope with their circumstances. Rather than pointing out ways your loved one is struggling, acknowledge all they are handling. 

This might sound like, “I’ve been thinking about everything you are managing: your work, your relationships, the changes you’ve made in the past year, and decisions about your future. It is a lot. You deserve support. Have you considered seeing a therapist?” 

This reflection highlights external and situational stressors and acknowledges their weight. Pointing to things that are “wrong” with the individual, such as “You seem angry all the time,” or that they are not handling well, such as “You seem to be struggling with this transition,” are likely to evoke a defensive response. In contrast, validating stressors conveys empathy and concern without judgment. 

2. Understand resistance 

Appreciate what attitudes and barriers might prevent someone from seeking therapy. Simple questions like, “What would get in the way of you going to therapy?” or “Do you have reservations about therapy?” can reveal what may be holding them back. 

Listen first, then respond by acknowledging what you heard, and providing a counter perspective or an offer of help. 

Reluctance may be grounded in beliefs about the type of person who goes to therapy, discomfort sharing with a stranger, or doubts about whether therapy works. 

Let’s look at a couple of examples of resistance and how to respond: 

Resistance: Therapy is for people who are weak or unable to manage stressors. 

Response: All sorts of people benefit from therapy. It takes a lot of courage to feel and talk about the hardest things in life. It might feel easier to continue as you have, but I think trying something new will have real benefits. 

Resistance: How is a stranger going to help me? I can’t imagine sharing all my personal information and explaining who I am to someone who doesn’t know me. 

Response: Therapists have years of training and experience in helping others.They are skilled in building trusting relationships.Those of us close to you will not have the same objectivity, perspective, or strategies as a trained professional. I think it is worth being curious about how therapy might help you as it does for others. 

Hesitancy may also stem from practical considerations, including cost, time, and effort required to establish care. 

3. Build hope and motivation 

When someone is depressed, anxious, grieving, or otherwise suffering, it can be hard to believe that anyone’s words or support will improve things. Lend your confidence by communicating what you know about therapy’s efficacy or how you believe it will help. 

If you have first-hand experience with therapy, share how you’ve found it valuable. 

Alternatively, point to data. The American Psychiatry Association  reports that about 75% of therapy seekers have benefited from therapy. 

You can also refer to the Society of Clinical Psychology’s list of research that supports evidence-based treatments for various concerns, including depression and anxiety, insomnia, substance and alcohol use, chronic pain, eating disorders, relationship distress, and more. 

Treatments that are classified as evidence-based means that randomized controlled trials (RCTs) or comparable studies have found statistically significant improvements in mood, functioning, and other symptoms for participants. 

You don’t have to cite research studies, but you can say, “There is extensive research providing evidence that therapy works. I believe in the data.” 

Lastly, express optimism. This can sound like, “I am hopeful that you, like many people before you, will experience relief in having an expert guide you during this overwhelming time” or “I really believe that sharing the specifics of your experience will help you feel less alone with all you are managing.” 

Your hopefulness can be an antidote to someone’s doubts. 

4. Make action easy 

Moving forward can feel challenging, even when someone is motivated to connect to a therapist. 

Talk through the next steps and provide tangible support, such as: 

• Calling the number on the back of a health insurance card to ask for details on mental health/behavioral health coverage
  
• Search the Monarch therapist directory and email your loved one contact information for three potential providers
  
• Make a referral to someone in your network (if you’re a therapist), or ask your own therapist (if you have one) for referrals
  
• If cost is a barrier, search online for lower-cost options, including community mental health clinics, providers who charge on a sliding scale, graduate training programs, or therapy funds
  
• Offer to cover responsibilities (childcare, dog walking, cooking, errands) during the appointment hour 

Even if your loved one does not start therapy, remember that you have done two meaningful things: expressed care and normalized seeking support. 

Continuing the conversation

The seeds you plant in conversation may take weeks or months to grow, but your words can be meaningful catalysts for change and connection. Successfully encouraging someone to try therapy often requires a series of conversations, not a single suggestion. 

The Stages of Change Model theorizes that behavioral change does not happen spontaneously. Instead, people move through four phases: pre-contemplation, contemplation, preparation and, finally, action). 

Your nudge might help a loved one move forward in the process, even if they aren’t ready to schedule an appointment yet. 

Remind yourself to continue to revisit the idea of support using these same approaches. A gentle check-in can sound like, “If you decide to try therapy as a source of support, please know that I am here to help you with that process. I believe in it.” 

It is difficult to witness someone you care about go through a hard time. You can curtail how you express care and encourage professional support, and maybe refrain from facilitating action. 

The most persuasive arguments won’t convince someone who is unwilling to try therapy. But, when done thoughtfully, the conversation will convey empathy and care, which in and of itself can be impactful.

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