How to Engage Teens in Therapy

Working with teens can be incredibly rewarding.

It can also leave you sitting across from someone who answers every question with “fine,” “I don’t know,” or a shrug.

Sometimes a teen chose to be there. Sometimes a parent, school, or another adult made that decision for them. Sometimes they genuinely want support but have absolutely no interest in sitting down and immediately explaining their inner world to someone they barely know.

So when you're thinking about how to engage teens in therapy, the goal is not necessarily to find the perfect question that suddenly makes them open up.

Often, it starts with creating enough comfort, choice, and curiosity for them to want to participate.

A quick note about my perspective: I’m a coach, not a therapist. My work is rooted in executive functioning and coaching young people, and the ideas below come from years of sitting across from kids, teens, and young adults and figuring out what helps them participate more fully. Therapists should always use their own clinical judgment and adapt ideas to the needs of each client.

For me, teen engagement usually comes down to three things:

• Getting their buy-in

• Moving beyond the surface

• Creating opportunities to see more of who they really are

Here are five practical strategies that can help.

1. Start with buy-in, not compliance

A teen showing up is not the same thing as a teen being engaged.

They can sit in the chair, answer every question, and still be mentally somewhere else.

That is why one of the first things I look for is buy-in.

What would make this time feel useful to them?

Where do they actually want help?

What do they wish adults would stop bringing up?

Sometimes their answer will be very different from the concern that brought them there.

A parent might be focused on missing assignments. The teen might be much more concerned about always feeling behind.

A school might be focused on behavior. The teen might be thinking about how embarrassed they feel when they lose control.

Those differences matter.

You do not have to abandon the larger goals of the work. But when a teen can see some connection between the session and something that matters to them, participation often becomes much easier.

You can ask:

• “What would make this actually useful for you?”

• “Is there anything everyone keeps bringing up that you are completely tired of hearing?”

• “If we made one thing easier this week, what would you pick?”

Sometimes giving them permission to dislike the process is the first step toward getting them involved in it.

2. Give them something to react to

Some teens struggle with completely open-ended questions.

“What are you thinking?”

“What do you want to work on?”

“How was your week?”

Those questions can feel enormous.

Instead, give them something concrete to respond to. (Our free icebreakers for teens are full of these.)

That might be:

• A choice between two options

• A scale

• An image

• A short list

• A game

• A hypothetical situation

• A statement they can agree or disagree with

It is often much easier to say, “None of those fit,” than to generate an answer from nothing.

That response gives you somewhere to go.

If you put three choices in front of a teen and they reject all three, that can still be useful information.

“Okay. What would you put there instead?”

Now they are helping shape the conversation rather than simply answering it.

3. Pay attention to what happens around the conversation

You can learn a lot about someone when the focus is not entirely on talking.

This is one of the reasons I use games so often, along with other therapy activities for teens that take the spotlight off talking.

A game gives you both something else to look at. It lowers some of the pressure of maintaining eye contact and producing the “right” answer.

But the game itself is only part of what matters.

You might notice a teen who:

• Takes a long time before making a move

• Changes the rules to make something more interesting

• Becomes highly competitive

• Laughs when they make a mistake

• Gets frustrated quickly

• Refuses to guess unless they know the answer

• Takes a risk you did not expect them to take

None of those behaviors automatically tells you something profound about them.

That part matters.

You are not diagnosing someone based on how they play a trivia game.

But what happens during play can give you something genuine to explore.

You might say:

“I noticed you really did not want to guess unless you were sure. Was that just this game, or do you feel like that in other situations too?”

Or:

“You changed your strategy pretty quickly after that round. What made you decide to switch?”

The game creates the opportunity.

Your expertise helps you decide whether there is anything worth exploring.

4. Use their interests, but do not turn everything they like into therapy

If a teen loves a game, show, sport, character, hobby, or fandom, that can be an incredible entry point.

But there is a difference between using their interests to connect and immediately turning their favorite thing into an intervention.

Sometimes if someone tells you they love a game, the best response is simply:

“Tell me what you like about it.”

Not:

“Great! Which character represents your emotional regulation?”

Teens notice when adults are trying too hard.

Their interests can help you understand how they think, what they value, what they find funny, what kinds of challenges they enjoy, and what makes them light up.

You can build from there.

If they love prediction games, try something involving choices or risk.

If they love strategy, give them something they can plan.

If they like absurd humor, let some of your questions be ridiculous.

If they hate trivia because they do not like answering unless they know they are correct, that tells you something useful about what kinds of activities may or may not feel comfortable.

Use what they give you.

You do not have to force it into a metaphor.

5. Give them choices without giving them twenty choices

Choice matters.

Too much choice can become its own problem.

Instead of asking:

“What do you want to do today?”

Try:

“We can start with a quick game, do a check-in, or look at something from last week. What sounds best?”

If you need a few starting points, these therapy check-in questions are a good place to begin.

Three options feel manageable.

You can do the same thing with activities.

“Do you want something competitive or something more creative?”

“Would you rather talk through this or put it on a scale first?”

“Do you want me to pick, or do you want to?”

As you get to know a teen, you will start learning what kinds of choices work best.

Some will immediately tell you what they want.

Others would much rather you narrow it down for them.

The point is not to hand over control of the entire session.

It is to let them have some ownership of how they enter it.

Getting beyond “everything is fine”

One of the more interesting challenges is when a teen is engaged, cooperative, and genuinely says everything is going well.

Sometimes they are avoiding something.

Sometimes everything really is fine.

You do not have to manufacture a problem.

Instead, you can shift from:

“What is wrong?”

to:

“What is working?”

If someone rates every area of their life a 10, you can explore:

• What helped it get to a 10?

• What would help it stay there?

• What have they been doing differently?

• Is there anything they want to protect or maintain?

• What would they notice first if things started slipping?

That can lead to a surprisingly meaningful conversation.

Progress deserves attention too.

Where games can help

Games can be especially useful with teens because they give you another way into the session.

Sometimes they are simply an opener.

Sometimes they help someone settle in.

Sometimes a teen who barely wants to talk becomes completely absorbed in a challenge.

Sometimes they start asking for the same game every week.

That does not mean the game needs to secretly be therapeutic.

Sometimes they just like the game.

That matters.

Enjoyment, familiarity, and shared experiences can all become part of the relationship you are building.

Opening Play was created around that idea.

It gives therapists, counselors, and coaches a library of interactive games, check-ins, and guided activities they can use depending on what a session needs.

Sometimes you start with play.

Sometimes you check in.

Sometimes something comes up and you want a way to explore it a little further.

The practitioner still decides what fits.

The activity simply gives you another place to begin.

The best engagement strategy is still the relationship

There is no activity that will make every teen talk.

There is no perfect list of questions.

There is no game that guarantees engagement.

But you can create conditions that make participation more likely.

Give them some choice.

Notice what interests them.

Offer something concrete to respond to.

Pay attention to what happens when the pressure to talk comes down.

Let humor be humor.

Let games sometimes just be games.

Keep showing them that you are interested in who they actually are, not just the problem someone else wants you to fix.

That is usually where the real work begins.